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Both men and women can face menopausal syndrome in varying degrees. But hormone replacement therapy is riddled with risk, from heart disease to cancer. A recent clinical study finds flaxseed beats out HRT therapy in overall effectiveness for menopausal syndrome.
As a woman heads into her menopausal years, she may be met with varying degrees of what is often referred to as menopausal syndrome. Men too sometimes face some symptoms of menopausal syndrome during those years, but such symptoms and occurrence are generally less severe.
Menopause is not a disease. It is a natural metabolic change that accompanies changes that revolve around reproductive abilities. Menopause is distinguished from perimenopause in that menopause occurs when menstruation stops completely. During perimenopause, a woman might have irregular menstruation or she may miss menstruation for a month or more before it returns. In contrast, the typical criteria for menopause include not menstruating for more than a year.
Issues women face regarding menopause in addition to the discontinuance of menstruation and the loss of reproductive abilities include a host of menopause syndrome-related symptoms such as mood swings, joint pain, hot flushes and night sweats, insomnia and others.
Men sometimes also have these symptoms during their 50s and 60s, though generally less severe.
The reason for much of menopausal syndrome relates to the body producing less estrogen. For women this means their ovaries are simply producing and secreting less estrogen.
Men produce estrogen by converting testosterone with an enzyme called aromatase.
This means that reduced levels of aromatase, testosterone or both can lead to lower than healthy estrogen levels in men.
Many of the cells of the body contain estrogen receptors on their surface. When estrogen attaches to these estrogen receptors, it stimulates the cell to function in a number of ways.
These include stimulating the production of critical substances, such as collagen in the case of skin cells, cortisol in other cells (which balances inflammation and increases energy), mucosal secretions among mucosal linings, and neurotransmitters that assist in mood balance and cognition among neuron cells.
When the body's production of estrogen is dramatically reduced – in both men and women – the receptors will lie dormant or be replaced by non-estrogens. This causes the cells to produce less of these important substances, and produce the symptoms linked to menopausal syndrome that both men and women can experience.
Phytoestrogens as estrogen replacement
In both men and women, phytoestrogens can help alleviate problematic symptoms related to low estrogen levels. Phytoestrogens are contained generally in plant-based foods: Grains, beans, seeds, fruits and vegetables.
Phytoestrogens are nature's estrogens. They attach to estrogen receptors just as estrogen does, and thus stimulate most of the same activities that estrogen does.
Among phytoestrogen sources, some of the highest levels of phytoestrogens are found in soy and flax. And clinical research has supported the fact that these two foods can significantly reduce menopausal symptoms.
Flaxseed clinically tested for menopausal symptoms
This is what was found in a recent study which also compared flaxseeds to pharmaceutical hormone replacement therapy (HRT). Researchers from the Departments of Nursing and Pharmacy at Turkey's Izmir Katip Celebi University investigated the potential of flaxseed reducing menopausal symptoms with 140 women volunteers who had not experienced menstruation for at least a year.
The women were divided into four groups of 35. Groups one and two did not take - nor had they been taking - hormone replacement therapy. Both of these groups were given five grams of flaxseed per day. (A tablespoon of whole flaxseed equals about 11 grams.) They received the flaxseed from the researchers in bulk and took the flaxseeds daily for three months. The only difference between group one and group two is that group two also received information training about menopause.
Group three received hormone replacement therapy as prescribed by a physician. Their HRT consisted of 2 milligrams of estradiol hemihydrate and 1 milligram of norethindrone acetate per day.
Meanwhile, group four – the control group – received no treatment.
The length of the study was three months for all four groups.
Everyone in all four groups received two tests at the beginning and end of the testing period. The testing consisted of the Menopause Rating Scale – first used in 1992 – and the SP-36 Quality-of-Life Scale – a leading test since 1987. The menopausal rating scale measured the various menopausal issues including intensity and frequency.
The scores for the tests before and after the three months were analyzed by computer to create a statistical analysis for the results.
Flaxseed matches HRT in reducing menopausal symptoms
After the three months, the researchers found the groups that consumed the five grams of flax per day had significantly fewer and less-intense menopausal syndrome symptoms.
The group that didn't receive any HRT treatment nor flaxseeds (control group) had increased menopausal syndrome symptoms by an average of 7%.
Groups one and two had a decrease in menopausal syndrome symptoms, by an average of nearly 9% and 10%.
This actually means that the daily flaxseeds improved menopausal symptoms by up to 17% when compared to the control group.
Meanwhile, those women who received pharmaceutical HRT drugs also saw their menopausal symptoms decrease, by about 10%. This was slightly higher (10% compared to 9.8%) than group two, but the difference was very slight.
Quality of life scores reveal flax' advantage over HRT
One might wonder what is the advantage of flaxseed over pharmaceutical hormone replacement therapy - besides cost. While flaxseed therapy with menopause education basically matched HRT in the reduction of symptoms, there is more to hormonal therapy than simply menopausal syndrome symptoms.
The two flaxseed groups in this study experienced significantly improved Quality-of-Life scores. Group one's QOL scores increased from 38.93 to 49.00, while group two saw QOL scores increase from 38.63 to 41.69.
The HRT group, however, had reduced Quality-of-Life scores. Their scores went down from 37.29 to 34.65.
The control group also had a reduction of Quality-of-Life scores – from 34.94 to 33.82.
This means the Quality-of-Life scores of those who took hormone replacement therapy drugs dropped more than those who didn't do any therapy.
Another obvious advantage for flax relates to side effects. HRT typically comes with a host of side effects. One of these was evidenced from the large Women's Health Initiative, a 15-year study of over 161,000 women. This study found combination HRT therapy (such as in this study) came with a significantly increased risk of cardiovascular diseases. Short-term HRT use also increased inflammation (C-reactive protein). Other studies have shown increased risks of breast cancer with HRT.
Other adverse effects of HRT typically include intestinal irritation, vaginal bleeding, nausea, headaches and others.
What this all means is when flax is compared to HRT utilizing a complete spectrum - symptoms plus quality-of-life plus adverse side effects - we can conclude that flax significantly outperformed HRT in this clinical study.
What's in a Quality-of-Life Score?
When it comes to overall effectiveness of any therapy, QOL is a critical component. A therapy is rightly measured by both its symptom reduction and its Quality-of-Life scores because no one wants to feel worse overall when they are undergoing a therapy. For example, if someone takes an NSAID for a headache and finds the headache gone but is now faced with feeling drowsy and a stomach ache, or just a feeling of being down in the dumps, how effective was the therapy?
As this study proved, flaxseeds not only reduce symptoms of menopause – at practically the same levels as the HRT therapy: But flax also increases quality of life and comes with positive side effects. These include flax' positive effects upon digestion, cholesterol and cognition.
For example, flax contains considerable amounts of phytosterols, which reduce levels of oxidative low-density lipoproteins (LDL). Flax also contains healthy prebiotic fiber, so it aids digestion and bowel movements. Pertaining to cognitive levels, flaxseed comes with considerable content of an omega-3 fat called alpha linolenic acid or ALA. ALA is converted by a desaturase liver enzyme into heart- and brain-healthy docosahexaenoic acid (DHA). DHA is utilized by heart, brain and nerve cell membranes to help protect them from free radical damage.
For these many reasons, I always sneak a good dose of flaxseeds into the smoothies I make for my wife and I.
For additional research on the health benefits of flaxseed consult the GreenMedInfo.com database on the topic: Flaxseed Health Benefits Research.
Cetisli NE, Saruhan A, Kivcak B. The effects of flaxseed on menopausal symptoms and quality of life. Holist Nurs Pract. 2015 May-Jun;29(3):151-7. doi: 10.1097/HNP.0000000000000085.
Physicians Desk Reference. 2005
Pradhan AD, Manson JE, Rossouw JE, Siscovick DS, Mouton CP, Rifai N, Wallace RB, Jackson RD, Pettinger MB, Ridker PM. Inflammatory biomarkers, hormone replacement therapy, and incident coronary heart disease: prospective analysis from the Women's Health Initiative observational study. JAMA. 2002 Aug 28;288(8):980-7.
Originally published: 2015-06-10
Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet. 1997 Oct 11;350(9084):1047-59.