Eating right, avoiding things like alcohol and stress can help
By Deborah Jeanne Sergeant
Beginning in their 40s or 50s, most women experience at least some of the symptoms of menopause as their ovaries stop making reproductive hormones.
The symptoms can include hot flashes, night sweats, mood swings, low libido, fatigue and weight gain. Hormone replacement therapy can mitigate these effects. However, for those who cannot or do not want to take that route, other strategies can help.
Night sweats and anxiety can hamper the ability to sleep well at night. Soda Kuczkowski, sleep health educator and owner of Start With Sleep in Buffalo, said that addressing a magnesium deficiency can also help with sleep in menopausal women.
“Eighty percent of the population is deficient of magnesium, which controls so many different things,” she said. “If you have ample levels of magnesium, it can offset it. If you’re hot, you can’t sleep.”
Measures such as supplementing to address dietary deficiencies, improving overall health and obtaining sufficient sleep may all mitigate the effects of menopause for some women. But Vanessa Barnabei, OB-GYN and professor of OB at Jacobs School of Medicine and Biomedical Sciences at UB, said that none of these are FDA approved.
“In all the hormone therapy trials for hot flashes, there’s a huge placebo effect,” Barnabei said. “If you’re doing a study and hormones versus nothing, even the women on nothing get better for a while.”
While some natural approaches may improve symptoms for a few months, “none of these make hot flashes go away 100% except estrogen,” Barnabei said. “That’s unrealistic for women doing non-medical things.
Acupuncture, paced breathing, and yoga: little data supports any one of them. They all help some people a little bit but nothing has the same effect as estrogen.”
She said that although soy products gained notoriety for a while, it is difficult to consume enough soy through the diet and supplements work better to ensure patients get enough.
“They are soy isoflavones,” Barnabei said. “They have estrogen-like qualities. It’s easier to get those in a supplement. They have some data to support benefit and are probably safe.”
Fezolinetant, a non-hormonal medical therapy not yet FDA approved, may offer help. Barnabei said that it affects pathways in the brain that influences hot flashes. She expects FDA approval, as it has both efficacy and safety profiles.
“I think that will be helpful for women who can’t or don’t want to take hormones,” Barnabei said.
She said that losing weight may help some women reduce hot flashes, as well as reducing alcohol, caffeine and stress.
“There are a lot of options,” Barnabei said. “A lot of providers are uncomfortable with estrogen but don’t know a lot of the good options for women, leaving them without any options. That’s when women turn to Google and the internet and see things that worked well for other women.
“In a few years, they will get better on their own. If they need something to help, it may be worth trying.”
But she also warned, “natural” does not necessarily mean “safe.” Before trying any dietary supplement, patients should consult with their healthcare provider to ensure that the supplement is not contraindicated for other health conditions or medication.