During menopause, a woman undergoes profound and extreme biochemical changes in all aspects of her body. It can be one of the most trying periods in a woman's life. Lasting up to 10 years, the menopausal transition includes well-known symptoms such as hot flashes, night sweats, mood swings, and sleep disturbances.1-5 Menopause also increases the risk of heart attack and stroke,6 depression, osteoporosis, arthritis, dementia, and frailty.3
While the troubling symptoms of menopause gradually fade as a woman completes the menopausal transition, the health risks remain or grow larger. By World Health Organization estimates, 1.2 billion women worldwide will be postmenopausal by the year 2030, making these health risks an impending public health disaster.3 And managing those symptoms is a clinical challenge, with few safe and effective options.2
Until the turn of the 20th century, the standard management of menopause included administration of equine estrogens derived from horse urine (Premarin®) and progestin; a synthetic female hormone that is different than natural progesterone.7
Fortunately, just when the risks of conventional hormone therapy were becoming evident8, data emerged showing that estrogen-like molecules from plant sources (phytoestrogens) could produce many of estrogen's favorable effects minus most of the harmful ones. A 2013 study showed that these phytoestrogens were effective at decreasing hot flashes, irritability, and sexual problems.9
Use of estrogen-like molecules from plant sources is growing increasingly popular, and intense scientific research has begun to reveal the remarkable effectiveness of plant extracts in achieving relief of menopausal symptoms, while at the same time providing protection against some of the very conditions that conventional hormone therapy is notorious for causing.10-13
Two important plant extracts lead the field in bioidentical hormone therapy for relief of menopausal symptoms. Prenylflavonoid molecules in hops include the most potent phytoestrogen discovered thus far,14-17 while lignans found in the Norway spruce combine mild estrogenic actions with potential anticancer, antimicrobial, anti-inflammatory, and immunomodulatory activities that neatly fill the needs of women as they approach and transition through menopause.18
Women who are undergoing or nearing menopause, and who would like to prevent or mitigate menopausal symptoms such as hot flashes and sleep disturbances, are increasingly interested in natural phytoestrogens from hops and spruce as an alternative to mainstream hormone replacement therapy.
A Natural Solution For Menopausal Symptoms
Hops are the female flowers of the hop plant (Humulus lupulus). Their bitter, floral taste has been used for centuries as a flavoring and natural preservative in beer.14,19 But they also contain specialized glands that secrete powerful bioactive molecules with significant potential impact on human health.15,20
Among these compounds is a molecule called 8-prenylnaringenin (8-PN), which research suggests is the most potent known phytoestrogen (plant-derived estrogen-like molecule).14-16, 21-23 These estrogenic properties make hops and 8-PN extremely attractive for use during menopause, when estrogen levels drop and produce the disquieting symptoms of menopause.21
The estrogenic properties of hops extracts, and particularly of 8-PN, are known to alleviate menopausal symptoms and disorders, including osteoporosis, hot flashes, and low sex drive.17 8-PN is known to be rapidly and almost completely absorbed after oral dosing.24
Studies in rats whose ovaries had been removed in order to produce experimentally-induced menopause show that the animals underwent hot flashes, just like women. Administration of either estrogen or 8-PN from hops was able to reverse these symptoms (measured as increased temperature of the tail skin).25 Further studies revealed that this effect is at least partly the result of 8-PN binding to and activating estrogen receptors in tissues outside of the brain.25
In a human study, women undergoing menopause took a hops extract standardized to 100 or 250 micrograms/day of 8-PN or a placebo for 12 weeks. Even the lower dose of 100 micrograms 8-PN was significantly superior to placebo at reducing symptoms of menopause after only six weeks, especially the hot flash score on a standardized menopause scoring scale.26 A similar study, using 100 micrograms/day of 8-PN, demonstrated significant reductions after eight weeks of therapy on the same scores, as well as a patient-reported visual scale of menopausal symptoms.27
Cut Hot Flashes In Half
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The Norway spruce (Picea abies) produces abundant quantities of the plant lignan 7-hydroxymatairesinol, or HMR. In the digestive tract, HMR is converted to an active compound called enterolactone.18,33-35 Both HMR and enterolactone are mild phytoestrogens, and as such, offer additional support for women undergoing menopausal transition.18,35,36
In one important study, menopausal women supplemented with either 36 or 72 mg of HMR lignan per day for eight weeks.37 The supplement was readily absorbed and distributed in the women's bodies, raising 7-HMR levels in the blood by 191% in the lower-dose group, and by 1,238% in the higher-dose group. The higher dose also produced a 50% reduction in the mean number of weekly hot flashes, from 28 to 14.3.
Nutrients Proven To Ease Menopausal Symptoms
In addition to the benefits provided by phytoestrogens and other protective molecules in hops polyphenols (8-PN) and spruce lignans (HMR lignan), a handful of other nutrients have shown promise in easing the menopausal transition and protecting against breast cancer. Here is a brief summary of some of the most effective nutrients:
- Cruciferous vegetables, especially broccoli, are rich in biomolecules called isothiocyanates, which are potent inhibitors of liver enzymes that activate potential carcinogens, including estrogen. As a result, consuming cruciferous vegetables promotes breast health and can reduce the risk of breast cancer by as much as 40%.48 Eating large amounts of broccoli (more than a pound per day) shifts the important ratio of estrogen 2:16 hydroxy metabolites in favor of the protective 2-hydroxy molecule.45 In order to get the most benefit, consider taking concentrated broccoli extracts.
- Dong quai has a long history of medicinal use in Asia for menopausal symptoms.49 Modern studies reveal that extracts of the plant have estrogenic effects in menopausal rats, suggesting a mechanism of action for its ancient properties.49 There is also some evidence that extracts may be useful in treating female arousal disorders, which are common around the time of menopause.50
- Vitex agnus-castus (Chasteberry) contains compounds in both the berry and the leaf that have been shown to induce relief of common menopausal symptoms.51,52 Studies attribute these effects to activation of estrogen receptors, indicating that the plant has beneficial phytoestrogen properties.53
How To Measure Breast Cancer Risk
Of special importance, a recent study demonstrated that when HMR lignan is combined with indole-3-carbinol, a beneficial compound in broccoli and other cruciferous vegetables,41 it produces a vital shift in the ways that natural estrogen is metabolized in a woman's body.42
Although estrogen is a natural hormone produced by both women and men, it undergoes chemical changes through the actions of enzymes in the liver. One of those enzyme systems produces so-called 2-hydroxy estrogen breakdown products, while the other produces 16-hydroxy versions of the molecule.43 The 2-hydroxy version appears to offer protection against breast cancer,44 while the 16-hydroxy version remains powerful enough to raise a woman's chances of developing breast cancer.45 The ratio of 2-hydroxy to 16-hydroxy molecules is therefore a good measure of a woman's breast cancer risk, with the higher the ratio (meaning more beneficial 2-hydroxy and less dangerous 16-hydroxy), the lower her risk.43,46 In the recent study, a breast health nutritional formula containing HMR lignan plus indole-3-carbinol was shown to be capable of shifting estrogen metabolism toward the 2-hydroxy version and raising the 2:16-hydroxy ratio; an important step in minimizing the risk of breast (and possibly other) cancers.42 This is in line with other studies demonstrating that consumption of cruciferous vegetables nudges the 2:16-hydroxy ratio in a direction that favors protection from breast cancers.45,47
Replacing estrogen lost to menopause was once relegated to taking unnatural-to-the-body estrogen drugs and dangerous synthetic progestins (which is not the same as progesterone). These pharmaceutical approaches are declining as maturing women insist on natural hormone replacement protocols.
Treatment with plant-derived, estrogen-like molecules called phytoestrogens and natural progesterone are showing great promise in relieving symptoms of the menopausal transition and at restoring some of the protection enjoyed by premenopausal women against cancer and other chronic conditions.55
Extracts of hops and Norway spruce are rich in such phytoestrogens, as well as in other molecules that protect women against low-estrogen-induced conditions. These molecules have now been studied and appear to lead the field in the combination of symptom relief and protective effects.
Additional plant extracts, many of them in use for centuries in traditional medical systems, can add further symptomatic relief and disease-preventive effects. These natural plant derivatives are increasingly being made available in convenient combination formulations.54
Reprinted with kind permission of Life Extension
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- Cosentino M, Marino F, Ferrari M, et al. Estrogenic activity of 7-hydroxymatairesinol potassium acetate (HMR/lignan) from Norway spruce (Picea abies) knots and of its active metabolite enterolactone in MCF-7 cells. Pharmacol Res. 2007 Aug;56(2):140-7.
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