The big event: master perimenopause the natural way

Marshall Norton, Jr.

Ask herbalist Susun Weed what to take for your perimenopause symptoms, and you're apt to get an interesting response. "Did you take anything for puberty?" she asks.

Weed, director of the Wise Woman Center in Woodstock, New York, believes perimenopause--like puberty--should be experienced as a natural stage of life and not treated like a disease. If, however, you need relief from hot flashes, headaches and other discomforts associated with perimenopause, Weed recommends an herbal rather than a medical approach.

Weed's response to perimenopause is just one of many. Opinions vary widely on what to do during this transitional period. A physician may suggest hormone replacement therapy (HRT) or, at the very least, a regimen of diet, exercise and nutritional supplements. An herbalist, on the other hand, might suggest enriching your body with naturally brewed teas and elixirs, but otherwise accepting the symptoms as they come--much like a preteen girl deals with acne flare-ups or her monthly menstrual cycle.

No matter what course you choose, perimenopausal treatments work differently for different women. The first treatment you try might not be the one that works best--or not work at all. "As varied as our genetic code is, it's that kind of response you get with perimenopausal women," says Fort Wayne, Indiana, obstetrician and gynecologist E. Conrad Hicks. Hicks prescribes over-the-counter treatments as well as natural products for perimenopausal patients. "Some patients are only going to consider natural treatments," he says.

Like many physicians, Hicks has reservations about natural remedies because the government does not regulate them as tightly as conventional medications. He has found success, however, with a supplement containing black cohosh and vitex, also known as chaste tree berry. These herbs can help reduce the fluctuations in estrogen levels common in perimenopause, and Hicks reports an 80 percent success rate in patients who take the supplement.

Potent Potables

Weed is an outspoken advocate of incorporating herbs into your diet as you pass through your post-menopausal years in optimal health and comfort. In her book, New Menopausal Years the Wise Woman Way: Alternative Approaches for Women 30-90, Weed suggests these herbs:

Black cohosh. Counters menstrual pain, regulates menstrual flow, relieves headaches and eases joint pain, fibromyalgia, arthritis and rheumatism. Also reduces water retention and breast tenderness and increases vaginal lubrication. Take spoonfuls of black cohosh tea, up to one teacup per day.

Chaste tree berry (vitex). Quells hot flashes, counters dizziness, increases fertility and triggers menstrual flow. Also protects against cancers of the reproductive system. Take 1 milliliter of vitex tincture one to four times daily, or drink one to four cups of tea made from freshly powdered berries.

Red clover. Reverses premature onset of menopause and moderates the intensity of hot flashes. Also eases incontinence and relieves symptoms of cystitis. In addition to red clover teas and tinctures, use the sweet blossoms in salads or add them to a pot of rice. Weed admits that her red clover elixir tastes a lot like black tea, so you may want to add fennel or peppermint-high in calcium and antioxidants--to make it more palatable.

Weed brews herbal teas from weeds growing on her farm. Capsules don't offer the full benefit of the natural herb, she says, and brewing herbal tea the way you'd brew a cup of Earl Grey doesn't allow the herbs to steep long enough to be beneficial. Every night, Weed prepares a canning jar filled with a cupful of dried herbs and boiling water, letting the elixir brew for at least four hours.

Creams & Lotions

Another way to relieve perimenopausal symptoms is with natural progesterone creams, transdermal skin creams that provide small, steady doses of progesterone to balance estrogen fluctuations. They are effective in treating hot flashes and night sweats, and they may help with mood swings, vaginal dryness, headaches and regulating the menstrual cycle.

Natural Nutrition

In addition to herbs and creams, a number of foods contain nutrients beneficial to perimenopausal and menopausal women. Certain foods are rich in phytoestrogens--chemical compounds that mimic the behavior of estrogen. Since phytoestrogens can increase and decrease estrogen and progesterone levels, maintaining a balance of them in your diet helps ensure a more comfortable passage through perimenopause.

Phytoestrogens are common in the remedies recommended by naturopaths as safe alternatives to hormone replacement therapy (HRT), which can cause side effects. These range from headaches and weight gain to stroke and blood clots. Soy is by far the most abundant natural source of phytoestrogens, but they can also be found in hundreds of other foods such as apples, beets, cherries, dates, garlic, olives, plums, raspberries, squash and yams.

Lori A. Futterman, RN, PhD, and John E. Jones, PhD, co-authors of The PMS and Perimenopause Sourcebook, suggest avoiding products that contain high amounts of refined sugar or sodium, deep-fried foods and caffeinated foods such as coffee, tea and chocolate.

To offset deficiencies in your diet, Futterman and Jones recommend a multivitamin supplement as well as additional doses of magnesium and vitamins C, E and B complex. Hicks says that a calcium supplement helps prevent a loss of bone density--a common occurrence in menopausal women. Weed prefers teas made from stinging nettle to stimulate the adrenal glands, oat straw for emotional resiliency and comfrey to strengthen bones.

Weed believes women should embrace this often-turbulent time in their lives. The transition into menopause, she says, "is the liberation of the woman's spirit. Of course it's going to affect you."

Whatever you believe about perimenopause, there's no denying that hot flashes, vaginal dryness, breast tenderness and increased risk for heart disease and osteoporosis are common experiences during this time. Whether you think these are crosses to bear or mere symptoms, your physician, naturopath or herbalist can recommend a variety of ways to make the transition a smooth one.

Perimenopause and Menopause Defined

Perimenopause is the medical term for what many women would call "being in" or "going through" menopause.

During this period and extending through menopause--averaging around the ages of 35 to 40 for the start of perimenopause and 51 for actual menopause--there essentially is a breakdown in communication. Your thyroid and pituitary glands--which normally help regulate hormone levels in your body--basically stop communicating with your ovaries.

At menopause, defined by the Council of Affiliated Menopause Societies (CAMS) as the cessation of menstruation, your ovaries cease to release eggs. Menopause occurs with the final menstrual period, which is known with certainty only after you have gone a year or more without menstruating. Genetic factors can influence the age you reach menopause. Women who smoke may reach menopause up to a year and a half earlier than non-smokers, the council says.

CAMS defines perimenopause as the period immediately prior to menopause and the first year after menopause. Only about 10 percent of women abruptly stop menstruating, experiencing no irregularities with their menstrual periods.

Get Moving to Get Comfortable

Regular physical activity can play ah important rote in managing uncomfortable symptoms of perimenopause as well as other health concerns--such as heart disease and osteoporosis--that significantly increase after menopause.

Aerobic exercise, such as walking or dancing, can elevate your mood, relieve stress and help reduce depression or anxiety. Aerobic exercise also burns calories, which promotes the loss of abdominal fat--the place most women gain weight during perimenopause. Hot flashes occur less frequently among physically active postmenopausal women than among those who don't exercise. Strength training helps prevent loss of muscle mass and bone density. By stimulating bones, strength training stalls the onset or progression of osteoporosis.

The American Council on Exercise recommends, "To reap the benefits of exercise, a balanced program of weight-bearing aerobic activity, strength training--with weights, resistance bands, yoga or even gardening--and flexibility is essential." Consistency is important. Try to fit in some moderate activity most days of the week.

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