What's Your Menotype?

Menopause can be a confusing time in a woman’s life. The fact is that many women (and their doctors) struggle with choosing the best method to relieve menopausal symptoms. Gone are the days when menopausal women pop synthetic hormone pills that doctors have touted as a magical solution. In today’s society, menopausal women are reviewing their options and demanding safe and effective remedies. To help women choose the best treatment for their particular symptoms and situations, we found that three different universal patterns exist, which we have coined as “menotypes.” The following menotype quiz is designed to help you target the menotype that best fits you and your menopause experience. Simply go through the symptom list and mark the blocks that best describe you. Then tally your score and match it to the corresponding menotype to find out about treatment recommendations. If you fit the description of menotype A, you have an easier time than the other groups in deciding which course of action to take because A types really do not experience strong menopausal symptoms such as hot flashes, night sweats and so on. They do not have any signs of osteoporosis, and hormone analysis does not show a major deficiency. This group accounts for five to 10 percent of the menopausal women we see in our clinic (in other cultures it is much higher). Symptom Picture

• None or mild menopausal symptoms
• No osteoporosis present
• No strong family history of osteoporosis.

Hormone Testing

• Preferably saliva hormone testing. Second best are blood tests for hormone levels of estrogen, progesterone, testosterone, DHEA and thyroid.
• Normal to low-normal levels of hormones (based on test results) indicate menotype A.

Treatment Recommendations

• Plant-based diet of vegetables, fruits, nuts, seeds and legumes (especially soy foods), along with some animal products such as cold-water fish and organic poultry.
• Daily supplements: high-potency multivitamin, natural vitamin E (400 IU) and calcium (1,000 milligrams)/magnesium (500 mg).
• Regular exercise.
• Consider homeopathy and/or acupuncture as preventive treatments for menopausal symptoms.
• Herbal therapy such as black cohosh is optional.

In our experience, this represents the largest menotype group, making up about 55 to 65 percent of menopausal women. If you fit the profile of menotype B, you have more choices to make. You may be experiencing some uncomfortable meno-pausal symptoms, possibly while trying to juggle a career and/or home life. Menopausal symptoms are generally rated in the mild to moderate category. For some women in this group, symptoms are minimal, such as the occasional hot flash, mild insomnia or a reduction in libido. For others, the symptoms are so pronounced that they interfere with daily activities. Some women say they feel scared, confused and angry at the same time because the symptoms they’re feeling are stronger than they had anticipated or they’re becoming aware of their increased risk for heart disease and osteoporosis. They may also be frightened they’ll get breast cancer–which can appear regardless of menotype. Confusion and anxiety may also arise over deciding which approach to take to relieve symptoms. A woman might be under pressure from her doctor to use hormone replacement, or she may be unsure if the natural treatment she wants to use actually works. Symptom Picture

• Mild to moderate menopausal symptoms
• No personal history of osteoporosis
• Family history of osteoporosis is not a major factor (although could be present)
• If osteoporosis is a major risk factor, go directly to menotype C

Hormone Testing

• Normal to borderline low

Treatment Recommendations

• First-line treatment: herbal therapy (black cohosh), along with nutritional supplement, diet and lifestyle recommendations as given for menotype A for six to eight weeks. If there is no response, go to the second line of treatment described below. Consider homeopathy and/or acupuncture.
• Second-line treatment: natural progesterone and/or DHEA or pregnenelone, available in Canada only through prescription from your naturopathic doctor. If vaginal dryness and /or severe hot flashes/night sweats are present and do not respond to treatment in menotype B recommendations, use natural hormone replacement as described in menotype C.

The protocol for menotype C is very straightforward. Simply put, this category is for menopausal women who, for one reason or another, require hormone replacement therapy. This accounts for approximately 25 to 30 percent of all menopausal women we see in our clinic. The real decision comes down to whether to use “natural” or “synthetic” hormones. In general, it makes sense to use hormones identical to those you find in the human body (and not what you find in a horse), so I tend to favour “natural” or “bio-identical” hormones over synthetic. Symptom Picture

• Moderate to severe menopausal symptoms
• Women who fit into menotype B but are unresponsive to treatment
• Women who have osteoporosis or very strong risk factors for osteoporosis also fit into this category

Hormone Testing

• Low

Treatment Recommendations

• Natural hormone replacement.
• Diet, supplements and exercise as recommended in menotypes A and B.

In summary, discover your “menotype” and work with your doctor to benefit from a tailored program that safely and effectively relieves your menopausal symptoms. Homeopathic Treatments for Menopause For short-term use, choose from the following sample of remedies, available at health food stores. Take every 12 hours for up to seven days. See a qualified homeopathic practitioner for more individualized treatment. Belladonna, 6C, is useful for flushing in the head and face that comes and goes suddenly, accompanied by sweat, redness, throbbing and congestion. Graphites, 30C, for hot flashes, especially on the face, with nosebeeds, weight gain, scanty periods and sharp pain in the lower abdomen. Pulsatilla, 30C, if you weep easily and seek comfort, have hot flashes, hemorrhoids and varicose veins. Often feel chilled and prefer open air. Sepia, 30C, for vaginal dryness and pain during sexual intercourse, anxiety about sex and hot flashes. Menstruation is heavy and irregular. Candidiasis is a common recurrence. Sudden fainting spells, chills, tearfulness, irritability, indifference to loved ones and hair loss Cal carb, 30C, weight gain, panic attacks, anxiety about memory loss. Noises in the ears, perspiration on the face, craving for sweet food and tendency to candidiasis. Backache, swelling of the finger joints and varicose veins are present.

About Black Cohosh Black cohosh (Cimicifuga racemosa), a member of the buttercup family, is found in Europe, Asia, North America and Siberia. Historically, First Nations people used it to treat menopausal symptoms and irregularities. Black cohosh continues to be the top choice for these conditions, and is the most thoroughly studied herb included in today’s menopause formulas. In fact, a monograph by the prestigious German Commission E (a medical council that analyzes herbal medicines in Germany) extensively documents the clinical value of black cohosh. It has no known toxicity at reasonable dosages (extremely high dosages may cause digestive upset, headaches or dizziness). Recommended dosage: a 40-mg capsule containing standardized extract of 2.5 to 2.6 percent triterpene glycosides (the active ingredient), two to four times daily. Menopause Relief (IMPAKT Communications, 1998), by Angela Stengler, ND, and Mark Stengler, ND