The hormonal changes that occur during menopause may cause several symptoms such as hot flushes, sleeping problems and mood swings. The menopausal symptoms observed are primarily driven by the female body producing less estrogen.
Estrogen is the female sex hormone and levels begin to taper off around the age of 40 to 45. At this time, periods become less frequent until at such point that they stop. When a woman’s periods stops, this is classified as the beginning of menopause and usually this is around the age of 50, although it can be earlier or later.
Women can no longer get pregnant after menopause and for many the reality of no more contraception or periods is a good thing. However, the idea of no longer being fertile comes with its own health problems. Overall, menopause is a time of great physical and emotional changes.
Menopause is often accompanied by other major life changes too. Signs of ageing may become more prevalent and children may have become independent or have already moved away. A woman’s parents may need more care and career changes are also quite common at this stage of a woman’s life.
The symptoms of menopause primarily include hot flashes and excess sweating. Physiologically, vasodilation of peripheral blood vessels occurs, causing increased blood flow near the surface of the skin. Skin temperature increases and this occurs mainly in the hands, chest, face, abdomen and legs.
The occurrence of hot flashes coincides with estrogen fluctuations and is a result of changes in how the body regulates body temperature. It is much the same when the body raises the core temperature set point during a fever. During a fever, a person may feel cold in an environment where others feel fine.
During menopause, there are subtle but abrupt changes in luteinizing hormone and brain norepinephrine levels. Together these hormones cause cardiovascular changes and a change in the core temperature set point. This causes vasodilation of blood vessels and sweating, indicating a hot flash.
Given this mechanism, hot flashes and changes in core body temperature have been reported by menopausal women to contribute to difficulty in sleeping. However, studies show that hot flashes usually occur after becoming awake rather than causing a woman to become awake during the night.
Instead, restless leg syndrome, sleep apnoea and mild anxiety disorders have all been shown to be better indicators of sleep disturbances in menopausal women. There is significant evidence that the interplay between estrogen and other important neurotransmitters in the brain are responsible for these sleep disturbances.
With fluctuating changes in estrogen, mood swings and depressive moods are also common in menopausal women. Neurotransmitters such as serotonin and dopamine are all affected by changes in estrogen levels, which are intimately associated with changes in the behavior and the mental health of a woman.
Long Term Health Side Effects of Menopause
Osteoporosis is a disease of the bone with progressive changes in bone structure and bone density. This leads to an increase in bone fractures, which increases the rate of morbidity and mortality in women. Osteoporosis is common in women over the age of 50 and is caused by the loss of the hormone estrogen.
Estrogen helps protect bone tissue through its action on bone metabolism. Estrogen regulates the activity of cells called osteoclasts, which absorb old and damaged bone. Without estrogen’s influence, there is an increase in the activity of these cells leading to rapid loss of bone mineral density and ultimately, osteoporosis.
Menopause Supplements Health Benefits
Menopause symptoms can be relieved in many ways. For many, hormone replacement therapy (HRT) is prescribed by their GP. However, HRT comes with its own side effects, such as nausea and breast tenderness, as well as an increased risk of developing cardiovascular disease.
Dietary supplements are also commonly taken as a natural alternative to HRT. These supplements are not direct HRT replacements but can naturally support the body and mind during menopause.
In combination with dietary supplements, lifestyle changes such as mediation, relaxation exercises and yoga can help improve a woman’s wellbeing and promote better sleep quality.
Exercise and sports can also help a woman during menopause through its positive effects on the cardiovascular system, controlling weight gain and improving mobility. Exercise can also enhance mood and is an evidence-based treatment to reduce stress, improve self-esteem, and improve state-of-mind.
Lignans are polyphenol compounds that are enriched in seeds, grains, vegetables and legumes. Flaxseeds are the richest dietary source of lignans that are also enriched in fibre, protein, and various micronutrients. Flaxseeds are also often used as the basis for lignan dietary supplements.
Lignans are known as phytoestrogens because they are precursors to compounds that mimic estrogen in the human body. Lignans are converted by bacteria in the gut into compounds such as enterolignans, enterodiol and enterolactone, which mimic estrogen activity in humans.
Enterodiol and enterolignan have both been extensively studied and have been shown to have significant estrogenic activity. In these studies it was shown that they can bind to estrogen-receptors and change the expression of estrogen-responsive genes in women.
However, the binding of these phytoestrogens is weaker than human estrogen and therefore these compounds can be described as having anti-esterogenic activity. This is important because weak activity can help reduce the risk of hormone-associated cancers such as breast, uterine and ovarian cancer.
In addition, lignan-rich diets have also been studied and have been associated with a significant reduction in the risk of cardiovascular disease. These diets are associated with significant reductions in LDL cholesterol levels and therefore lignans are suggested to be cardioprotective.
Hop extracts come form the Humulus lupulus L. plant, which is well known for its usage as a preservative and a bittering agent in the beer brewing process. However, hops have been used for centuries as a medicinal herb as well.
Hops contain many flavonoids, terpenes and iso-alpha-acids (bittering substance), which are known to impart many health benefits. More recently, some of these flavonoid compounds have been show to have additional estrogenic activity.
In particular it is the hop extract, 8-prenylnaringenin (8-PN), which is classified as a phytoestrogen because it has been shown to relieve menopausal discomforts through this specific activity.
In a randomized controlled trial, the 8-PN hop extract was shown to be a potent phytoestrogen that was associated with alleviating symptoms of menopause. This included stabilization of the core temperature (hot flashes), as well as simultaneously improving aspects of sexual motivation.
In another study the effect of the hop extract 8-PN on bone loss, it was shown to help regenerate bone mineral density. Osteoporosis is a major concern for menopausal women and this dietary supplement may help reduce the risk of menopause-induced osteoporotic fractures.
L-tryptophan is a naturally occurring amino acid that can be found enriched in a range of foodstuffs, including meat, fish, eggs, dairy, grains, and seeds. Tryptophan is a precursor of the neurotransmitter serotonin and diets enriched in tryptophan are associated with improved sleep and mood.
L-tryptophan levels in the body are altered during menopause due to the intimate relationship with the level of the hormone estrogen. The reduced levels of tryptophan impacts serotonin production and administration of supplemental L-tryptophan has been shown to increase levels of serotonin synthesis and release.
Supplemental tryptophan has also been shown to increase melatonin levels in the brain. Melatonin is a neurotransmitter-like compound that is produced by the pineal gland in the brain and is involved in the regulation of circadian rhythms and the onset of sleep.
These increases in melatonin and serotonin caused by L-tryptophan supplementation are associated with significantly reduced sleep latency as well improved sleep quality. Therefore, in the case of menopause, supplementation with L-tryptophan may help promote a more regular sleeping pattern.
The compound 5-hydroxytryptophan ( 5-HTP ) is synthesized from the amino acid tryptophan and is a precursor for both serotonin and melatonin. Research shows that the neurotransmitters, melatonin and serotonin, are associated with the regulation of sleep patterns.
The amino acid 5-HTP, although not directly associated with circadian rhythms, has been implicated in the sleep-wake behavior rather than directly promoting sleep. During the sleep-wake cycle there are changes in the regulation of the core body temperature that help facilitate sleep.
Fluctuations in the levels of estrogen are already implicated in changes in the core temperature set point. This is an important observation in the case of menopause where hot flashes and poor temperature control are reported health issues associated with sleep disturbances.
Who Should Use Menopause Supplements?
- Pre-menopausal women
- Peri-menopausal women
- Post-menopausal women
Menopause Supplement Interactions
Most menopause supplements are considered safe and non-toxic. However, the supplement 5-HTP has been reported to have adverse effects when combined with certain medications.
This is because 5-HTP increases the levels of the neurotransmitter serotonin, which in some instances is not advised. The following lists the medications that may interact with 5-HTP and cause severe side effects:
- Antidepressants such as fluoxetine, paroxetine, amitriptyline, sertraline and others
- Monoamine oxidase inhibitors (MAOIs) such as phenelzine and tranycypromine
Menopause Supplement Combinations
- Hop extract and lignans are often combined together
- Calcium and vitamin D can help protect bone from menopause-mediated osteoporosis
Why Take Menopause Supplements
During menopause, the balance of hormones changes in a woman’s body causing significant life changes during this time. Most menopausal women will experience symptoms that can get in the way of every day life. Dietary supplements that ease the symptoms of menopause are beneficial for a number of reasons.
The reason for taking menopause supplements, include
- To counteract the severity and frequency of hot flashes
- To improve sleeping patterns
- To control weight gain
- Improve sexual motivation or desire
- Reduce the risk of estrogen-sensitive cancers
- de Kleijn M, van der Schouw Y, Wilson P, et al. Dietary intake of phytoestrogens is associated with a favourable metabolic cardiovascular risk profile in postmenopausal U.S. women: the Framingham study. J Nutr. 2002; 132(2): 276-282
- Hümpel M, Isaksson P, Schaefer O, et al. Tissue specificity of 8-prenylnaringenin:protection from ocvariectomy induced bone loss with minimal trophic effects on the uterus. J Steroid Biochem Mol Biol. 2005; 97: 299-305
- Heyerick A, Vervarcke A, Depypere H, et al. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas. 2006; 54(2): 164-175
- Velentzis L, Cantwell M, Cardwell C, et al. Lignans and breast cancer risk in pre- and post-menopausal women: meta-analyses of observational studies. Br J Cancer. 2009; 100(9): 1492-1498
- Aidelsburger P, Schauer S, Grabein K, et al. Alternative methods for the treatment of post-menopausal troubles. GMS Health Tech Assess. 2012; 8: Doc03
- Zaineddin A, Buck K, Vrieling A, et al. The association between dietary lignans, phytoestrogen-rich foods, and fiber intake and postmenopausal breast cancer risk: a German case-control study. Nutr Cancer. 2012; 64(5): 652-665
- Keiler A, Zierau O, Kretzschmar G. Hop extracts and hop substances in treatment of menopausal complaints. Planta Med. 2013; 79(07): 576-579
- Wharton W, Gleason C, Olson S, et al. Neurobiological underpinnings of the estrogen-mood relationship. Curr Psychiatry Rev. 2013; 8(3): 247-256