Analysing for the products of collagen breakdown is not quite specific to bone, however. Arthritic conditions  also involve collagen breakdown, as does the spread of cancer secondaries through the tissues. Collagen from these different sites varies in composition and that may, perhaps, be distinguished in the analysis. However, bone also releases osteocalcin, alkaline  phosphatase enzyme, calcium and phosphate, which are not released from other collagen containing tissues. Those combinations are distinctive.

This serves to give the reader an idea of what can be achieved by biochemical  monitoring.  Such measurements are not routinely available to women who may be concerned about their bone density. Without them it is very hard to know just how you are doing in this respect. Perhaps more biochemical monitoring might become available in the future.

Nutritional Treatment of the Other Symptoms of the Menopause

When one comes to study symptoms of the menopause other than osteoporosis there is much less experimental data available.  One reason for that it is that many of the symptoms are very non-specific. They may well be more common at the menopause, but they are symptoms anyone could get at any time, such as depression, irritability, mood swings etc. Because they are not specific menopausal symptoms, little work seems to have been done on them within the context of the menopause. Much more specific symptoms are hot flushes, vaginal dryness, night sweats and palpitations. Hot flushes (“flashes” in the US) and night sweats are connected as both relate to temperature  control.  Without  question, these are more difficult to treat nutritionally than is osteoporosis, probably because they seem to be  very specifically connected with the hormonal readjustments of the menopause itself. They are more easily controlled by hormone replacement therapy than anything else, if one is prepared to accept the disadvantages that go with that treatment. If one rejects hormone replacement therapy for whatever reason, then the situation places a heavy premium upon somehow getting sources of phytoestrogens, which, as described already, seem to be able to significantly support the woman’s oestrogen status. This could be done, at least in part, through diet, i.e. by eating those foods already listed above, that have significant phytoestrogen content. The alternative to that is to use concentrates of the actual phytoestrogens derived from the foods that contained them.

PHYTOESTROGENS 

The principle behind the use of phytoestrogen concentrates is partly that of convenience. Eating a diet largely composed of brown rice may be partly effective but highly inconvenient. The same would be true of a diet composed largely of soya beans. Indeed, such heavily imbalanced diets may be inadvisable for other reasons in the longer run. If the fraction of the food solids, which contains the phytoestrogen, is concentrated into a small volume, it can then be taken in much the same way as an ordinary food supplement. This could be done with gamma oryzanol, the phytoestrogen concentrate from rice, or with genistein, a phytoestrogen from soya bean.

The effectiveness of gamma oryzanol has been demonstrated by Ishihara, M (20) this study showed that according to an index of menopausal symptoms, 85% of cases were successfully treated by use of 100mg of the product three times daily. There are several other such studies.

A study was done on a selection of less specifically menopausal symptoms by Horoschak A. (21) (Epistaxis means nosebleeds). Success rates of 75 to 100% were noted with intakes of 400mg/day each of hesperidin and ascorbic acid (vitamin C). Hesperidin, a bioflavonoid, comes from oranges and lemons and has also been referred to as “citrin” and as vitamin P. It has also been shown to eliminate or reduce hot flushes, 87% of patients responding to the treatment. Clinically, some workers have noted the same response from moderate to high doses of vitamin C. It is speculated that this may be due to the vitamin C increasing the bioavailability of oestrogens in the body, but further research is needed.

VITAMIN E  

Numerous studies have demonstrated that Vitamin E reduces the severity of hot flushes and other symptoms associated with menopause. In the clinical trials, doses ranged from 10- 100 mg daily. (100 IU = 67 mg). Around 100-200 IU can be recommended to ensure the intake is sufficient, provided that this is not contraindicated by high blood pressure, malignancy or use of the drug Warfarin. Indeed, anyone who is taking a medical drug should seek advice before using any of the supplementations suggested herein.

CHROMIUM

No studies appear to have related chromium to any of the non-osteoporosis menopausal symptoms. However, the evidence already cited above showing that chromium enhanced oestrogen production in postmenopausal women, should, logically, indicate that benefits can be expected from chromium in any condition that is critically dependent upon oestrogen levels.

SUGAR

One additional dietary consideration seems to emerge in relation to the non-osteoporotic symptoms, and that is avoidance of sugar. This is a pretty good dietary guideline anyway, since too much sugar in the intestines inhibits mineral absorption, especially that of magnesium, and because sugar encourages wrong bowel bacterial flora, tends towards diabetes and other chronic diseases and is known to combine with cell proteins to produce damaged “glycosylated” proteins. Rosetta Reitz, who is referred to above, is convinced (p161) that “Women who do not eat man-refined sugar seem to have fewer and milder flashes”. This is an interesting observation rather than a study, but it suggests yet another way in which an industrialized diet could contribute to abnormal and unnatural problems with the menopause – which is a natural change in woman’s life.

General Status in Critical Nutrients

There is reason to refer once again here to the book by Rosetta R. Her two quotes are repeated here:

“Among the women I interviewed I found those who were concerned with the food they ate were experiencing menopause with more ease.”

“Altogether, I have noticed that the women who take vitamins regularly have less problems”.

One should take these points very seriously into account when considering the non-osteoporotic symptoms of the menopause. Vitamins C and E plus the various forms of phytoestrogens seem to be the main nutrients having a direct and specific effect upon such symptoms. However, it may well be that several other nutrients apart from chromium have an indirect, though no less beneficial action upon menopausal symptoms. It seems much more likely that this is more so than not. This would explain why women of menopause age, having good nutritional status in micronutrients, generally have an easier time at the menopause than those who do not. It would also tend to explain why populations with less exposure to industrialized foods show far fewer of their women experiencing adverse menopausal symptoms.

Overall, there are both general and specific reasons for thinking that by avoiding nutritional

imbalances and deficiencies, the menopause becomes less problematic and more free from symptoms.

A Word about Herbs

Many Herbs are advocated for menopausal symptoms, the non-porotic ones. There is general dearth of scientific studies to lend any support to these claims, although there are a great array of candidates. Dong Quai, Black Cohosh, Mexican Yam and Licorice root are prime contenders, but are all unproven. There are a great many more as almost every culture around the world has its own particular alleged herbal remedies for the menopause. This does not mean that these herbs are all useless, but rather that at present the buyer is not buying a reliable and proven product. For anyone wishing to know about these claims and allegations, Biomedical Information Services Ltd issues a fact-sheet listing these herbs and the specific types of claims made for them. Several of these herbs are alleged to be effective on account of their phytoestrogen content. 

To make sense of this one should of course consider what weight of the herb is recommended as a treatment dose and what is the identity and concentration of phytoestrogens contained in it. 

Usually, such information is not offered. Given the very low dose of a herbal remedy compared to food intake, the situation suggests that foods should be better sources of phytoestrogens than herbs, unless herbs showing a specially high content of active phytoestrogens can be found and demonstrated. A particular confusion seems to surround the Mexican yam, Dioscorea. This plant was long used as the principal source of steroids for manufacture of the contraceptive pill. It has therefore become associated in people’s minds as a provider of oestrogens. This is a mistake because the plant itself does not appear to be a source of active oestrogen or progesterone. What it contains is a substance called diosgenin, which is a precursor of oestrogens and progesterone. However, it needs to be converted into these hormones by industrial chemistry, so that to suggest that the yam itself is an effective source of oestrogen or progesterone seems to be inaccurate. The psychological associations of this yam and its former use by the pharmaceutical industry may have been played upon.

There may be little harm in experimenting with most of these herbs, so long as one understands that the claims made about them seem, at this time, to be largely insecure.