Professional Documents
Culture Documents
Part 1
Resource #1 Age at menopause: Do chemical exposures play a role?
Experts are looking at a potential influence between environmental
exposures and age of menopause. This is something that is still in the early stages
but there is research suggesting that there could be a link between endocrine-
disrupting compounds and early menopause. The long-term implications of early
menopause can be severe. There is still a lot of research to be done especially
because isolating effects of chemicals can be difficult among many other influences
that can impact the beginning of menopause. In the 1970s, the first evidence came
about that exposures could cause early menopause, through exposure with tobacco
smoke. Since then, other chemicals such as dioxins, polychlorinated biphenyls, and
phthalates have been associated as well. The natural start of menopause can depend
on several different factors such as genetics, body weight, activity, smoking, and
contraceptive use. One exposure associated with early menopause is smoking.
Studies had shown that woman who smoke on average begin menopause 1 to 2
years earlier. It may seem as not much, but the potential consequences overall can
be large. Recently, scientists also discovered that secondhand smoke could
accelerate menopause as well. The Womens Health Initiative observational study
estimated that nonsmokers exposed to secondhand smoke started menopause 13
months before those not expose to smoke. Hydrocarbons in tobacco smoke reduce
the number of developing follicles, inhibit estrogen synthesis, and enhance
metabolism of estrogen in the live. Several chemicals such as mono-(2-ethyl-5-
hydroxyhexyl)phthalate are speculated to slowly damage the follicular pool or
impede the production of oocytes in utero. It is hard to tell what is being targeted
because of feedback loops. It is important to use humans and not animals because
the animals do not have the same fundamental features of the reproductive cycle.
Ongoing research is attempting to focus on environmental health research and
chemicals in human life (Schmidt, 2017). This is a new perspective on menopause,
because it looks at whether there are other causes rather than the natural ones
within the body, that cause menopause. Smoking and even drug use is a large
problem in todays times. For instance, if there is a link to secondhand smoke and
menopause, then that can be a large scale problem simply because so many people
are exposed to it these days. By smoking, they are harming themselves but also
dozens of others that are around them, breathing in their smoke. It could be that
there are chemicals within the environment that are causing menopause to begin
earlier, which could in turn cause earlier death ages due to earlier instances of
cardiovascular disease, cancer, etc.
Part 2
Pros/Benefits:
Most effective treatment for hot flashes and night sweats
Can ease vaginal symptoms (Mayo Clinic, n.d. a)
Role in preventing osteoporosis (Womens Health Concern, 2017)
Cons/Risks:
Increased risk of heart disease, stroke, blood clots, breast cancer (Mayo
Clinic, n.d. a)
Can have serious health risks if taken in high doses for a long time
Risks are higher in older women, such as over 60 years old (North American
Menopause Society, n.d.)
Part 3
Diet
Vegetables and fruits high in vitamin C and antioxidants to help with aging
Soy and flaxseeds contain dietary phytoestrogens
Fiber-rich whole grains (oatmeal, quinoa, brown rice) help to fill you up so
you don't eat as much
Unsaturated fats such as nuts, seeds, avocados, fatty fish, and olive oil
Calcium to protect bones, approx. 1,200 milligrams daily, can get it from
low-fat dairy, sardines, salmon, broccoli, and kale
Vitamin D (& oily fish) help to absorb calcium
Avoid foods full of added sugar and salt sugar promotes weight gain and
salt can lead to high blood pressure and cardiovascular problems
Cut back on empty calories in sugary treats and drinks
Eat a diet of 1,200 calories daily and stick to it
It is important to not just cut calories and cut them too low, this can cause
other problems and not lead to weight loss
Drink a lot of water (Martinac, 2017)
Exercise
Dont be sedentary being physically active helps to either drop to a healthy
weight or stay at a healthy weight, get up and move, even just walking helps
Aerobic exercise burns fat & improves cardiovascular health
Strength training enhances lean body mass & counteracts loss of bone
density
Stretching maintains range of motion
Do a combination of the 3 types of exercise, aerobic, strength training, and
stretching
Exercise for at least 30-60 minutes at least 3 times a week (Hill, 2017)
The most effective way to maintain a healthy weight with diet, is eating high-
quality foods such as fruits and vegetables, whole grains, and the healthy fats and
proteins. A person will get more from these foods rather than eating high calorie
foods with no or little nutritional value. It is important to find a diet that works for
each person and their individual body based on their likes and dislikes. Another
effective way is cutting sugars, sugary drinks, and all the calories with no nutrition.
This can cause great changes in a persons weight just by doing this and switching to
water. While cutting sugars and eating better can help a person lose weight, the
most beneficial will be better eating with a combination of physical activity. Physical
activity can be beneficial in promoting better health through a healthier heart and
lungs. This helps a person lose weight but also lower their risk of cardiovascular
disease, heart attack, etc. Exercising will burn more calories in your body than just
the normal that are used every day. Anything that keeps you moving and your heart
rate elevated is beneficial (Kendall, 2017).
Part 4
Osteoporosis is a condition characterized by porous bones that are weakened
and brittle. As people age, bone breakdown occurs more than bone buildup, so there
is a loss of bone mass. The holes in the bone grow larger and more numeroud with
weakens the insides of the bones. Womens bones to begin with, are lighter and
thinner than mens bones generally. Also, the decrease of estrogen can cause bone
density loss because normally it helps to protect bones. There is a direct
relationship between the loss of estrogen and the development of osteoporosis.
Women are four times more likely than men to develop osteoporosis. As much as
half of the total bone loss can occur within the first ten years post-menopause. In
some women, the bone loss can occur rapidly and severely. The longer that a female
is without estrogen, the greater the bone density loss will be (International
Osteoporosis Foundation, n.d.).
Prevention:
Adequate calcium intake from childhood and beyond
Regular physical activity
Avoid under-nutrition
Avoid smoking and alcohol
Treatment:
Calcium and Vitamin D
Hormone replacement therapy
Raloxifene hormone like medication
Bisphosphonates
Denosumab if cannot take bisphosphonates
Teriparatide for men and postmenopausal women with very low bone
density
Abaloparatide new medication with potential to rebuild bone
Hormone replacement therapy is one of the best treatments, but there are
still issues between whether the risks are too great
Part 5
Recommend:
Black cohosh is a plant from North American that was primarily used for
menstrual problems and childbirth by American Indians. This is one of the most
studied botanical to use in menopausal women. The mechanism is not understood
but some studies do suggest that there is an estrogenic activity, but it is not
estrogenic. With the 12 clinical trials using this for menopause, only one showed
negative results with vasomotor symptoms. The most common side effect is mild
gastric complaints. Ideally it is suggested for women with breast cancer since it is
not estrogenic. One negative thing is, long term conditions have not been studied
with this. Scientists found black cohosh is an equivalence of conjugated estrogens on
improving symptoms for menopause (Geller, 2005). I would recommend this to
patients because there are studies done that show there are positive results. Also,
the side effects seem minor and there are no documented cases of drug interactions.
Out of all the herbal remedies, this seems to be safe to use. I have even found a study
that explains why it could be of good use. When looking for recommendations this is
what I want to see, published evidence that it is something good for the body and
not harmful. I also want to know that it works, which this publication shows that it
does.
Valerian is a grass and the root can be used to treat disorders such as
dizziness, neural pains, anxiety, and menopause symptoms because of its
phytoestrogenic components. Phytoestrogens are complexes like estrogen that can
be found in plants and have estrogenic and antiestrogenic qualities. In a study I
found, valerian root was an effective treatment in reducing hot flash frequency is
some women. It is unsure how valerian root works although it could be through the
increase of gamma aminobutyric acid. It seems to work best after talking it regularly
for more than a few weeks (Mirabi & Mojab, 2013). The side effects appear to be
minimal, such as headaches, dizziness, and gastrointestinal disturbances, according
to the NIH (National Institutes of Health, 2013). I would recommend this root to a
patient to try because I believe it could be beneficial in helping them. If my patient
were looking for an herbal remedy, it seems to be a safe alternative than some
treatments. Although I would warn patients that it could make them drowsy
because it can also be used for insomnia. So, it would need to be taken at a lower
dosage. There are studies and credible sources that reference using this root. So,
since the information is credible, the side effects do not seem too severe, and it
appears to work to help hot flashes, I would recommend this to a patient.
Not Recommend:
Gotu kola is a plant that has been used for many years in India, China, and
Indonesia to treat many different conditions. It is used in the United States in
ointments to help with minor wounds or treat psoriasis. Side affects are rare but can
be things such as skin allergy and burning sensations, headache and extreme
drowsiness. There and also many interactions that can happen. One severe
interaction can cause liver damage if taken with other drugs that affect the liver as
well. It can act as a diuretic and rid the body of access fluid. This can be harmful and
cause the body to lose too much fluid. Gotu Kola acts as a sedative and could interact
with anxiety or insomnia medications and make the reaction stronger (Ehrlich,
2015). I would not recommend this herb because I think that the side effects and
reactions are too great. It can also affect women over 65 so I think that this would
not be beneficial to recommend since post-menopausal women could fall at this age
range. They would have to take a lesser dose and work their way up. I think there
could be better therapies out there that are safer with fewer side effects. I would not
want to recommend something that I do not feel is totally safe because I am
supposed to be looking out for their best interest. I would not want to make them
feel worse than they already do or give them more problems than they already have.
Chaturvedi, A., Nayak, G., Nayak, A. G., & Rao, A. (2016). Comparative Assessment of
the Effects of Hatha Yoga and Physical Exercise on Biochemical Functions in
Perimenopausal Women. Journal of Clinical and Diagnostic Research: JCDR,
10(8), KC01KC04. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028509/
Ehrlich, S.D. (2015). Gotu kola. University of Maryland Medical Center. Retrieved
from www.umm.edu/health/medical/altmed/herb/gotu-kola
Geller, S.E. (2005). Botanical and Dietary Supplements for Menopausal Symptoms:
What Works, What Doesnt. J Womens Health (Larchmt), 14(7). Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764641/
Hill, C. (2017). Successful Weight Loss Plan for Menopausal Women. Livestrong.
Retrieved from https://www.livestrong.com/article/466276-successful-weight-
loss-plan-for-menopausal-women/
Kozakowski, J., Gietka-Czernel, M., Leszczyska, D., & Majos, A. (2017). Obesity in
menopause our negligence or an unfortunate inevitability? Przegla d
Menopauzalny = Menopause Review, 16(2), 6165. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509974/
Mayo Clinic (n.d. a). Hormone therapy: Is it right for you? Retrieved from
https://www.mayoclinic.org/diseases-conditions/menopause/in-
depth/hormone-therapy/art-20046372
Mayo Clinic (n.d. b). Osteoporosis treatment: Medications can help. Retrieved from
https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-
depth/osteoporosis-treatment/art-20046869
Mirabi, P., & Mojab, F. (2013). The Effects of Valerian Root on Hot Flashes in
Menopausal Women . Iranian Journal of Pharmaceutical Research: IJPR, 12(1), 217
222. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813196/
National Center for Complementary and Integrative Health (2017). Passionflower.
Retrieved from https://nccih.nih.gov/health/passionflower
North American Menopause Society, (n.d.). Hormone Therapy: Benefits and Risks.
Retrieved from https://www.menopause.org/for-
women/menopauseflashes/menopause-symptoms-and-treatments/hormone-
therapy-benefits-risks
Simmonds, S. (2017). The LadyCare Menopause Magnet: What is it and What Does it
do? Woman and Home. Retrieved from http://www.womanandhome.com/diet-
and-health/542462/ladycare-menopause-magnet
U.S. Food and Drug Administration (2017). Menopause and Hormones: Common
Questions. Retrieved from
https://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118624.htm
Womens Health Concern (2017). HRT: Benefits and Risks. Retrieved from
https://www.womens-health-concern.org/help-and-advice/factsheets/hrt-
know-benefits-risks/