Menopause: a new stage in life

News about hot flashes!

Practical relief with a "one-a-day" formula!

Menopause is a normal stage of life for women, usually between the ages of 40 and 55, when ovulation and fertility come to an end. The World Health Organization defines menopause as a period of twelve consecutive months without menstruation and without viable eggs in the ovaries. During this period, the ovaries stop producing two kinds of hormones: estrogen and progesterone, which play a major role in a woman's life.

Unpleasant symptoms are associated with menopause and related hormonal changes. They include hot flushes, sweating, insomnia, headaches, vaginitis, nervousness, as well as memory and concentration problems. All of these symptoms can make menopause a difficult time. In addition, bone loss and the risk of cardiovascular disease increase. The period leading up to menopause, known as perimenopause, is characterized by fluctuating hormone levels, as well as occasional menopausal symptoms.

The severity of symptoms varies from woman to woman, but appears to be particularly related to diet and environment. In many parts of the world, women experience far less severe symptoms than women in North America and Western Europe.

Another factor in the severity of menopausal symptoms is the functioning of the adrenal glands. In a woman, these glands can continue to supply estrogen and progesterone to the body after the onset of menopause. However, stress, poor diet, lack of sleep and caffeine consumption can interfere with adrenal gland function, intensifying menopausal symptoms.

Hot flushes: the number-one challenge of menopause

Hot flushes" are the most common symptom of menopause. In North America and Western Europe, 72% of menopausal women experience hot flushes.¹. Their frequency varies from woman to woman, from a few incidents per month to several in an hour, as does their duration, which ranges from five to forty years.

Hot flushes refer to the "vasomotor" symptom. During an incident, a woman's heart rate may increase by five beats per minute, and skin temperature may rise dramatically. The symptoms of hot flushes are mainly felt in the face, neck and upper body, and are accompanied by increased sweating. On the other hand, the body's actual core temperature decreases due to heat loss through perspiration.

Experiencing hot flashes is certainly unpleasant, but worse still, they can have a dramatic impact on quality of life by interfering with daily activities. They can lead to interrupted sleep, insomnia, and increased anxiety and irritability.

Low estrogen levels are believed to be a factor in the occurrence of hot flashes. Estrogen helps regulate the body's core temperature. In post-menopausal women, even small changes in core temperature seem to trigger cooling measures (sweating and hot flushes), as estrogen is insufficient to adequately deal with such cooling. The process is not fully understood, as other factors are certainly involved. Some women do not suffer from hot flushes during menopause and the associated reduction in estrogen.

Risks of hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) has, until now, been the main treatment for hot flushes administered by the medical profession. It involves using conjugated estrogens (Premarin®) or a combination of estrogen and progesterone to make up for the absence of these hormones during menopause. In terms of results, HRT has been effective in reducing hot flushes, preventing bone loss and fractures, and treating vaginal dryness.

Despite the benefits of HRT, three major clinical studies of HRT outcomes, published between 2002 and 2010, highlighted the risks of the treatment. They unexpectedly demonstrated that HRT significantly increased the risk of heart attack, stroke, blood clots, breast cancer, endometrial cancer (when estrogen is used alone) and gallbladder disease.³.

Because the results were so unfavourable, the majority of North American doctors abandoned HRT for their patients. Today, HRT is used only for women with severe menopausal symptoms, and only in very small doses over a very short period of time.

Some health professionals prescribe the use of "bio-identical" hormones extracted from soy or hairy yam, which are considered less potent and safer than HRT. These hormones are available in pharmacies in a variety of forms. Unfortunately, although they are presumed to be safer than HRT, major clinical trials have yet to confirm the safety of bio-identical hormones.⁴.

Natural alternatives to HRT

Given the trend away from HRT, women have had to look for alternatives to treat their menopausal symptoms. Reducing stress, exercising regularly, avoiding smoking and establishing a positive, healthy environment can all contribute to treatment⁵. Consuming natural food supplements that are designed to relieve menopausal discomforts can also play a role for menopausal women seeking relief. In recent times, soy-based foods and extracts of plants such as black cohosh and red clover have been used by menopausal women to alleviate symptoms such as hot flushes. These plants contain phytoestrogens or "dietary estrogens", meaning that they are estrogenic compounds consumed with food and not produced by the endocrine system. Phytoestrogens mimic the body's estrogenic effects. Soy-based phytoestrogens include the isoflavones genistein and daidzein.

A source of phytoestrogens has recently been discovered that has more marked effects than soy products. Hops (Humulus lupulus L.), a plant best known for its use in beer production, has been shown to contain a high level of a phytoestrogen called 8-prenylnaringinin (8-PN). 8-PN is a prenylflavonoid, and it has been possible to prepare standardized extracts of 8-PN from hops, which have been clinically tested in humans for the relief of hot flushes.

Lifenol® - Clinically proven hop extract

Hop extract marketed under the Lifenol® brand name contains between 0.15% and 0.25% 8-PN. It has been clinically tested in women to verify its safety and efficacy against menopausal symptoms.

In one clinical trial, post-menopausal women were given a placebo or a dietary supplement containing 85 mg Lifenol®. After six weeks, 60% of women using the dietary supplement had experienced a reduction in their hot flushes. The average reduction was 30%.⁶.

A second study assessed menopausal women's general quality of life. Again, women were given either a placebo or a dietary supplement containing 85 mg of Lifenol®. A promising 90% of women taking the Lifenol®-containing supplement reported an improved quality of life, and three times as many women in the same group reported a "strong" improvement in six weeks compared to the placebo group. Symptoms measured included sweating, insomnia, nervousness and dizziness.⁷.

Lifenol® hop extract: safety first

Despite its effectiveness in reducing menopausal symptoms, we know that hormone replacement therapy (HRT) has dangerous side effects. This makes the safety of any natural alternative just as important as its efficacy.

To determine the safety of their hop extract, the creators of Lifenol® conducted safety studies which demonstrated that 8-PN was safe for general consumption at maximum single doses of 750 mg per day.⁸. This far exceeds the recommended 85 mg per day in dietary supplements.

A clinical study also assessed the effect of 8-PN on breast tissue. The researchers concluded that low doses of prenylflavonoids (less than 10 mg per day) were unlikely to elicit estrogenic responses in breast tissue relevant to breast carcinogenesis.⁹. The daily dose of Lifenol® studied for the relief of hot flushes contained a maximum amount of prenylflavonoid 8-PN of 0.21 mg, almost fifty times less than the 10 mg indicated in the study.

Lifenol® was also studied for its possible negative effects on the endometrial thickness of the uterine wall. When administered alone as part of HRT, estrogens have been associated with a thickening of the endometrial lining of the uterus, which can lead to uterine cancer. The study showed the positive estrogenic effects of 8-PN, while confirming the absence of uterine wall thickening.¹⁰.

So, although 8-PN is a phytoestrogen that resembles estrogen, it has very different effects on different targets.¹¹. As a precaution, women experiencing various disorders should consult their healthcare professional if they have a history of breast or endometrial cancer, or any other hormone-dependent cancer.

In addition to its benefits for the immediate symptoms of menopause, 8-PN has protective effects on long-term health problems. 8-PN has been shown to have preventive effects against cancer and to inhibit angiogenesis, a healing process that can transform benign tumors into malignant ones.^{12, 13}. In addition, 8-PN may play a role in preventing bone loss and protecting cardiovascular health.^{14, 15}.

Lifenol® hop extract: non-sedating product

In health food stores, supplements containing hops are commonly recommended in formulations for insomnia or relaxation. Dried hop cones are known for their sedative and sleep-inducing effects. Lifenol® is a hydroalcoholic extract of hops, but produces none of the sedative effects typical of dried hop cones.¹⁶.

Cimicaria and sage: other plants to relieve menopausal symptoms

8-PN extracted from hops is not the only nutraceutical with beneficial effects on menopausal symptoms. Chickweed is a phytoestrogen that helps reduce the incidence of hot flushes. In one study, 40 mg of black cohosh was as effective as conjugated estrogens, without affecting the endometrial thickness of the uterine wall, unlike estrogen therapy. In another study, 80% of participants reported a reduction in menopausal problems after one month's use.¹⁷.

Sage, a plant with a long history of traditional uses, is also known to help reduce hot flushes and night sweats.¹⁸.

Other natural food supplements to consider during menopause:

References

1. Nelson HD (2008) Menopause. Lancet 371(9614): 760-70. doi: 10.1016/s0140-6736(08)60346-3
2. "Natural solution for hot flashes". Naturex.
3. Murray, Michael, N.D. "The Encyclopedia of Natural Medicine." Third Edition. Atria. p. 784-785.
4. Ibid. p. 786.
5. Torkos, Sherry, BSc Phm. "The Canadian Encyclopedia of Natural Medicine." Second Edition. 2013. HaperCollins Publishers. pp 348-349.
6. Erkkola, R. et al, A randomized, double-blind, placebo-controlled, cross-over pilot study on the use of a standardized hop extract to alleviate menopausal discomforts. Phytomedicine (2010), doi:10.1016/j.phymed.2010.01.007
7. Heyerick, A. et al. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas 54 (2006) 164-175.
8. Rad, M., et al. Pharmokinetics and systemic endocrine effects of the phytoestrogen 8-prenylnaringenin after single oral doses to postmenopausal women. Br. J. Clin. Pharmacol. 62:288-296.
9. Bolca, Selin et al. Disposition of hop prenylfavonoids in human breast tissue. Mol. Nutr. Food Res. 2010. 54, 1-11.
10. Naturex. "Effects of Lifenol® on the endometrium and vaginal cytology of menopausal women." Unpublished.
11. Naturex. "Renew your sense of womanhood with Lifenol." 2012.
12. Brunelli, E. "8-prenylnaringenin inhitibs epidermal growth factor-induced MCF-7 breast cancer cell proliferation by targeting phosphatidylinositol-3-OH kinase activity." 2009. J Steroid Biochem. Mol. Biol. 113:163-170.
13. Pepper, MS. "8-prenylnaringenin, a novel phytoestrogen, inhibits angiogenesis in vitro and in vivo." J Cell Physiol, 2004 Apr; 199 (1): 98-107.
14. Effenberger, K.E. et al. Regulation of osteoblastic phenotype and gene expression by hop-derived phytoestrogens. J. Steroid Biochem. Mol. Biol. 96:387-399.
15. Sehmisch, S. Comparison of the phytohormones genistein, resveratrol and 8-prenylnaringenin as agents for preventing osteoporosis. Planta Med. 2008. 74:794-801.
16. Fromentin, Emillie. "Lifenol® is not a traditional hops extract for insomnia." Internal paper.
17. Murray, Michael, N.D. "The Encyclopedia of Natural Medicine." Third Edition. Atria. p. 790.
18. Health Canada. "Monograph: Sage. Natural Health Products Directorate.

http://webprod.hc-sc.gc.ca/nhpid-bdipsn/atReq.do?atid=sage.or&lang=eng