Search Skin Biology
Changes in Skin and Hair with Menopause and Aging: What Every Woman Should Know
 |
|---|
During normal aging, the skin becomes thinner, looser and less elastic and hair growth lessens and the hair shafts become thinner. In men, this is a fairly gradual effect which accelerates after age 45. In women however, the abrupt hormonal changes at menopause are more sudden and drastic.
The final menstrual period of a woman marks the start of menopause. This cessation of menstruation is preceded by gradual physical changes over several months to years. The average age at menopause is 51, although this varies greatly between the ages of 40 and 55.
The decreases in estrogen levels can cause a thinning and drying of the skin which can produce more wrinkles. Hair follicles tend to shrink and the hair shafts become thinner. Sexual intercourse can become painful due to a thinning of the protective walls of the vagina. Breasts may sag as mammary tissue is replaced with more fat tissue.
There are numerous methods to counter these changes. Diet, exercise, certain vitamins and nutritional supplements, and newer and safer estrogen replacement therapies (ERT) all delay or reverse many of these deleterious changes in skin and hair. The use of human growth hormone (HGH) or HGH hormone releasing substances also produces improvements in skin and hair.
Estrogen Replacement Therapies (ERT)
Estrogen Reverses Vaginal Changes
Improvements in Estrogen Replacement Therapy
Newer ERT Methods Reduce Cancer Risks
Reducing C-16 Hydroxyestrone to Lower Cancer Risks
Exercise Lowers Your C-16 Hydroxyestrone Level
Substances in Vegetables that Reduce C-16
How I-3-C and Ascorbigen Reduce Cancer Risk
Isoflavones as Anti-Cancer Agents from Plants
Other Plant Anti-cancer Agents
Anti-estrogenic Fiber from Plants
Why Fatty Diets Increase Estrogenic Cancer Risk
Estrogen Plus Androgen Improves Libido
Effective Herbal Therapies for Menopause
Tocotrienols against postmenopausal breast cancer
Human Growth Hormone (HGH) Reverses Aging Effects
Low Cost Human Growth Hormone (HGH) Releasers
Estrogen Replacement Therapies (ERT)
The family of estrogen hormones plays many roles in the body. The principal forms of estrogen are estrone, estradiol and estriol. In addition to regulating a woman's reproductive system, estrogens help maintain skin and hair health plus the firmness of the breasts. Most estrogen is released by the Graffian follicles prior to ovulation.
Recently, there have a number of clinical studies indicating that some types of ERT had benefits but also significant health risks. It should be emphasized that these studies concentrated on older methods of estrogen replacement, primarily through the use of hormones from pregnant horses.
It is possible that newer ERT methods will not show these negative aspects. For example, early versions of cholesterol lowering drugs actually raised the death rate. Then, as newer lipid lowering drugs were developed, it was possible to demonstrate a decrease in mortality.
Estrogen and Breasts
After menopause, the glandular tissue in your breasts tends to be replaced by fat tissue, causing your breasts to sag. Subcutaneous fat is also reduced. Larger breasts are more prone to sagging than smaller breasts because their weight stretches the supporting ligaments. Exercise cannot prevent this change because you do not have muscles in your breasts.
ERT will maintain some firmness in your breasts and preserving more of the glandular tissue. An alternative is the implantation of saline implants to restore the breast contour.
Estrogen and Hair Growth
Menopause changes the balance between your body's levels of female hormones and male hormones (androgens) which in turn affects your hair. There is a relative increase in the level of male hormones in your body due to the decrease in estrogen.
At times, the fine, light hairs covering your face tend to darken and thicken. Estrogen therapy will reduce this excessive hair growth. Alternatively, these hair can be removed plucking or using hair-removal creams. More permanent hair removal is gained with electrolysis or laser treatments.
The hair on your scalp begins to thin, as does the hair in the pubic area. Estrogen replacement therapy reduces this hair thinning.
Products such as minoxidil also improve hair growth in women. They often work better restoring hair in women than in men.
Information is available at www.folligen.com.
Estrogen to Prevent Wrinkles
The drop in estrogen production makes your skin thinner and less elastic which produces more wrinkling and sagging. Your skin is producing less collagen and elastin, the supportive and elastic proteins in the skin. Again, estrogen replacement therapy works to maintain more adequate production of collagen and elastin.
As the skin becomes more delicate, it is more susceptible to damage from the sun. To help reduce wrinkle formation, a reflective sunscreens (not chemical sunscreens) with a sun protection factor (SPF) of at least 15 should be used to protect your skin when outdoors.
A 1997 study of 3,875 postmenopausal women concluded that the estrogen helped aging women have a younger looking skin, helped maintain skin's collagen, thickness, elasticity and ability to retain moisture.
The study found that the chances of having dry and wrinkled skin were 30 percent less in women who took estrogen replacements in comparison with women who did not. While smoking and sun exposure may adversely affect skin health, the researchers adjusted for these two factors, and found the benefits of estrogen on skin health were still significant.
The study, led by Dr. Laura B. Dunn of the University of California at San Francisco, was published in the Archives of Dermatology (1997;133:339-342). The researcher commented, "skin wrinkling can negatively affect psychological well-being, sometimes initiating a vicious cycle of diminished self-care leading to deteriorating outcomes".
Commenting on the study, Dr. Fran Kaiser, director of the menopause clinic at St. Louis University School of Medicine in Missouri said, "When estrogen is good for your heart, good for your bones, promotes vaginal lubrication, protects against incontinence and now is good for the skin, how can you knock it? There are so many other good reasons to support estrogen use. This is one extra added bonus.''
Another recent skin study of 98 postmenopausal women with hormone replacement therapy (oestradiol gel or patches) or without hormone replacement therapy measured skin thickness, skin hydration, and skin surface lipids. They found that estrogen therapy increased skin thickness 7 to 15% and skin lipid sebum by 35% (Callens et al 1966).
Beyond hormones to improve your skin, products that have been clinically-demonstrated to improve skin renewal and rebuild and increase the skin's collagen, elastin and water-holding proteoglycans are copper peptide creams such as the Neova and Neutrogena Active Copper lines.
When these skin renewal creams are used conjunction with an alpha hydroxy acid exfoliating cream, there is an improved and faster skin renewal. For example, there are creams that contain a mild but effective 2% salicylic acid. Other AHA and BHA creams are available at beauty counters.
For effective exfoliation, the cream should contain at least 7% alpha hydroxy acid and or 2% salicylic acid. Unless you are allergic to salicylates, the salicylic acid creams are best. Recently, the European Commission warned that AHAs, such as glycolic acid, increased the amount of sun damaged cells in users.
Most skin creams and moisturizers on the market only provide a brief water-barrier over the skin and hydrate (wetten) the proteins in the skin's outer layers.
Estrogen Reverses Vaginal Changes
After menopause the walls of the vagina produce fewer secretions and become drier, thinner, more fragile, and less lubricated thinner. The vagina gradually becomes shorter, narrower, and more prone to irritation. The normal vaginal lubrication occurring with sexual excitement is slower.
ERT taken in pills or skin patches re-establishes the more youthful tissue integrity of the vagina and increases vaginal lubrication which makes sexual intercourse more comfortable. But ERT may take several months to have a significant effect. Some vaginal creams containing estrogen, obtainable from your physician, can relieve the dryness. The estrogen cream is applied directly to the affected tissue inside your vagina and relieves the dryness in a few weeks.
Some experts recommend extending the period of foreplay before making love and applying a water-based vaginal lubricant can help reduce potential discomfort. Maintaining the muscle tone in your pelvic area can help you maintain a pleasurable sex life. Daily pelvic-floor (Kegel) exercises improve pelvic area muscle tone.
One method used to treat vaginal dryness is the use 1 gram of a estriol cream for seven continuous days, and reduce to a maintenance dosage of two to three applications a week.
Improvements in Estrogen Replacement Therapy
Most medical therapies begin as marginal improvements, then over the years are improved by researchers and clinicians in the field.
For example, heart operations to clear clogged arteries actually worsened the patient’s chance of survival before 1985, but continuing improvements have may these operations among the most successful surgical procedures.
ERT has markedly improved over the past 20 years. The widespread use of ERT began in the 1960’s. By 1975, Premarin, an estrogen made from pregnant mare's urine, became one of the most prescribed drugs in the USA.
Estrone sulfate is the form of estrogen in Premarin, and estradiol-17B is the form found in products such as Estrace and Estraderm. However, the early use of estrogen ERT was associated with an increase in breast, uterine, and cervical cancer.
Most particularly the increase was associated with particular estrogen breakdown product called C-16 estrogen (discussed below). But overall, women on ERT live longer than those not taking ERT.
Researchers observed that women who experience excessive PMS and unpleasant symptoms of menopause usually have too little progesterone when compared to estrogen.
This observation led to newer ERTs that use lower dosages of estrogen and the combination of estrogen with progesterone.
Surprisingly, this has resulted new ERTs that actually decreases the incidence of most cancers in women. For example, while estrogen alone may increase the risk of uterine cancer, when used estrogen is used in combination with progesterone, the uterine cancer risk actually drops.
Medical researchers find that only about 10-20 percent of women who can benefit from ERT actually take the pills or use the newer "patch" that supplies the drugs through the skin.
This is unfortunate, because women using ERT after menopause cut their heart disease in half and are protected from many of the problems of osteoporosis.
This protection lasts for as long as they are taking estrogen. Estrogen may prevent or slow the progression of Alzheimer's disease.
Newer ERT Methods Reduce Cancer Risks
Some early studies of ERT showed increases in breast cancer rates, but these have been outweighed by many studies which show no increase in cancer rates. Women on ERT consistently have a lower overall death rates.
Newer ERTs use lower dosages of estrogen which is often combined with progesterone. Progesterone (from pro (supporting) gesterone (gestation or pregnancy)) is the other major hormone your ovaries synthesize and its primary function is to support pregnancy. Progestogens can be either natural or synthetic and prevent the negative effects of estrogen on the uterus.
Studies of the newer methods of ERT have found no increase in breast cancer and some studies have actually demonstrated a lower incidence of breast cancer in women on low doses of ERT compared to women not on ERT.
A study published in the Journal of the American Medical Association in July 1995 found no increased risk of breast cancer in middle-aged women using lower dosage estrogen or estrogen-progestin combinations. Another study announced in March 1996 by the American Cancer Society found that women who developed breast cancer while taking estrogen replacement therapy after menopause were less likely to die from breast cancer.
Finally, an analysis of 28 studies, funded by the National Cancer Institute, reported that that menopausal therapy consisting of 0.625 mg conjugated estrogens per day did not increase the breast cancer risk (Dupont et al, Archives of Internal Medicine, vol. 151, January 1991).
One study in the New England Journal of Medicine (June 1995) suggests that ERT may increase the risk of breast cancer may increase in certain women. Women who should not be on ERT are those who have had estrogen-dependent breast cancer, advanced endometrial cancer, liver disease or active thrombophlebitis (blood clots to the legs or lungs).
Other medical diseases such as gallbladder disease, liver impairment and a specific type of hypertension may worsen with estrogen. But, even in these conditions, the estrogen patch or estrogen vaginal cream have been shown to be safe.
ERT is now even being recommended for women with breast cancer to ease menopausal symptoms and protect against cardiovascular disease and osteoporosis. A study in Gynecologic Oncology, April 1997, Estrogen Replacement Therapy in Women With Prior Diagnosis and Treatment of Breast Cancer conducted by investigators at the University of Texas M.D. Anderson Cancer Center in Houston followed 49 women who underwent at least two years of ERT after being treated for breast cancer.
The researchers found that ERT did not have a significant effect on the cancer outcome. Only one of the 49 women had a cancer recurrence. She had begun therapy 2 1/2 years after being treated for breast cancer and developed another tumor more than 4 1/2 years later.
A 1998 study presented at the North American, found ERT reduced the risk of colorectal cancer in women. A review of 18 epidemiological studies USA and Europe of the effects of ERT by Dr. Meir Stampfer of Harvard University found that women currently taking estrogen had up to a 34% reduction in colorectal cancer incidence compared with women who had never used ERT. On average, there was a 20% reduction in colon cancer and a 15% lowering in rectal cancer rates in women on ERT.
Another 1998 study of menopausal women on ERT (estrogen with progestin) reported in Gynecologic Oncology (March 1998) by Drs. Harry Ziel, William D. Finkle, Sander Greenland of the Kaiser Permanente Medical Center and UCLA concluded that ERT decreased their risk of developing endometrial cancer. This study covered 22-years of data on women older than age 45.
Previous epidemiological studies had found estrogen-only therapy was associated with an increased risk of endometrial cancer. The new study followed women on estrogen combined with a progestin (medroxyprogesterone).
The lowest endometrial cancer incidence (1991 through 1993) occurred with the highest estrogen prescriptions and contradicted the view that the use of estrogen increased endometrial cancer. The use of medroxyprogesterone along with estrogen accounted for the decrease in cancer.
Estriol for ERT
Estriol is also being researched for ERT. It is a weak estrogen that provides the anti-aging benefits of therapy without the apparent increased risk of cancer. During pregnancy, large amounts of estriol are secreted by the placenta and high estriol levels appear to protect the fetus. Estriol is used extensively in Europe for ERT. Because it is a weak estrogen larger doses are used. A dose of 2 to 3 mg of estriol is equivalent to about 1 mg of the type of conjugated estrogens that were used in Premarin. Premarin tended to cause endometrial hyperplasia, a condition which may precede uterine cancer. Estriol therapy does not cause endometrial hyperplasia. Estriol therapy reverses vaginal atrophy and improves cervical mucus. Estriol therapy seems to avoid other side effects reported for other estrogens such as nausea and breakthrough bleeding. Both researchers and estriol users have especially remarked on the quality of skin improvement.
Estriol may help prevent breast cancer. Dr. H. M. Lemon and associates of the University of Nebraska Medical Center found that estriol reduced mammary tumors induced by gamma radiation in female rats from 75% to 48%. In another study by Lemon and his colleagues, estriol was found to have "the most significant anti-mammary carcinogenic activity of 22 tested compounds" and "estriol is less likely to induce proliferative changes in the target organs of cancer-prone women than estrone or estradiol".
Estriol is used at 8 mg daily or taken in a combination of 80% estriol, 10 % estrone and 10% estradiol in a product called TriEst. TriEst, with it's 10% estradiol is felt to have better effects on improving improving learning and memory. Estriol or TriEst are available in Europe.
DHEA for ERT
Some women use DHEA as an ERT. In the body, DHEA can be converted into estriol and other estrogens. These women usually take 15 mg of DHEA three times a day. Women taking DHEA should also take 1 to 10 mg melatonin and plus isoflavone soy extracts to reduce breast potential breast cancer risks.
Reducing C-16 Hydroxyestrone to Lower Cancer Risks
There are further steps that a woman can take to reduce their cancer risks. Estrogen acts to constantly prepare the uterine and mammary gland tissues for possible pregnancy by activating parts of the chromosomal material (DNA) so that the necessary changes transpire. Estradiol is the specific type of estrogen normally secreted by the Graffian follicles. Estradiol acts on the uterus and mammary gland in a well controlled manner.
However, estrogen has two breakdown pathways, one producing 2-hydroxyestrone (a safe metabolite) and the other producing the pathway dangerous 16-hydroxyestrone. Women with a family history of breast cancer have abnormally high levels of C-16 in their blood. (Bradlow and Michnovicz, 1989). The C-16-hydroxyestrone binds tightly to the DNA so that the cell division processes are permanently “turned-on”. This type of estrogen is what produces the cancerous cell growth in these tissues (Sloesand et al 1981, Swaneck 1988, Lustig 1989, Messina et al, 1991).
Exercise Lowers Your C-16 Hydroxyestrone Level
Fortunately, there are ways to lower your blood C-16 level. Exercise is surprisingly effective in reducing the blood C-16 level (Frisch, 1987). Regular exercise also lowers your blood pressure, cholesterol level and your risk of developing type II diabetes. Even moderate exercise, such as walking half an hour three times a week, significantly benefits your body.
Substances in Vegetables That Reduce C-16
Perhaps more important than the use of drugs, a good diet can reduce the formation of C-16 (Byers and Graham 1984, Musey et al 1987). Dr. Lee Wattenberg at the University of Minnesota in the 1970’s found that feeding animals a chemical from cruciferous (or more specifically brassica) vegetables such as cabbage, broccoli, Brussels sprouts, and cauliflower plants called indole-3-carbinol had an anticancer action similar to feeding them the whole vegetable (Wattenberg, 1978).
In 1990, Dr. Jon Michnovicz found that women who taking I-3-C daily doubled their blood level of “safe” C-2 estrogen while cutting in half their blood level of unsafe C-16 (Michnovitch, 1990). A later $20 million National Cancer Institute study also concluded that I-3-C was really the vegetable substance that increased C-2 estrogen production while decreasing the level of unsafe C-16 estrogen (Bradfield and Bjeldanes, 1984).
How I-3-C and Ascorbigen Reduce Cancer Risk
The biochemical pathway that removes the dangerous C-16 is controlled by a group of enzymes called "mixed function oxidases" (MFO). This is a large and diverse set of enzymes that is kept in a state of readiness to render harmless toxic substances including carcinogens (Wattenburg and Loub 1978, McDanell et al 1987).
Plants contain natural substances such as I-3-C that keep the MFO’s in a state of readiness to detoxify dangerous substances such as C-16. Another beneficial plant product called ascorbigen, a fat-soluble form of the vitamin C family which now is known to contain at least seven distinct compounds (Dashwood 1988).
Ascorbigen is I-3-C bound to ascorbic acid and also present in brassica vegetables. The combination of dietary supplementation with both I-3-C and ascorbigen produces up to an 80-fold increase in intestinal or liver MFO activity in experimental animals (Byers and Graham 1984, McDanell et al 1987).
The famous two-time Nobel prize-winning biochemist, Linus Pauling, long ago argued the importance of vitamin C as an anticancer agent, even though it was not realized at the time that vitamin C existed in at least 7 different forms (Cameron and Pauling 1979a,b).
Other protective substances from plants in addition to I-3-C are now known to be most effective when they are bound to one of the forms of vitamin C.
These substances which may also reduce cancer risks include pectin (Kritchevsky 1978), bioflavinoids (Vinson 1987), and a form of vitamin C is called isoascorbate (Rencricca 1979).
There is also a substance called sulforaphane, found especially in Brassica vegetables such as broccoli, that stimulates enzymes in the liver to break down such dangerous carcinogens as aflatoxin and polybrominated biphenyls.
Limonene, found in citrus fruits, and lignan, found in whole grains, have also been observed to slow, stop, or even reverse the growth of steroid-involved malignant tumors (Aldercreutz, 1984).
Isoflavones as Anti-cancer Agents from Plants
Some foods have high levels of phytoestrogens, or plant estrogens. These phytoestrogenic compounds are found in soy foods, flax seeds, and some herbs and called isoflavones and lignans.
One of the first phytoestrogens to be studied was in red clover. It was noted that when female sheep ate a diet high in red clover, their menstrual cycles became irregular.
An antiestrogenic prescription drug, tamoxifen, binds to the DNA in a manner similar to the safe C-2 estrodiol. Women using this drug have a lower incidence of breast cancer and the drug also reduces the growth rate of existing breast cancer cells by 30-40% (Nayfield 1991, Han 1992).
Isoflavones are phytoestrogens from plants that are chemically similar to the drug tamoxiphen. They reduce the risk of breast cancer by binding to the estrogen receptor sites on the chromosomal material in mammary gland cells and preventing the dangerous C-16 form of estrogen from binding.
Soy products (soybeans or tofu) are particularly abundant in isoflavones, such as genistein and daidzein, which are weak estrogens and have been observed to reduce the incidence of experimental tumors in mammals (Barnes et al, 1990).
Barnes reported in the Journal of the National Cancer Institute that the isoflavone called genestein inhibits two enzymes necessary for tumor growth and reduces the blood supply to tumors (Mesina and Barnes 1991).
Women in Asia, where the diet is high in soy foods, usually consume more than 35 grams of soybeans or soy-derived food per day as opposed to the American woman who may only get 1-2 grams per day. Asian women have less menopausal symptoms and had a lower incidence of breast cancer.
However when Asian women come to America and adopt the traditional American diet, their postmenopausal symptoms increase as does their incidence of breast cancer.
Several studies have found a protective effect of soybean products against the development of breast cancer. The protective effect may be due to the fact that phytoestrogens can act both as weak estrogens and weak anti-estrogens. It is presumed the anti-estrogen effect on the breast confers protection against breast cancer.
Soy foods also appear to be useful in preventing or lessening the risk of osteoporosis and heart disease.
A 1990 study of 23 American women showed that a diet high in soy food and flax or linseed meal reversed the atrophic changes seen in the vagina after menopause.
A 1995 study of 58 post menopausal women showed that a diet high in soy decreased postmenopausal hot flashes. A study at the University of Illinois showed a significant increase in bone density after six months of a high soy diet.
Other Plant Anti-cancer Agents
Plants are loaded with anti-oxidants which inhibit cancer development. The free radical forms of oxygen also damage DNA and can cause the critical mutations in the chromosomal material needed to lead to malignancy.
In addition to the vitamin C family, the carotenoids family (or carotenes) is a large group of plant anti-oxidants which includes beta carotene. Carotenoid ingestion reduces the incidence of breast cancer by 20% (Hunter, 1993). Carotenoids are abundant in yellow, orange, or dark green colored vegetables (e.g. carrots, cucumbers and squashes).
Other protective plant antioxidants are the vitamin E family, plus the newly discovered tocotrienols which are similar to vitamin E. Other anti-oxidants are the polyphenols such as those found in green tea, and other substances known as phenolics and coumarins from in parsley, carrots and celery (Michnovicz, 1994).
Some bioflavinoids in fruits and vegetables also inhibit the production of the dangerous C-16 estrogen while increasing levels of safe C-2 estrogen (Yatsukawa 1988). One to two grams of bioflavinoids are present just a few servings of fruits and vegetables.
Bioflavinoids also are anticholesteremic agents which will lower the circulatory disease, heart attack, stroke and hypertension (Zemtsova and Bandyyukova 1982, Matsubara et al, 1987). The bioflavinoids naringen and quercetin make cells more resistant to invasion by viruses and environmental pollutants (Robinson et al, 1981, Beladi et al 1982, and Middleton 1984).
Anti-Estrogenic Fiber from Plants
Plants also contain insoluble fiber such as cellulose which can bind to any estrogen that passes from the liver to the intestine so that it is excreted from the body (Rose and Goldman, 1991). A lack of fiber in the diet lets the carcinogenically dangerous forms of estrogen be reabsorbed from the intestine back into the bloodstream from the gastrointestinal tract.
Why Fatty Diets Increase Estrogenic Cancer Risk
Fatty diets have two dangers. First, people who eat a calorie-dense fat-rich diet have less appetite for the protective fruits and vegetables and ingest far less of the protective plant factors.
Secondly, fat molecules within us also form "lipid peroxides" which damage cells. So the results of a fat-rich diet are both more damaging lipid peroxides in the body while the lack of appetite leads us to ingesting less of the protective plant factors.
Overweight women have 50% higher breast cancer rates than women of normal weight. Fat cells produce extra amounts of estrogen in women.
Before menopause, the extra estrogen produced by fat cells is compensated for by a biochemical feedback mechanism that reduces other estrogen production.
But this mechanism does not function well after menopause and more dangerous forms of estrogen are increased. The risk of breast cancer doubles after menopause.
Estrogen Plus Androgen Improves Libido
At menopause, in addition to the drop in estrogen levels, the amount of testosterone in women is reduced by half, resulting in diminished sexual desire, thinning pubic hair, flatness of mood, dry skin and decreased mental sharpness.
A 1997 study presented at a symposium entitled "The Emerging Role of Estrogen-Androgen Therapy in the Care of the Postmenopausal Patient," at the World Congress of Gynecology and Obstetrics in Copenhagen, Denmark found that adding small amounts of androgen to the ERT package restores failing libido along with reducing hot flashes and restoring decreased bone density, all consequences of menopause. Dr. Elizabeth Barrett-Connor of the University of California, San Diego, School of Medicine commented, “Androgen, for some women, is the 'missing hormone' of their postmenopausal years. Hormone therapy should be tailored to each individual according to symptoms, and combination estrogen-androgen therapy can be a significantly better option for some women than ERT alone. These findings are exciting because they add to a growing body of research showing one-size-doesn't-fit-all in hormone replacement therapy.”
Like estrogen, androgen production drops significantly after menopause but its replacement has been far less studied than estrogen. After menopausal many women experience a drop in sexual enjoyment and frequency of orgasm. "The decline of androgen levels after menopause is an important factor in the decline of sexual interest, yet libido remains a subject that many postmenopausal women -- and their doctors – are uncomfortable discussing," said Dr. Alex Vermeulen of the University of Ghent, Belgium. "But sexuality should be just as much a part of life after menopause as before."
A physician and psychiatrist, Dr. Susan Rako has written extensively on this topic. Her book, The Hormone of Desire: The Truth About Sexuality, Menopause and Testosterone can be purchased through her website at www.susanrako.com
Effective Herbal Therapies for Menopause
Many women report very good results with the use of various types of herbal therapies to reverse or mitigate menopausal changes. The National Institute of Health began a study in 1993 comparing ERT with alternative herbal methods, but the results won't be finished before 2003.
In 1936, Japanese scientists discovered a species of wild yam growing in Mexico contained a chemical called diosgenin, which is very similar to progesterone. According to Rosemary Gladstar in Herbal Healing for Women (Simon & Schuster, 1993), wild yam is "the most widely used herb in the world today" and over 200 million prescriptions yearly use the yam's progesterone-like compound. Also, certain varieties of soybeans hormone-like substances similar to human estrogen and progesterone.
While fewer clinical studies are available, one study found that soy isoflavones promote an anabolic (rebuilding) effect on bone density in post-menopausal women by binding to the estrogen receptors in bone tissue. Women who use soy products have lower breast and uterine cancer, fewer menopausal symptoms, and their incidence of osteoporosis also are reduced.
Leanna Standish, director of research at Bastyr University in Seattle, and Tori Hudson, Professor of gynecology at the National College of Naturopathic Medicine, reported that a double-blind placebo-controlled study with herbs traditionally used for menopause: dong quai, licorice, motherwort, burdock, wild yam resulting in 70% of women in the study gaining relief from hot flashes with these natural herbs.
Common items and their daily recommended dosages in such herbal therapies are:
| Soy extract isoflavones | 125 mg (about 55 mg genistein isoflavones, 52 mg daidzein isoflavones and 11 mg glycitein isoflavones) |
| Dong Quai Extract | 500 mg |
| Black Colash | 150 mg |
| Ginseng Root (panex) | 50 mg |
| Borage or Primrose Oil | 200 - 1,500 mg |
| Plant progesterone from Mexican yam roots (Dioscorea species) | 1 to 5 grams (varies with source) |
| Calcium | 800-1500 mg (for osteoporosis) |
| Magnesium | 400-750 mg (for decreasing irritability) (take calcium and magnesium in the evening to improve sleep) |
Other herbs used for easing menstrual difficulties include herb vitex (chaste tree) (said to help the pituitary gland balance estrogen and progesterone production), black cohosh, sage, alfalfa, and phytoestrogens found in citrus fruits, berries, cherries, whole grains, flax seeds, and plant fiber.
Also reported of value are the essential fatty acids in flax seed, borage and black currant oil, and the bioflavinoids found in the pulp and white rind of citrus fruits.
Tocotrienols Against Post-Menopausal Breast Cancer
Prof. Lester Packer recommends that post-menopausal women take a supplement of 100 milligrams daily of tocotrienols which appear to inhibit this type of breast cancer. Packer's ideas are detailed in a recent book "The Anti-Oxidant Miracle" (John Wiley and Sons, About $25). This is advice from today's best anti-oxidant research scientist.
The tocotrienols are from plants such as rice bran, palm fruit, barley, and wheat germ. These molecules will not replace the essential requirement for the vitamin E family but appear to block many of the degenerative changes of aging and are under intense investigation. Tocotrienols, also in alpha, beta, gamma, and delta isomers, are very similar to the vitamin E molecules but have three double bonds in the side chain of the molecule. Gamma tocotrienol is the major form in nature and appears to possess the strongest health benefits.
Tocotrienols in combination with vitamin E reduce the growth of breast cancer cells in culture, but vitamin E alone does not have this effect (Guthrie 1997).
Tocotrienols are present in low levels in rice bran oil and palm oil but obtaining health enhancing amounts of these tocotrienols would require consuming one cup per day of oil. Tocotrienol supplements are now available from vitamin and nutritional outlets.
Human Growth Hormone Reverses Aging Effects
HGH is used clinically to stimulate growth in children who grow too slowly. But it also improve skin and hair quality. HGH (also called somatotrophin) is produced in the pituitary gland in the brain. It influences the growth of cells, bones, muscles and organs. HGH peaks in adolescence when the most rapid growth occurs. If children have too little HGH, they become dwarfed, while if they have an excess they become giants.
HGH is one of the hormones, like DHEA, estrogen, melatonin, progesterone, testosterone that decline with age. The production of HGH falls 80% from age 21 to 61 which causes a loss of muscle, increased fat, and decreased physical mobility, socialization and energy levels. The decline in HGH is directly associated with many problems of aging, including wrinkling, gray hair, decreased sexual function, cardiovascular disease, osteoporosis and more.
Dr. Daniel Rudman of the Medical College of Wisconsin–Milwaukee (New England Journal of Medicine July 5, 1990) reported that, in a placebo-controlled study, HGH reversed aging effects in persons aged 61 to 81. Using injections of synthetically manufactured HGH, it was found that 6 months of injections reversed the aging process from 10 to 20 years in the patients who received HGH. In the control group that didn't receive HGH, the aging effects were not changed.
A later study between the years of 1994 and 1996 under the direction of Dr. Edmund Chein (Medical College of Wisconsin and Palm Springs Life Extension Institute) on the effects of growth hormone on humans has involved restoring HGH levels for 202 patients who are deficient in HGH. He reports that his patients increase their bone density by 2% and an increase muscle mass 10% every 6 months. Self assessment by patients resulted in improvements in muscle strength (88%), exercise endurance (83%), muscle size (81%), skin texture (71%), skin thickness (68%), skin elasticity (71%), wrinkle disappearance (51%), new hair growth (38%), and sexual potency/frequency (75%). There were decreases in the frequency of nighttime urination (57%), hot flashes (58%), and body fat loss (72%).
Some cosmetic surgeons use HGH to improve the quality of their surgeries. The administration of injected HGH causes many the organs of the body grow slightly, reversing the trends of aging, and it reverses osteoporosis. There are claims that it reverses cataracts. Some people over 50 have claimed it increases in sexual drive - back to the teen-age level.
Unfortunately, HGH has to be administered, like insulin, by needle injection, and currently costs $160 a week at this writing.
Gene Therapy For HGH Effects
HGH acts by causing the release of a second hormone called IGF-1 or Insulin Growth Factor 1. Dr. H. Lee Sweeny, of the University of Pennsylvania Medical Center, reported (Dec. 14, 1998) that the introduction of genes into old mice raised muscle mass by 27% and in young mice by 15%.
Humans lose 10% of their muscle mass each decade after age 50. The scientists introduced the genes into muscle tissue by using a virus called an adeno-associated virus. They first stripped the virus of disease causing genes, the attached the genes for IGF-1.
The virus was then injected into muscles were in entered the DNA of the muscle cells and began producing IGF-1. The use of such a gene therapy in humans would eliminate the need for HGH injections.
Low Cost Human Growth Hormone Releasers
An alternative way of increasing HGH, without injections and the high cost, is the use of natural HGH releasers or agonists known as secretagogues. These nutrients coax the pituitary to release more HGH.
Scientists find that as we grow older we still produce HGH, but blood levels decrease because the pituitary gland does not release the HGH.
The method used to release HGH is the use of "stacks" of amino acids and various metabolic intermediates.
The technique arose from experiments by muscle builders who found that the ingestion of simple molecules such as creatine and chromium picolinate would help increase in muscle mass without restore to steroids.
HGH–releasers are amino acids (such as arginine, lysine, ornithine, and glutamine), GABA (gamma–aminobutyric acid), extracts from the pituitary of cattle, various glucose or carbohydrate polymers, and extracts of "broad bean". These combinations release insulin as well as HGH. Insulin Growth Factor 1 (IGF-1) which mediates the actions of HGH is also increased.
How effective are such releasers? There are few independent controlled studies (probably because of a lack of patent protection) but enough experimental evidence exists to support the use of the products.
They are very similar to the muscle-building “stacks” of biochemicals that muscle builders use very effectively to build up their muscle mass. They are all very safe amino acids. Effective use of such releasers costs from $3 to $4 per day.
One twelve week study of HGH secretagogues found patient experienced a 30% average increase in IGF-I level plus enhanced energy and less body fat but more muscle. Faster hair growth and improvements in hair (less gray) and skin color occurred between the eighth and twelfth weeks.
This study used a combination of anterior pituitary peptides, sequenced glycoamino acid complexes, pharmaceutical saccharides, a plant-derived source of L-dopa and other botanical regulators of HGH release (Jamieson & Dorman, The Role of Somatotroph-Specific Peptides and IGF-1 Intermediates as an Alternative to HGH Injections, Presented for the American College for Advancement in Medicine, October 30, 1997; Klatz, R., Grow Young With HGH, Harper Collins Publishers, Inc., New York, NY 1997).
Sources of such products can be found on the Internet by searching “HGH releaser”.
DHEA for Moisturizing Skin
Dry skin is an increasing problem with age. DHEA is a hormone that is used to manufacture of many other hormones that improve your body's function. Because DHEA decreases with age, both with normal aging and after particularly after menopause, many physicians supplementing their patients' diets with DHEA. In one study, the average plasma DHEA was 542 in pre-menopausal women, 197 in post-menopausal women, and only 126 in a post-hysterectomy women. In a group of women between the ages of 55 and 85 years, women with higher levels of DHEA had a greater bone density of the spine and greater bone mass than those with lower DHEA levels. You take it orally, it's inexpensive, and has a positive effect on overall functioning and energy levels. There is some concern about the possibility that DHEA may increase prostrate problems in men. Thus, high dosage (above 25 mg per day) should be avoided by men.
Interestingly, DHEA turns on oil production by the skin. Skin creams containing DHEA have been reported to be very effective in increasing skin oil production on dry skin. Dr. Norman Orentreich has patented a DHEA cream for skin use. Information can be found at www.orentreich.com
Cost of Dietary Supplements and Foods
While, in a perfect world, it might be possible to eat a diet to obtain all the necessary anti-cancer and anti-oxidants from plants, it is very difficult in a practical sense.
The option is to supplement the diet with the concentrated substances and to also use a supplement to bind as much of the fat as possible (such as the drug Colestid or non-drug products made of processed chitin) so that it will not be absorbed.
But supplements can get expensive. There is no easy answer. The question is really “What is it worth to greatly reduce your risk of getting cancers and other degenerative diseases?” But, in general, the costs of supplements can be somewhat offset by eating a more healthy, but less costly diet with more fruits and vegetables.
Swedish researchers (Gerhardssen and Donahue, 1988) estimate that the number of cancer cases in males could be reduced by at least 30-40% and in females more than 60% by changes in the food that gets absorbed into our bodies via the gastrointestinal tract. Other estimates increase this percentage up to as high as 70% (Doll and Peto, 1981).
The breast cancer rate in the more affluent countries is about 10 and 15 times the rate in poor countries such as Thailand or El Salvador. Why? In the poorer countries, people eat large quantities of fruits and vegetables (Cohen, 1987).
Harvard Medical School researchers have found that low fat diets are effective in reducing colon cancer (Willett et al, 1992). A review of 88 studies of 10 different types of cancer, concluded that a diet high in fruits and vegetables dramatically reduces all the cancers (Steinmetz and Potter, 1991). For example, the risk of uterine cancer is lowered by approximately two thirds.
Progesterones and Natural Progesterones
Wild yams (Dioscorea villosa) produce a compound used by the pharmaceutical industry to synthesize progestogens. Many PMS and menopausal remedies contain wild yam or Mexican yam extracts. While many women report positive effects of Dioscorea, it is not the same as progesterone.
Dydrogesterone, Duphastan®, and Prometrium® are natural progesterone in use in Europe, Asia, Africa and Australia.
The following table lists a number of available progesterones. The purpose of this table is to give you some idea of the diversity of progesterone options that are available. Often a women who has difficulty with one product, may find another that works well for her. We do not claim this table is a complete listing.
| Brand Name | Type of Progesterone | Available Dosages | Distributor |
| Prometrium® | Natural Progesterone | 100 mg | Solvay |
| Amen® | Medroxyprogesterone Acetate | 10 mg | Carnick |
| Curretab® | Medroxyprogesterone Acetate | 10 mg | Solvay |
| Cycrin® | Medroxyprogesterone Acetate | 10 mg, 5 mg, 2.5 mg | Wyeth-Ayerst |
| Provera® | Medroxyprogesterone Acetate | 10 mg, 5 mg, 2.5 mg | Upjohn |
| Aygestin® | Norethindrone Acetate | 5 mg | Wyeth-Ayerst |
| Nortulate® | Norethindrone Acetate | 5 mg | Parke-Davis |
| Nortulin® | Norethindrone | 5 mg | Parke-Davis |
| Megace® | Mesgesterol Acetate | 20 mg, 40 mg | Bristol-Myers Squibb |
| Micronor® | Norethindrone | 0.35 mg | Ortho Pharmaceutical |
| Ovrette® | Norgestrelt | 0.075 mg | Wyeth-Arest |
| Nor-QD® | Norethindrone | 0.35 mg | Syntex |
| Nor-QD® | Micronized Oral Progesterone | 100 mg | Syntex |
| Nor-QD® | Progesterone Vaginal | 25 mg | Syntex |
| Nor-QD® | Suppositories | 50 mg | Syntex |
References
Callens 1996 - Callens A; Vaillant L; Lecomte P; Berson M; Gall Y; Lorette G, Does hormonal skin aging exist? A study of the influence of different hormone therapy regimens on the skin of postmenopausal women using non-invasive measurement techniques, Dermatology 1996;193(4):289-94
Questions or Advice?
Email Dr. Loren Pickart at drlorenpickart@gmail.com
Call us at 1-800-405-1912 Monday Through Friday (8 am to 6 pm) PST