While shopping in a health food store, I watched women piling their carts high with herbs and remedies that promised relief from menopausal symptoms, and I listened to a conversation between a middle-aged woman and a very young, female clerk. The customer was asking where she could find "Lydia Pinkham's Vegetable Compound." She explained that her concerns included dealing with hot flashes that left her looking like "a red, perspiring tomato" during the day and feeling like "a dripping sponge" during her fitful, sleeping hours. The clerk was totally clueless. I couldn't resist volunteering information I had learned about this preparation that countless American women have used in the past, including my own grandmother.
A package insert from a bottle of Lydia E. Pinkham's Vegetable Compound states:
At a certain age, Nature frees women of the child-bearing function, because the rigors of motherhood are more easily born in earlier years ... Instead of being a curb on health and happiness, menopause can leave women freer than she has been since she began menstruating. But for those who do suffer from 'hot flashes,' irritability and 'high strung' feelings, there is a tested way of finding relief.
Lydia E. Pinkham's Vegetable Compound, containing a mixture of the herb black cohosh and a prodigious belt of alcohol, is actually a relatively "modern" herbal remedy for menopausal complaints. It was patented in 1875, a mere 140 years ago and apparently is still available today, albeit somewhat difficult to find.
Women have historically used herbs for medicinal and healing purposes. Steeped as tea, crushed, dried, or ground into powder, plants and herbs have been taken or applied by women for hundreds of years in this country, and for thousands of years elsewhere in the world, to ease the pain of childbirth, soothe headaches, alleviate digestive problems, relieve menstrual cramps, improve the skin, eliminate joint pain, induce sleep, and lessen anxiety or depression, to name only a few uses.
We've seen a boom in interest in herbal, "natural," or "alternative" medicine, with best-selling books and major newsmagazine cover stories devoted to the powerful properties of plant-based remedies. I prefer the term "complementary" medicine to "alternative" -- it eliminates an artificial and unnecessarily adversarial division between so-called conventional or high-tech medicine and other kinds of medicine. I also prefer not to think in terms of "Eastern vs. Western medicine," or "big pharmaceutical companies versus ordinary citizens." I don't see an either/or approach, with battle lines drawn between two sides. Rather, I see women who are resourceful and excited as they research, ask questions and exchange information about new ways to take charge of their health.
Women and health care professionals who have shared their views on complementary medicine and menopausal health with me can be loosely organized into three groups:
1. Those for whom complementary medicine is a useful first line of offense, an initial step in relieving certain menopausal symptoms before exploring prescription options.
2. Those who view complementary medicine as a part of a self-care plan, used in conjunction with prescription therapy as a means of additional symptom relief and/or maintenance of well-being.
3. Those for whom prescription therapy is not an option, for personal or medical reasons or both, and who choose complementary medicine as their primary method of care.
I also encounter women who initially explore complementary remedies for menopausal symptoms, thinking that it will be easier to buy a product over the counter than to see their health care provider and sort through often contradictory and sometimes alarming information about prescription hormones. But it's not always easier.
There is a wealth of complementary options for managing menopausal symptoms. There are also challenges:
• What to take.
• How much to take, and in what combination with other medications.
• When to take it.
• If there are side effects.
• Where to find a quality product.
Just because a product is over the counter doesn't mean that it is safe, much less effective. And, remember that the old adage of "if a little bit is good, more is better" doesn't apply here. Recently, a woman told me that she was sure that her herbal preparation was natural and therefore she was convinced it couldn't be a problem. I reminded her that arsenic is also natural, but not necessarily good for us.
Among the women I talk to, there's a buzz of excitement and lots of networking as we look for ways to make our menopausal transition very different from our mothers'. Evaluating complementary remedies requires the same kind of vigilance we use when we evaluate any prescription hormone option for menopause. As I have done my own investigation about herbal remedies, talked with professionals and women who use them, and tried a few myself, these principles have been helpful in choosing among the many, many, complementary products available to us now:
• Decide which symptoms you most want to manage. That will help you prioritize among certain products.
• Educate yourself about including herbal or complementary remedies in your own self-care plan.
• Enlist the help of a knowledgeable professional who can guide you as you select, combine and monitor the effects of any herbs you may choose.
• Keep in mind that herbal is not a synonym for benign, and that in fact some plants are highly toxic, even deadly. Never assume that an herbal or natural preparation is harmless; thoroughly investigate everything you decide to put in your body.
• Bring your health care provider into the loop.
• Read labels carefully. The quality of some herbal preparations varies widely. If the label makes it hard to understand how much of a particular herb or other ingredient is in a product, look for another brand.
• Remember that some herbs or plant-based medicines exert very potent influences on the body.
• Be a wise consumer. Just as no prescription hormone will be a cure-all or silver bullet for all menopausal symptoms, the same is true for herbs and other complementary medicines. If a claim seems exaggerated, it probably is.
Just as we have explored many options in the past regarding our health, we can make well-informed, responsible decisions as we move through this time in our lives. With the assertiveness that comes with experience, the ability to know our own minds, and the wisdom about what is right for us, we are changing the path women walk during menopause. Whereas women once had little choice but to make this journey as if through a tunnel, guided only by faint light and with no freedom to stray from the course, we walk now in bright daylight, with possibilities for good health nearly as boundless as the reach of the sky above us on a perfect day.
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