Dr. Low Dog is an internationally recognized expert in the field of herbal medicine and integrative approaches to women's health. She is currently the Fellowship Director at the Arizona Center for Integrative Medicine and Clinical Associate Professor of Medicine at the University of Arizona Health Sciences Center. Find out more at drlowdog.com.
On April 6, 2011, Dr. Tieraona Low Dog, MD, gave a live webinar exploring ways to handle the changes that come with menopause. Nearly 200 people stopped by to hear Dr. Low Dog talk about easing symptoms through herbal solutions, lifestyle changes and hormone replacement therapy.
First off, Dr. Low Dog said, “I want us to set aside the notion that menopause is any kind of disease or disorder that has to be managed.” She adds that we’ve all survived the hormonal upheaval of puberty, and that 30 percent of women won’t even have symptoms as they go through menopause.
But for many who do experience symptoms, those symptoms can be exacerbated by stress. That’s why it’s important to examine our work and home environments and to introduce more calm into our lives. “This is a time to reconnect with who you are, and to be gentle and tender with your body,” says Dr. Low Dog.
To start, Dr. Low Dog recommends paced breathing. “Don’t ever underestimate breath work,” she says. Clinical trials have shown that women who practiced breathing exercises—inhaling for 5 seconds and exhaling for 5 seconds over a 15-minute period, twice a day—saw reduced severity and frequency of symptoms like hot flashes. Dr. Low Dog adds that breathing exercises can also calm blood pressure, and warm the body through enhanced circulation.
For even greater impact, expand the breathing practice into mindfulness-based stress reduction, which studies have shown to significantly reduce hot flashes, sleeplessness and stress even months after the practice has ended. “This is a wonderful opportunity to reconnect with your body and really start to get this stress under control,” says Dr. Low Dog. She points to many books, CDs and DVDs that can help guide your practice, including many that are available at Pharmaca.
Hypnosis is another route that many women see relief from. A study showed that women who were assigned to 5 weekly hypnosis sessions saw a 68 percent reduction in hot flashes, anxiety and sleeplessness. “If you don’t want to take hormones or other interventions, why not give this a try?” says Dr. Low Dog. “There’s good evidence for it.” She adds that even self-hypnotherapy CDs can be helpful.
Similar results were found in studies of women and acupuncture. Women receiving 12 once-weekly acupuncture treatments were compared against women taking venlafexine, a common anti-depressant that is used to ease anxiety and hot flashes. During the treatment both groups saw improvement, but two weeks later, women in the venlafexine group saw a return of their symptoms. At the end of the year-long study, the women in the acupuncture group still reported an increased sense of well-being, including increased sex drive and energy.
Herbs and supplements
Dr. Low Dog cites a number of herbal remedies that can be extremely helpful in easing the broad symptoms of menopause. Black cohosh, for example, is one of the most popular herbs for hot flashes and works well when it’s paired with St. John’s Wort, which acts as an anti-depressant. “We’re seeing a growing number of studies [on St. John’s Wort], either alone, or in combination with black cohosh, for relief of hot flashes and night sweats.”
She adds that 60-65 percent of women using St. John’s Wort are seeing relief from symptoms of depression and anxiety, about the same rate as prescription anti-depressants. (Though there are drug interactions to be aware of, such as birth control, drugs used to treat cancer and HIV, or anticoagulants. Speak with your pharmacist about the prescriptions you’re taking before starting St. John’s Wort.)
Other herbs that Dr. Low Dog likes:
- Siberian rhubarb, which has been clinically shown to reduce anxiety, hot flashes and night sweats.
- Sage, which aids in excessive perspiration and night sweats.
- Maca, which is thought to improve libido and sexual arousal.
- Whole soy, such as miso, tempeh or soy sauce. (Even if you’ve had breast cancer, Dr. Low Dog says, soy is no longer taboo.)
- Bacopa, an Ayurvedic herb that’s good for boosting brain function and memory.
- Rhodiola and ashwagandha, adaptogenic herbs that help your body deal with stress. Rhodiola is especially good for clearing mental fog and fatigue, and 11 controlled trials have shown it to help chronic fatigue, depression, anxiety. (“I love this plant,” says Dr. Low Dog. “For many women going through menopause, rhodiola can be a lifesaver.”) Ashwagandha is more of a relaxing herb, and can ease night sweats, aches and pains to help you sleep (find her ashwahandha tea recipe here).
Hormone Replacement Therapy
“There are obviously a lot of alternative therapies,” says Dr. Low Dog, “But HRT will be most effective for reducing your symptoms.” Available hormones include synthetic, natural and bioidentical versions.
Bioidentical hormones are identical to what your body makes, and are now available orally, as transdermal patches, or in a vaginal application. To make bioidentical hormones, scientists start with a plant source that’s naturally rich in hormones that are already very similar to human hormones—like soybeans and yams—and adjust them to exactly match our own. While many bioidenticals are only available through compounding pharmacies like Pharmaca, there are a few commercially available (see chart). “Natural, bioidentical, transdermal estrogen is probably my top pick,” says Dr. Low Dog.
Discuss your HRT options with your doctor or pharmacist. If your current doctor isn’t familiar with bioidentical or compounded options, Dr. Low Dog recommends looking for a local practitioner here.