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Hot flushes affect about three-quarters of menopausal women and are likely to be as individual as the women who have them. Most women will agree that flushing is uncomfortable and at times embarrassing, and can interfere with your ability to concentrate and carry out activities. The way that a flush can feel will vary with the woman. Most women will experience episodes of heat which vary in intensity, often accompanied with perspiration. Other symptoms include headaches, nausea, fatigue, dizziness, anxiety, ‘butterflies in the stomach’, confusion and palpitations.

It is thought that hot flushes are related to the changes in your hormones, in particular oestrogen. Hot flushes are not caused solely by oestrogen withdrawal. An increase of luteinising hormone (LH) commonly causes the symptoms that are associated with a hot flush. Thyroid disorders can also aggravate menopausal symptoms.

Most of the time the period when you experience hot flushes lasts for about 1-2 years, but some may experience these for up to ten years. Rest assured that you have the ability to lessen this time and to reduce the severity of your symptoms with natural methods such as diet and lifestyle modifications. There are also several herbal preparations that are effective at relieving uncomfortable menopausal symptoms, however it is important that these be sought from a qualified naturopath or herbalist as most over-the-counter preparations will not have the same quality, and a herbalist can design a tonic that is specific for your needs. Sage tea may help to reduce sweating.

Risk of Hot Flushes Occurring increases with:
A maternal history of hot flushes, early menopause, cigarette smoking, early menarche and alcohol use are considered to be risk factors for more severe hot flushes.

Improvement may be felt with:
Phyto-oestrogens
Phyto-oestrogens are structurally similar to the oestrogen molecule and because of this they can bind to the body’s oestrogen receptors. The effect that the phyto-oestrogens have is varied, but recent studies have shown that the oestrogen levels of the woman will determine what sort of action the phyto-oestrogens will have. In a postmenopausal woman who has very little oestrogen, then phyto-oestrogens will exert a pro-oestrogenic effect, whereas a woman who has an oestrogen dominant condition would experience an anti-oestrogen effect. In short, the phyto-oestrogens have a balancing action on oestrogen status.

Studies have shown that cultures with a high intake of soya products have significantly less menopausal symptoms than western cultures. Asian diets are high in soy based foods (40–100 mg per day of isoflavones in Asian diets as compared to <3 mg per day in western diets), and most women in these countries express minimal menopausal complaints. Several other studies have shown that soy can improve menopausal symptoms, in particular hot flushes. They suggest an intake of 10-15 g of soy protein or 60 mg isoflavones (range of 30-100 mg) per day.

There are several types of phyto-oestrogens and these are isoflavones, coumestans, lignans, flavones, flavonols and flavanones. Isoflavones are responsible for the cardio-protective activities, improving bone density and protecting against breast cancer. They are found mainly in soya products and legumes. Coumestans are the main phyto-oestrogen studied for menopausal symptoms, and these are found in legumes such as soya products, peas and beans, and are highest in sprouted legumes such as alfalfa, mung bean or snow pea. The western diet is generally very low in these foods, but it is not difficult to include them in your diet.

Increasing phyto-oestrogen intake can be easy. 100g of tofu per day has been shown to reduce hot flushes and vaginal dryness and can be prepared in many ways. You could also use soya milk, add miso and tempeh to your cooking, eat more alfalfa and snow-pea sprouts, or add 2 tablespoons of freshly ground flaxseed to your muesli or cereal every morning. It is possible to take soya supplements, however it is preferable to eat soya in its whole food form as this provides a synergistic blend of the protein and soy germ.

Vitamins
Several studies have shown that vitamin supplementation can reduce menopausal symptoms, including hot flushes. Vitamin E supplementation has shown a statistically significant advantage over placebo in reducing hot flushes over four weeks at a dose of 400 IU twice daily. It has also been shown to reduce other common symptoms of menopause including fatigue, dizziness, palpitations, and nervousness9.

Vitamin C and flavonoids may also be of assistance in reducing hot flushes because of their ability to improve vascular integrity. One study performed in the early 1960s showed that supplementation with the flavonoid hesperidin and vitamin C completely relieved hot flushes in 53% of the 94 women studied and reduced them in 34%9. Further research into this area is required.

Evening Primrose Oil
Evening primrose oil comes from seeds which contain the oils alpha-linolenic acid (an omega-3 fatty acid) and gamma-linolenic acid (GLA; omega-6 fatty acid), both precursors of eicosanoids, which are constituents of cell membranes. The biochemical pathway for metabolism of dietary GLA eventually leads to an anti-inflammatory prostaglandin. This is a very popular supplement for the treatment of hot flushes which many women swear by, however the evidence to support this is limited. Dosages required are between 1-3g daily and need to be taken over long periods of time3.

Aggravating foods
Some foods may aggravate hot flushes, and these should be avoided. These foods include alcohol, spicy foods, and coffee.

Lifestyle
Observational studies have shown regular aerobic exercise lessens the frequency and severity of hot flushes#. It has several other positive effects, such as an improvement of mood, memory, libido, energy and weight loss#.

Performing relaxation exercises every day, such as meditation and breathing exercises, can help to reduce the intensity of hot flushes.

It may be helpful to wear loose fitting clothing made from natural material such as cotton. Wearing outer layers that are easily removed allows you to easily cool down when you’re experiencing a flush.

Many women will experience night sweats that require them to change the sheets. By placing a towel under them, they can simply remove it if it becomes wet and this saves the trouble of changing the sheets every morning.

Stress and anxiety can bring on and worsen hot flushes therefore steps should be made to reduce stress in your life. Meditation, counselling and herbal medicine can help to reduce stress.

The Herbal Approach
Your Naturopath can create a treatment plan to ease your menopausal symptoms. The treatment may be a combination of hormone modulating, cooling and calming. A naturopath will also assess your adrenal and liver health as these are common underlying factors. An individual formula will not only be of high quality, it will be tailored to your specific needs.

Period pain is uncomfortable and unpleasant, and no woman should have to ‘grin and bear it’. While period pain is common, it isn’t normal. While symptoms vary considerable between women, the pain is usually described as a heavy, dull ache (congestive dysmenorrhoea) or spasmodic, cramping pain (spasmodic dysmenorrhoea). The pain may start before menstruation begins however most commonly the pain will start once the bleeding has commenced and intensifies as the flow becomes heavier and clots are passed. Vomiting or diarrhoea may accompany the pain. Many women can reduce the severity of their pain simply by changing their diet and exercising, however a combination of herbs, nutritional supplements and structural realignment and in some cases acupuncture can be very successful in treating the pain.

It is very important to point out to your practitioner if:

• The pain has changed in character or is present for the first time
• Pain is aggravated by pressure, bowel motions or sexual activity
• Fever or discharge accompanies pain
• Pain is on one side only, or radiating
• Usual pain control measures are no longer useful
• Pain worsens towards the end of the period

However, other underlying causes may also be to blame:

1- Pelvic inflammatory disease
PID is caused by infection and symptoms include abnormal bleeding and heavy menstruation. Other common symptoms include fever, fatigue and pelvic pain. It is interesting to note here that for an infection to establish itself the organ must have already been compromised. Maybe the nerve or blood supply to that area is inadequate or the drainage incomplete. While you may need some medical inetrvention it is importnat that the actual underlying cause of the infection is removed to prevent it reoccurring.

2- Intra-Uterine Device (IUD)
The IUD may cause heavy and painful periods and mid-cycle bleeding. A dislodged IUD or infection can cause severe pain and/or bleeding and needs immediate attention by your doctor.

3- Endometriosis and Adenomyosis
Endometriosis is caused by endometrial tissue growing in an incorrect place, such as the ovaries, tubes, outer wall of uterus, bladder or bowel. It is not well understood by this occurs, however it is believed to be a condition of oestrogen excess, as oestrogen is responsible for the development of endometrial tissue. It had also been suggested by some researchers that there is a parasite which moves the endometrium (lining of the uterus) to areas outside the uterus. Since oestrogen signals the body the regrow the endometrium each month the endometrium which has been moved keeps growing. Immune dysfunction and ‘backward’ or retrograde flow is another possible cause. Endometriosis can affect fertility as it can cause adhesions in the fallopian tubes.

Adenomyosis is caused by the growth of endometrial tissue in the uterine muscle. Symptoms are many and varied, and can include heavy and congestive or dull and dragging pain while menstruating or before ovulation. Often the pain is worse before the period or increases in severity towards last days of bleeding. Pelvic discomfort, painful sex and abnormal bleeding patterns can occur. Longer cycles are possible, however a shorter cycle with a heavy period is more common. The flow itself may be thick and tarry at the start and spotting and mid-cycle bleeding are possible.

4- Pelvic congestion syndrome
The most frequent symptoms include a dragging or heavy lower abdominal pain at any time of the period, congestive period pain, low backache and pain during sex. The lower abdominal pain often becomes worse at the end of the day as blood pools in the veins. The cause of this condition is in most cases corrected by osteopathic treatment or other manual techniques which restore the body's ability to have free blood flow to and from the pelvis as it is associated with engorged pelvic blood vessels. This condition is most common after the age of 35 and after a woman has had a number of pregnancies.

Tests that may be required

It is possible to effectively treat period pain in our clinic without most tests. However if your practitioner thinks it necessary they will refer you to a another member of the clinic or in some cases to a medical doctor for one of the following tests. It is important to us that you only have the tests that are really necessary to assist in your treatment.

1- Pelvic examination
This involves viewing the cervix with a speculum to see whether it is normal and healthy, and examining the pelvic organs by inserting a gloved hand into the vagina to feel the size, state and position of the organs. This can be used to show if the uterus is enlarged and tender due to pelvic congestion syndrome.
2- Laparoscopy
This involves inserting a thin-pencil like instrument through various incisions in the abdomen through which the organs can be viewed. This procedure requires a general anesthetic. Endometriosis, adenomyosis, adhesions, ovarian cysts and fibroids can all be detected using this method. It can also show if the pelvis is enlarged and tender or engorged pelvic blood vessels due to pelvic congestion syndrome. This technique is used in conventional medicine as a treatment for endometriosis.
3- Pap smear
This can be used to rule out infection as the cause of heavy menstruation. Cells are gently scraped from the surface of the cervix and sent to a pathology lab for testing.
4 – Ultrasound
This uses a type of imaging to show the contents of the pelvic cavity. The image may be taken abdominally or vaginally. It is most appropriate to diagnose adenomyosis or ovarian cysts.

Sporting injuries can range from the very mild to the very serious.

Prevention is important - so regular massages or osteopathic or orthobionomy checkups may assist you to prevent those injuries which arise from being out of balance.

For acute joint injuries which do not require medical intervention we suggest that your first thought be acupuncture.

After a skiing accident last year where my knee was twisted out 90 degrees to the side I thought that recuperation would take a while. To my surprise an acupuncture treatment rectified any damage to the point that I have not had a single pain in it since.
So if in trouble book in with Erni, Mei or GeJu.

For those who experience injuries or a failure to perform the way they would wish we would suggest that you may have an internal saboteur. This is so important to the professional high achieving athlete. If you would like to deal with these issues and while doing so find your optimal performance enhancing diet contact our clinic to make an appointment with our kinesiologist/nutritionist, Teya.