The following is an essay I wrote for inclusion in my book "Nutritional
Self-Defense," which you may find helpful in dealing with the symptoms and
physiological effects of menopause. To your health!

MENOPAUSE and NUTRITION

Menopause can bring about many physiological and emotional changes in a
woman's life.
It is a very stressful period, and requires excellent nutrition to go through
it gracefully.
Nutrition can greatly improve the menopausal process and alleviate many of
the symptoms
as well as side-effects of hormone replacement therapy (HRT).

Menopause literally means the cessation of the menses. Perimenopause refers
to the times
before and after actual menopause. The climacteric period (entire menopausal
process)
can last from five to ten years.
Average age of onset of menopause is 40 to 50 years. Onset before 40 is
considered
premature; onset after 55 isn't unusual. The average age is 51.4 years for
major symptoms,
discussed below, to appear.

THE HORMONAL CYCLE

In order to fully understand the menopause and all it entails, a full
comprehension of the
female hormonal cycle is important. Each month within a cycle of
approximately 28 days,
the hormone levels in a woman's body constantly fluctuate in a precise
ballet:

1.   Follicle Stimulating Hormone (FSH) is released from the pituitary gland
via signals
from the hypothalamus--the homeostasis-regulating gland of the endocrine
system. FSH
causes an ovum to ripen within the ovary, around which a layer of cells grows
that
secretes the specific female hormone estradiol, an estrogen.
2.   Estradiol stimulates the growth of the endometrium--the uterine lining.
(Estradiol's
specific function is to stimulate cellular growth.) Estrogen also increases
uterine
contractility, mucus production, and cervical dilation.
3.   When the estrogen level peaks, this signals the pituitary to reduce FSH
production.
4.   The pituitary then releases Luteinizing Hormone (LH) which stimulates
the follicle
to rupture, causing ovulation. The follicle is covered with the corpus
luteum--yellow
body--which secretes estrogen and progesterone.
5.   Progesterone governs the luteal phase, maturing the endometrium and
inhibiting
udden and intense heat on the upper body,
sometimes accompanied by sweating. A hot flush is usually preceded by an
aura--a
"feeling" that it is about to happen--and in less than a minute, the upper
body feels hot.
Redness is common, and body and skin temperature may rise a few degrees, then
fall to
slightly below normal after the flush subsides. Hot flushes may be
accompanied by
dizziness, headache, and palpitations. They may be experienced less than once
a week, or
as often as several times a day. Night sweats are most common as well as most
bothersome, contributing to sleep deprivation. Two-thirds of menopausal women
experience hot flushes; 80% experience them for a year or more; 25-30% will
have
problems for more than five years; some continue for over ten years.

Hot flushes can be triggered by stress, emotions, loud noises (menopausal
women are
more sensitive to loud noises), hot beverages, alcohol, and caffeine.

The exact mechanism of the hot flush is poorly understood, but is thought to
be caused by
pulsatile surges in the hypothalamic factors that regulate the release of LH
from the
pituitary. Hot flushes emanate from both sympathetic and parasympathetic
nervous
mechanisms that stimulate the release of prostaglandins that also contribute
to blood
vessel dilation.

Other symptoms include:

Vaginal dryness and atrophy of tissues resulting in thickening, hardening and
shrinking,
and possibly shortening of the vagina.

Depression, pessimism, nervousness, sensitivity to noise
Aggression, "meanness," paranoid episodes
Insomnia, waking in a jolt
Increased heart disease risk
Increased bone loss, resulting in osteoporosis.
Confusion, forgetfulness, moodiness
Polyuria (frequent urination at night). Usually caused by an overworked
pituitary
increasing output of vasopressin--antidiuretic hormone--during the day, where
urination is
infrequent and water retention as in puffy face, ankles, and fingers is
noticeable during the
day, but relieved at night when reclining (the reclined position increases
kidney filtration).
"Sick" headaches--those accompanied by dizziness, nausea, vision problems,
throbbing in
the head, and chills. These symptoms resemble the flu, but occur too
frequently, perhaps
weekly, or twice a month.
Heart palpitations, chest pains resembling angina; EKG shows no abnormality.
Severe and sudden fatigue not of other origins.
Anxiety, panic attacks
Unusual hair growth; growth in odd places
Mild to severe acne
Breast changes (due to absence of progesterone from corpus luteum of ovary,
and
sustained estrogen levels from ovaries and adrenals); sometimes resulting is
cysts and/or
cancer
Osteoporosis

Osteoporosis is by far the most insidious and dangerous effect of the hormone
depletion of
menopause. Though aging for both male and female results in bone loss, men
don't
experience an appreciable loss of bone mass until well into their seventies.
Not so for
women during menopause.

Thirty-five to forty percent of all menopausal women will suffer
osteoporosis.
Osteoporosis is most common in Caucasians; least common in blacks. Of
Caucasian
women, 25% will suffer vertebral compression fractures; 50% will succumb by
age 75.
Hip fractures will plague 84% of these women; of these, 34% will die of blood
clots,
pneumonia, and other complications.

Bone is dynamic--always changing, cells being replaced continuously. Maximum
bone
density occurs between the ages of 25 to 35. Increasing bone mass through
exercise is
most effective between the ages of 15 and 25.

In menopause, the expected loss of bone mass due to hormone depletion is 1-3%
per year.
The longer the menopause, the more the bone loss. By age 80, bone loss may be
30-59%.
This loss occurs all over, with marked loss in the spinal column
corresponding to as much
as a 21/2-inch reduction in height.

Disuse osteoporosis results from a sedentary lifestyle. The axial skeleton is
the first
affected: the spinal column, pelvis, and femur heads. Vertebral collapse
causes
displacement of the ribs, resulting in breathing difficulties and "dowager's
hump." Regular
stress on muscle, and therefore on bone, prevents this demineralization.

Those at highest risk are Caucasian, have a small frame, and are mostly
inactive.

Obese women's bones are more dense due to constant weight stress, which
increases
calcium laydown and lessens calcium loss in bones.
nes, rather than increases laydown of
calcium to the bones. This bone-protecting mechanism is the same for low
doses as for
high; high doses of estrogen in the HRT regimen are not indicated.

Progesterone with estrogen in HRT has been shown to promote laydown of
calcium to
bone, increasing bone mass.

Calcium supplements without HRT are less effective than HRT alone. See below
for
nutritional information.

NUTRITIONAL CONSIDERATIONS

Nutrition plays a major role in enduring any kind of life change, and that
includes
menopause. Because of the obvious adrenal involvement and the overtaxing of
pituitary
function, special attention must be given nutritional support of the immune
system.

High quality protein in moderate amounts--45 to 75 grams per day, every
day--is essential
to immune function, as it is protein that the body needs to make hormones,
enzymes, and
antibodies. Protein is also required to replace breakdown of muscle and other
tissues
during stress.


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