Menopause is an important and at times traumatic time in a woman's life. Her body is going through many changes (most of the time new to her) that can affect her socio-economic life that may requires her to make certain amount of adjustment. Even though menopause is a natural step in the process of aging, many women are still apprehensive about it because they do not know how severe is the new adjustment is going to be. Not many look forward to this new discoveries and fresh challenges because we are all creatures of habit. We rather choose to be comfortable than be thrust into the unknown.

Menopause is the medical term for the end of a woman's menstrual periods. Menopause is a natural part of aging. Menopause problem begins when the ovaries stop making hormones called estrogens. When the estrogen levels of the body drops, the monthly menstrual periods is affected. Menopause period can happen anytime after the age 45 or at times earlier. Menopause can also happen when the ovaries have been surgically removed.

When the body experiences low estrogen levels it exhibits certain body symptoms. The most common is hot flashes. Some women find it irritable and it can affect their sleep. It can also affect the mood. Other symptoms may include inflammation of the vagina and irregular periods. Because of the changes in the urinary tract and vagina, some women may have discomfort or pain during sexual intercourse. Eventually it may cause osteoporosis and increase risk of heart disease.

The changes during this period is not instantaneous. During this period of gradual change the body begins making less female hormones (estrogen and progesterone) and gradually it develop into full blown menopause.

Estrogen and Progesterone and Menopause

To understand menopause one has to understand the role of estrogen and progesterone. Estrogen plays a very important role in shaping the female body. Estrogen is vital for the development of breasts and hips, vagina, uterus and other female organs. Estrogen and pregnancy are closely interlinked.

Together with progesterone, estrogen regulates the changes that occur with each monthly period and prepares the uterus for pregnancy. More than 90% of the estrogen in a woman's body is made by the ovaries. The rest of the organs like the adrenal glands, liver, and kidneys make the rest of the estrogen. Women who are overweight when they are going through menopause may have fewer problems with hot flashes and osteoporosis because fat cells can also make small amounts of estrogen.

Apart from the above functions, estrogen also stimulates skeletal growth and helps maintain healthy bone density. It also helps to improve the health of the cardiovascular system by increasing 'good cholesterol' (HDL or high-density lipoprotein) and lowering 'bad cholesterol' (LDL or low-density lipoprotein) and in relieving menopausal symptoms.

Like estrogen, most progesterone is made by the ovaries, with a smaller amount made by the adrenal glands. It is second to estrogen in importance. The job of progesterone is to:

• Prepare the uterus so that the fertilized egg can grow and develop into a baby
• Help the breast to produce milk
• Maintain pregnancy

Symptoms of Menopause

About 80% of women report dislike the symptoms of menopause. The most common symptoms are:

• Night sweats, or hot flashes during sleep,
• Problems falling or staying asleep,
• Rapid mood swings or overall changes in mood, such as depression or irritability,
• Vaginal problems such as, dryness, irritation and frequent vaginal infections,
• Urinary problems, including burning or pain when urinating, or leaking when sneezing, coughing, or laughing,
• Difficulty concentrating or remembering,
• Diminished in sex and/or a change in sexual response,
• Weight gain,
• Hair thinning and/or hair loss,
• “Spotting” and/or abnormal bleeding.

Health Changes after Menopause

Osteoporosis

Osteoporosis is the thinning of  bones in a woman's body. After menopause women lose more bone than men. The part of the body most affected are the spine, wrists and hips.

Normally women are asked to consume synthetic estrogen. The problem with this drug is that it has been scientifically proven to cause cancer. Other methods of strengthening the bones is to consume more calcium based products. Plant based calcium found in herbs and fruits are the best source as they have been predigested by the plants and are easily absorbed by the body. The absorption rate of calcium tablets are only about 10% to 15%. Many women cannot tolerate it as they cause some physical irritation.

Heart disease

After menopause, women are more prone to heart disease. It is one of the leading cause of death in women after menopause.

The best way to control the adverse effects of menopause is to increase consumption of herbal supplements i.e. food rich in phytonutrients. Some plants contain plant hormone that can assist the women to arrest the effects of declining estrogen and progesterone levels.

Over the centuries, women has found plant estrogens to be effective for treating menopausal problems. Estrogens can be found in ginseng,  licorice root, red raspberry leaves, sarsaparilla, spearmint, damiana, motherwort, and wild yams. These Chinese herbal remedies and plant remedies from other cultures may be effective in treating hot flashes. Scientific research on herbal formulations containing Angelica Sinensis (Danggui) and Glycyrrhiza Glabra (licorice) was found to be effective in treating menopausal problems. Another formulation combines peony root (Paeonia Lactiflora) with dong quai and four other herbs and has been found to effectively reduce symptoms of cramping and pain associated with dysmenorrhea (painful menses). Research has shown that glabridin from Glycyrrhiza Glabra has positive menopausal and phytoestrogen effect.

These plants contain plant hormone that can assist the women to arrest the effects of declining estrogen and progesterone levels. Clinical studies have shown that phytoestrogens (from plant source) are among the dietary factors affording protection against cancer and heart disease and other menopausal problems. Below are extracts of researches that confirm that the folklore use of these herbs are not without scientific basis

Osteoporosis: Clinical studies by western scientists have shown that enhancement of osteoblast function caused by glabridin (phytochemical of licorice root) can help prevent osteoporosis and other inflammatory bone diseases.  130-701

Estrogenic Proof:

1) Clinical research by western scientists have shown that glabridin and glabrene from licorice roots exerts estrogenic activity.  91(4-5):241-6 

2) Clinical research by western scientists have shown that isoliquiritigenin and glabrene from licorice roots exerts estrogenic activity. 960-0760

3) Clinical studies by western scientists have shown that licorice root extract may be helpful for treating symptoms associated with premenstrual syndrome (PMS). Studies have shown that the extract has estrogenic activity and may help to regulate the estrogen-progesterone ratio.  39: 177-80.

4) Clinical research by western scientists have shown that glabrene, an isoflavene exerted varying degrees of ER (estrogen receptor) agonism in different tissues. 78(3):291-8

Heart Disease:

1) Clinical research by western scientists have shown that phytoestrogens (from plant source) are among the dietary factors affording protection against cancer and heart disease. 87:897-904

2) Clinical research by western scientists have shown that glabridin is a phytoestrogen, binding to the human estrogen receptor and stimulating creatine kinase activity in rat uterus, epiphyseal cartilage, diaphyseal bone, aorta, and left ventricle of the heart.  5704-5709

3) Clinical studies by western scientists have shown that two natural compounds derived from licorice root: glabridin, the major isoflavan, and glabrene, an isoflavene, both demonstrated estrogen-like activities and be used as a new agent for modulation of vascular injury and atherogenesis for the prevention of cardiovascular diseases in post-menopausal women. 147-55 

4) Clinical research by western scientists have shown that Glabridin (an isoflavan isolated from Glycyrrhiza glabra) being the most abundant and potent antioxidant and, as LDL oxidation is a key event in the formation of the early atherosclerotic lesion, the use of these natural antioxidants may be proven beneficial to attenuate atherosclerosis. 99893

5) Clinical research by western scientists have shown that the in vivo and in vitro reduction of the susceptibility of LDL to oxidation obtained with glabridin, may be related to the absorption or binding of glabridin to the LDL particle and subsequent protection of LDL from oxidation by inhibiting the formation of lipid peroxides and oxysterols, and by protecting LDL associated carotenoids. 68736

6) Clinical research by western scientists have shown that the antioxidant effect of glabridin on LDL oxidation (development of heart disease) appears to reside mainly in the 2' hydroxyl. 41259

7) Clinical research by western scientists confirmed the validity of the historical use of the drug, Paeonia Lactiflora for improving liver functions by preventing liver damage and micro-circulation disorders.  41991.

Cardiovascular Effects:

1) Clinical research by western scientists have shown that several compounds isolated from licorice roots (glabridin is the most abundant and active), were shown effective against LDL oxidation (protects against cardiovascular disease).³⁵ Plasma LDL from 10 normal subjects was found to be more resistant to oxidation following 2 weeks of administration of 100 mg of licorice root per day.³⁶ These effects could be important since oxidized LDL cholesterol is associated with accelerated atherosclerosis. Isoliquiritgenin isolated from licorice inhibited platelet aggregation (prevents blood clot in blood vessels) both in vitro and in vivo.³⁷  Abstract from an article written by Wendell L. Combest, Ph.D. Associate Professor of Pharmacology, Department of Pharmaceutical Sciences, Campbell University School of Pharmacy, Buies Creek, NC

2) Clinical studies by western scientists have shown that glabridin and glabrene bound to the human estrogen receptor, exhibited varying degrees of estrogen receptor agonism in vitro and in vivo, demonstrated estrogen-independent inhibitory activity on the growth of breast cancer cells and inhibited serotonin re-uptake which may be beneficial as antidepressant agents.

• Snait Tamir, Mark Eizenberg, Dalia Somjen., Naftali Stern, Rayah Shelach, Alvin Kaye, and Jacob Vaya. Estrogenic and Antiproliferative Properties of Glabridin from Licorice in Human Breast Cancer Cells. Cancer Research. 2000, 60, 5704-5709.

• Snait Tamir, Mark Eizenberg, Dalia Somjen, Sarit Izrael and Jacob Vaya. Estrogen Like-Activity of Glabrene and other Constituents Isolated from Licorice Root. J Steroid Biochem Mol Biol. 2001. 78:291-298.

• Snait Tamir, Sarit Izrael, Jacob Vaya. The Effect of Oxidative Stress on ERa and ERb Expression. The Journal of Steroid Biochemistry and Molecular Biology (August - 2002), 81

• Jacob Vaya, Dalia Somjen and Snait Tamir., (2002) Estrogen-Like Activity of Licorice Root Extract and its Constituents. Submitted for publication in: Herbal Medicines: editors; Lester Packer and Barry Halliwell, Publisher- Marcel Dekker Inc.