HRT And Natural Alternatives During Menopause

Many women in the UK take HRT (hormone replacement therapy) to help alleviate menopause symptoms such as hot flushes, low mood, anxiety and insomnia.

Let’s take a look at what happens during the transition through menopause, how HRT functions in the body and natural ways to help manage symptoms.

What is menopause and how does it affect the body?

Menopause is the term used for when a woman’s periods stop. It’s a natural ageing process that signals the end of childbearing years, usually between the ages of 45 and 55. Hormone levels start to fluctuate and decline during this time, specifically sex hormones oestrogen and progesterone.

Low levels of oestrogen influences many other functions in the body. This is why many women experience menopause symptoms such as night sweats and hot flushes, difficulty sleeping, weight gain, mood swings, anxiety, bladder problems, vaginal dryness and low sex drive. Low oestrogen is also associated with low bone density. Bones become weaker with an increased risk of fracture and a condition called osteoporosis. An increased risk of uterine cancer and heart disease are associated with low oestrogen levels.

Hormone replacement therapy

HRT is a treatment which replaces low levels of oestrogen and/or progesterone to help relieve menopause symptoms, prevent the risk of osteoporosis and reduce the risk of uterine cancer. It is available in many different forms including pills, patches, gels, sprays, creams or injections.

Whilst HRT clearly has health benefits, there are also side effects and risks to consider, such as an association between long-term HRT use and heart disease, stroke, breast cancer and an increased risk of deep vein thrombosis, or DVT, a type of blood clot. Risks and benefits should always be discussed with your GP prior to starting HRT so that you can make an informed decision.

Natural alternatives to support the menopause

Adopting a healthy diet and lifestyle coupled with nutritional supplements and botanical therapies offer natural, yet effective strategies to help manage symptoms for many menopausal women. 

1. Eat a whole foods, balanced diet to help balance hormones. Avoid refined carbohydrates, sugars, processed foods and saturated fats. Opt for a wide variety of brightly coloured vegetables and fruits, whole grains, nuts and seeds, good quality lean protein and healthy fats.

2. Avoid trigger foods such as alcohol, caffeine and spices which act as vasodilators, causing night sweats and hot flushes.

3. Eat phytoestrogens daily. Phytoestrogens are plant oestrogens which mimic oestrogen effects in the body. They help reduce sweating, hot flushes and vaginal dryness, support bone health and reduce the risk of some cancers. Try taking 2 tablespoons of ground flaxseed daily by adding to yoghurt, porridge, soups, smoothies or salads. Other phytoestrogen foods include soy, chickpeas and sesame seeds.

4. Eat oily fish 2-3 times a week (salmon, sardines, mackerel, anchovies and herring) which contain calcium and vitamin D to support healthy bones. Other calcium-rich foods include dark green leafy vegetables, nuts and seeds, broccoli and tofu. Oily fish also contain omega-3 fatty acids which support hormone balance and protect our cell membranes.

5. Exercise regularly to support a healthy weight, cardiovascular function, improves sleep and increases the ability to cope with stress. Weight-bearing exercise is known to be extremely beneficial for bone growth and repair, reducing the risk of osteoporosis.

6. Avoid stress and promote calm using self-help techniques such as deep breathing, gentle exercise (ie, walking, Pilates, Yoga, Tai chi), meditation or journaling. Complementary therapies such as acupuncture may also be beneficial.

7. Sleep well. Use good sleep hygiene techniques such as switching off devices an hour before bedtime, reading or listening to music before going to sleep, taking a hot Epsom salt bath (contains magnesium to help relax the muscles and mind) to help get a good night’s rest. Always go to bed and wake up at the same time each day, and sleep for 7-8 hours.

Supplement considerations

• Multi-vitamin to provide key nutrients aimed specifically at supporting menopause
• 5-HTP (5-hydroxytryoptophan) to promote calm and restful sleep (must be avoided if taking SSRI anti-depressant medication)
• Vitamin B complex to provide vitamins B6, B12 and folate to support energy, mood and brain function
• Vitamin E to relieve hot flushes and vaginal dryness
• Calcium and vitamin D combined to support bone health
• Omega-3 fatty acids to help reduce hot flushes and balance hormone levels
• Omega-7 (sea buckthorn oil) to relieve vaginal dryness
• Flaxseed, soy, red clover isoflavones and sage – to relieve night sweats and hot flushes

Botanical considerations

• Black cohosh, widely used as an alternative to HRT to relieve hot flushes, mood swings and insomnia
• Hops to relieve anxiety, restlessness and insomnia
• Maca to improve sleep, mood, energy and relieve hot flashes
• Chaste tree, particularly beneficial when combined with black cohosh
• Dong quai to relieve menopausal symptoms, particularly in combination with soy isoflavones

Summary

Whether you are considering HRT or trying to find a suitable alternative, always discuss first with your GP who can advise you of the benefits and risks in your individual case. Consult with a registered Nutritional Therapist who can support you through the menopause with advice on diet, lifestyle and supplementation.

Written by Melanie Dixon DipION mBANT CNHC, Registered Nutritional Therapist for Vitaminology