Sue:
You have included hundreds of natural ways for women to feel better and take care of themselves during perimenopause and beyond. How do you feel about the popularity of health supplements and herbs that are currently being marketed to perimenopausal and menopausal women?

Linda:
I have mixed emotions concerning the plethora of supplements and herbs being marketed to the aging women. On the one hand I'm very grateful that it is now recognized that specific nutrients and herbs can be safer alternatives to drugs for a wide variety of symptoms. Nutritional supplements are no longer relegated to folk medicine or anecdotal remedies but are considered "good science." On the other hand, because the menopausal woman represents such a huge demographic to manufacturers, many companies are promoting all sorts of mixtures that are virtually useless.

And the unsuspecting woman is at a loss
trying to determine which ones are good or effective and which are not. What I do is follow the advice of people I know to be credible. I buy products that have been researched and developed by companies that I know are honest and I read books and newsletters to find out what other scientists and researchers are endorsing. Also, check labels and sift out those products that add extra fillers, additives, and dyes.

Herbs & Other products

Sue:
I'm asked very frequently about herbs and products like black cohosh, Estroven, Promensil, and Dong Quai to name a few, as far as their effectiveness and how they might help with perimenopausal symptoms. Can you talk about how these products and herbs work and how they should be used safely and effectively?

Linda:
Many herbal products have been tested by both time and clinical studies to show their effectiveness and safety. The problem that arises for the individual is in choosing one with enough of the active ingredient that is of benefit. Many products have been tested and some found not to have adequate potency. It's very difficult knowing how to judge one product over another. I look for the word "standardized" on the label and also I tend to go with companies I know are reputable. When I hear that something didn't work on a woman I wonder if it's her own individual biochemistry or if it's that she ended up with a poor product. Sometime we never know.

You mentioned a couple of time-tested herbs
and a couple that are relatively new.

Black cohosh
has a long track record as an herb that is effective for a variety of female complaints. Its been used extensively in Europe over 40 years and is becoming quite popular here in the US for relieving hot flashes, vaginal dryness, depression, insomnia, and mood swings. While it is not an estrogen itself, it contains compounds that exert an estrogenic effect. Black cohosh is called an adaptogen because it balances your own estrogen--enhancing it if you need more and lowering levels if yours are too high. It also does not stimulate breast cancer cells in culture and many researchers feel it is safe for breast cancer patients. You can find black cohosh itself, combined with other herbs, in tinctures, tablets, or in a standardized form called Remifemin. The type you take determines the amount and that you will find on the outside container.

on black cohosh

Dong quai
is a root that has been used by the Chinese for thousands of years for gynecological complaints. It is high in natural plant estrogens called phytosterols and acts specifically on the uterus to reduce cramps and muscular pain. Some women should avoid this herb--if you have heavy menstrual bleeding, take blood-thinning drugs, or have fibroids. The recommended dosage is 250 mg in tablet form, two to four times a day. You also might see black cohosh combined with several other herbs. Since I've already mentioned two herbs that produce estrogen-like effects, I would also like to add one that acts as a progesterone in the body so that we balance these two female hormones.

Chaste tree or Vitex
is another hormone balancer that is used to alleviate menopausal symptoms like hot flashes and depression. Recent scientific study has determined that it works by affecting the ratio of LH and FSH hormones, which are brain hormones that help regulate estrogen and progesterone. There is also good scientific evidence that the flavenoid molecules in this plant can lower blood cholesterol as well. Take 300 - 600 mg in tablet or capsule form.

You've mentioned
a few new products on the scene.

Promensil
is an extract of red clover that is being marketed as a standardized isoflavone, a plant that shows estrogenic activity. The recommended tablet a day is suppose to be equal to the amount in a typical vegetarian diet or Japanese diet. It is believed that the reason these two groups do not experience as many menopausal symptoms is due to the high isoflavone content in their diet. The question is, is it the isoflavones alone that accounts for their lack of symptoms or is something else in the food? Many women have reported relief so it may be worth a try.

Estroven
I must admit that I don't know much about Estroven other than there are several different varieties, one for mood, bone-building, and other symptoms that I have since forgotten. I did read the labels and my first impression was that the dosage for mood or anxiety seemed small in comparison to a multi-vitamin/mineral tablet. If you are taking a multivitamin this would not be necessary. I also noticed how expensive they were and that you can get the same thing in other products for much less money. This is certainly not an extensive analysis but my thoughts after a cursory glance at the label.

Anxiety & Perimenopause

Sue:
Many women really have a hard time with nervousness and the jitters during perimenopause and menopause. How can they best alleviate these anxious feelings naturally?

Linda:
Anxiety is something we deal with our entire lives, not just at menopause. But I do realize some women are overly anxious and may need to talk about their feelings with either a good counselor or some of their trusted friends. There are also many things that we can do with our diets that may help curb some of the stress to our bodies. First and foremost, work at minimizing some of the known stressors to the body: excess sugar, caffeine, alcohol, and soda pop. Not only do these foods weaken our bones, they also aggravate our adrenal glands, the glands that take over the production of estrogen when our ovaries are easing up.

Nutrient insufficiency can also be a subtle cause of anxiety. Stress can create deficiencies in many nutrients and vice versa. Make sure you have adequate B-vitamins because each one of them plays a different yet important   role in maintaining a healthy nervous system. Vitamine E, so necessary to our cells, relieves symptoms of anxiety and mood swings triggered by an estrogen/progesterone imbalance, typical of perimenopause. Both calcium and magnesium help combat stress and nervousness, as well as muscular and emotional irritability. These are the basics but probably all nutrients in some way contribute to a healthy central nervous system. Get them all in a multi plus add a calcium/magnesium tablet because you won't get enough from a multi alone.

Exercise
And, above all, exercise is the greatest destressor of all. It increases your circulation and gets the oxygen to the brain and nerves. It helps you feel calmer, sleep better, and improves your general feeling of well-being. Calming herbs include: chamomile, passion flower, valerian root and motherwort. Herbs to fight anxiety and depression are: ginko biloba, Siberian ginseng, dandelion root, and St John's Wort.

Other ideas:
Other practices you might consider are:

• hot baths
• meditation
• prayer
• biofeedback
• or any hobby or interest that personally relaxes you.
  Take the time to be good to yourself, and not just at the menopause.

"When will I feel like myself again" ?

Sue:
Probably one of the biggest hurdles for women to overcome during perimenopause is the fact that they can't rely on their bodies anymore- they are changing and many women feel powerless over these changes. Many women ask me, "When will I feel like myself again" ? How would you counsel a woman to meet these challenges and make a vibrant life for themselves?

Linda:
It's true.
When we're drenched from hot flashes, and we can't sleep, and our body seems like it's not our own, we often wonder if it will ever end and if we will ever feel normal again. I can't answer this for everybody because we are all so different, but I can tell you from my own experience and from testimonials from other women, that even if you don't feel exactly the same way you did in your 30's or 40's, you can still feel great. For me, some of the changes that I now notice after going through menopause (I'm 3 years past) are really positive. I have a new confidence, a sort of a knowing feeling about life that I didn't before. I do feel a bit wiser, relaxed, and acceptance of life. I'm not fighting aging as much. This doesn't mean that I don't have new goals because I do. I have a considerable amount of energy. I still work out but I'm not excessive anymore. I am more philosophical about life and quite content with this stage now. Actually I'm more than resigned to it. I'm embracing it as a new adventure.

Book excerpt from
Menopause without Medicine
Depression and Mood Swings

also see

Linda Ojeda
& "Her Healthy Heart" Interview

• Heart Disease is a women's problem, too!
• Replacing "bad" fats with "good" fats
• Mineral supplements and heart protection
• Heart health and perimenopause/menopause
• Natural options for heart protection
• Book Excerpt:
  ALCOHOL: A DOUBLE-EDGED SWORD

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Menopause Without Medicine:
Feel Healthy, Look Younger, Live Longer
by Linda Ojeda

Dr. Ojeda broke new ground when she began to study nonmedical approaches to menopause more than 10 years ago. Now she has revised and updated her definitive resource, incorporating the latest findings about estrogen, mood swings, and osteoporosis. Throughout, Ojeda shows how women can enjoy optimal health at any age by making simple, inexpensive changes in diet and lifestyle.

Her Healthy Heart:
A Woman's Guide to Preventing and Reversing Heart Disease Naturally
by Linda Ojeda

More women between the ages of 44 and 65 die of heart disease than from all types of cancer combined. "Her Healthy Heart" provides detailed information on how women can reduce their risk of heart disease by making changes in diet, increasing physical activity, and managing stress. 25 illustrations.

Chocolate Soy Brownies
This dessert is brought to us by Patricia Greenberg. Patricia has created this delicious brownie which will be loved by your entire family!

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Written by a research scientist in the field of nutrition, this book describes how the body's digestive, communication, and nervous systems function, and links fatty acid intake to memory, mood and behavior. Schmidt explains how most "low-fat" diets are actually unhealthy and how many people today get little or none of important fatty acids like omega-3 in their junk-food meals. 10 charts & tables.