Q: What herbs do you recommend for hot flashes during menopause? And, why do we have them?
A: As our baby boomer population moves into its 40s and 50s, menopause is becoming an important health issue. When women stop ovulating, they experience a decrease in circulating estrogen levels. This in turn leads to increased reactivity of blood vessels and the autonomic system that regulates perspiration.
Hot flashes are also common in women who are receiving anti-estrogen treatment for breast cancer as well as men receiving hormonal therapy for prostate cancer.
From an Ayurvedic perspective, the reason women have fewer heat-related illnesses (referred to as Pitta imbalances) during their reproductive years is that they naturally release accumulated heat through their monthly menstrual flow.
According to Traditional Chinese medicine, Tibetan medicine and Ayurvedic medicine, the blood is considered the heating principle in the body.
When a woman transitions through menopause, she no longer has the opportunity to release the accumulated fire through her periods and therefore, for a time, may experience hot flashes. The intensity of hot flashes seems to correlate with how abruptly a woman has a decline in her estrogen production. When a woman goes through a surgical menopause, she experiences a very abrupt change in her hormonal levels whereas during natural menopause the changes are more gradual.
A recent study looked at the incidence of menopausal symptoms in Asian woman and found that they were considerably less common and disabling. When they were given hormone replacement therapy, they showed the anticipated rise in blood levels of estrogens, but did not report much in the way of benefits on the subjective symptoms of menopause. Many researchers are suggesting that the difference between Asian and American women's experience is related to the intake of natural estrogens in their diet.
There are three categories of plant-based estrogens:
- Phytoestrogens, also known as isoflavones; soybeans, garbanzo, pinto, and navy beans are common sources of isoflavones.
- Lignans; flaxseeds, sesame seeds, wheat bran, and olives are good sources of lignans.
- Coumestans; alfalfa sprouts, split peas, and lima beans are good sources of coumestans.
Although they are considerably less potent than pharmacological doses of estrogen, these natural substances interact with estrogen receptors in a similar way that our own hormones work. Increasing your intake of these natural plant-based estrogens is an important first step in reducing the severity of menopausal symptoms.
Herbs that have been traditionally used for menopause, including Dong quai, Black Cohosh and Shatavari have not been well studied by Western scientific principles. A recent report from Kaiser Permanente in Oakland, California failed to demonstrate any definite value of Dong quai in women who were followed for six months.
Research on Black Cohosh, a traditional Native American herb has generally supported its value in reducing uncomfortable menopausal symptoms. Other studies using traditional Ayurvedic herbs are in progress around the world.
Try following a "Pitta pacifying" (heat reducing) program that includes reducing your intake of very spicy, salty, and sour foods and drinking a couple cups per day of tea made with cooling herbs such as spearmint, fennel, coriander and hibiscus. Perform a daily self-massage (with herbal or sesame oil) and surround yourself with cooling, soothing aromas such as lavender and ylang ylang.
Pay attention to balance. Minimize toxicity and maximize nourishment on physical and emotional levels. Give your physiology time to transition through this important stage of life and you will channel your creativity into greater vitality and freedom.