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 Naturopathic Medicine: Graceful Transition: Managing Menopause 
Lauri Aesoph M. ND ©

As for menopausal depression, the research done on this symptom may be flawed and results vary from study to study. For example, age, not menopause, is frequently used as a marker in these investigations. A National Institute of Mental Health report showed that women 45 and older actually suffered less occasions of depression than younger females (3,4).

Hormone Treatment
According to one survey, approximately one-quarter of postmenopausal women rely on synthetic estrogen to carry them through menopause and beyond. Another six percent use both progesterone and estrogen (5). For many who use estrogen replacement therapy (ERT), hot flushes are cooled, vaginal atrophy diminishes and osteoporosis and cardiac disease are said to decrease.

In exchange for these benefits, a woman may suffer from irregular vaginal bleeding (6) or increase her risk of breast and endometrial cancer, especially if she has a personal or strong family history of cancer (7). Estrogen given alone can cause adverse effects. Many gynecologists now supplement menopausal patients with a new version of ERT called hormonal replacement therapy (HRT), a combination of estrogen and progesterone.

However, even HRT isn't without risk. Some British researchers suggest that HRT is addictive, claiming PMS, postpartum depression and menopausal depression are evidence that female hormones alter mood. HRT can promote feelings of well-being and some women on HRT show signs of drug dependency. In light of this, blanket HRT prescriptions for all menopausal women over long periods of time could be dangerous (8). Some naturopathic physicians only recommend HRT for patients at high risk of developing osteoporosis.

The damaging effects of the three type of active estrogens used during hormonal therapy is a health issue seldom addressed in the U.S. Estrone (E1), formed from estradiol and a substance called androstenedione, which originates mainly from the adrenals, can induce cancer. Estradiol (E2), the primary estrogen secreted by the ovaries, may also lead to cancer though the chances are smaller. The weakest form of estrogen, estriol (E3), is mainly converted from estrone in the liver. A small fraction of estradiol can also be changed into estriol.

For years, European clinicians have used estriol in recognition of its noncancerous and possibly cancer protective properties. A New England Journal of Medicine study revealed elevated estriol levels in animals guard them against the tumor-inducing effects of estradiol and estrone--the estrogen forms used to treat menopausal women in the U.S. (7).

Herbal Estrogens
Menopause doesn't mean that a woman's estrogen supply dries up overnight. Her adrenal glands and fatty tissue continue to contribute to an estrogen reservoir that gradually diminishes over several years. If a woman chooses to forgo HRT, she can boost her natural hormone pool somewhat using herbs, supplements and lifestyle habits.

Phytoestrogens are plant sources of estrogen. Botanicals such as Dong quai, licorce, black cohosh, unicorn root and false unicorn root exert about 1\400 of the estrogenic activity seen in synthetic forms. Phytoestrogens work by balancing your natural hormone levels either up or down, whatever is needed.

There are no long-term, well controlled studies on the effects of phytoestrogens and other natural hormone sources. Most of the evidence we have at this point is based on clinical observations. Therefore, naturopathic physicians and other natural health practitioners disagree about when and how long phytoestrogens should be used.

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