Safely Manage Menopausal SymptomsAugust 2014
By Alicia Nadil
During menopause, a woman undergoes profound and extreme biochemical changes in all aspects of her body. It can be one of the most trying periods in a woman’s life. Lasting up to 10 years, the menopausal transition includes well-known symptoms such as hot flashes, night sweats, mood swings, and sleep disturbances.1-5 Menopause also increases the risk of heart attack and stroke,6 depression, osteoporosis, arthritis, dementia, and frailty.3
While the troubling symptoms of menopause gradually fade as a woman completes the menopausal transition, the health risks remain or grow larger. By World Health Organization estimates, 1.2 billion women worldwide will be postmenopausal by the year 2030, making these health risks an impending public health disaster.3 And managing those symptoms is a clinical challenge, with few safe and effective options.2
Until the turn of the 20th century, the standard management of menopause included administration of equine estrogens derived from horse urine (Premarin®) and progestin; a synthetic female hormone that is different than natural progesterone.7
Fortunately, just when the risks of conventional hormone therapy were becoming evident8, data emerged showing that estrogen-like molecules from plant sources (phytoestrogens) could produce many of estrogen’s favorable effects minus most of the harmful ones. A 2013 study showed that these phytoestrogens were effective at decreasing hot flashes, irritability, and sexual problems.9
Use of estrogen-like molecules from plant sources is growing increasingly popular, and intense scientific research has begun to reveal the remarkable effectiveness of plant extracts in achieving relief of menopausal symptoms, while at the same time providing protection against some of the very conditions that conventional hormone therapy is notorious for causing.10-13
Two important plant extracts lead the field in bioidentical hormone therapy for relief of menopausal symptoms. Prenylflavonoid molecules in hops include the most potent phytoestrogen discovered thus far,14-17 while lignans found in the Norway spruce combine mild estrogenic actions with potential anticancer, antimicrobial, anti-inflammatory, and immunomodulatory activities that neatly fill the needs of women as they approach and transition through menopause.18
Women who are undergoing or nearing menopause, and who would like to prevent or mitigate menopausal symptoms such as hot flashes and sleep disturbances, are increasingly interested in natural phytoestrogens from hops and spruce as an alternative to mainstream hormone replacement therapy.
A Natural Solution For Menopausal Symptoms
Hops are the female flowers of the hop plant (Humulus lupulus). Their bitter, floral taste has been used for centuries as a flavoring and natural preservative in beer.14,19 But they also contain specialized glands that secrete powerful bioactive molecules with significant potential impact on human health.15,20
Among these compounds is a molecule called 8-prenylnaringenin (8-PN), which research suggests is the most potent known phytoestrogen (plant-derived estrogen-like molecule).14-16, 21-23 These estrogenic properties make hops and 8-PN extremely attractive for use during menopause, when estrogen levels drop and produce the disquieting symptoms of menopause.21
The estrogenic properties of hops extracts, and particularly of 8-PN, are known to alleviate menopausal symptoms and disorders, including osteoporosis, hot flashes, and low sex drive.17 8-PN is known to be rapidly and almost completely absorbed after oral dosing.24
Studies in rats whose ovaries had been removed in order to produce experimentally-induced menopause show that the animals underwent hot flashes, just like women. Administration of either estrogen or 8-PN from hops was able to reverse these symptoms (measured as increased temperature of the tail skin).25 Further studies revealed that this effect is at least partly the result of 8-PN binding to and activating estrogen receptors in tissues outside of the brain.25
In a human study, women undergoing menopause took a hops extract standardized to 100 or 250 micrograms/day of 8-PN or a placebo for 12 weeks. Even the lower dose of 100 micrograms 8-PN was significantly superior to placebo at reducing symptoms of menopause after only six weeks, especially the hot flash score on a standardized menopause scoring scale.26 A similar study, using 100 micrograms/day of 8-PN, demonstrated significant reductions after eight weeks of therapy on the same scores, as well as a patient-reported visual scale of menopausal symptoms.27
Hops Battle Breast Cancer
Hops extracts, rich in 8-PN, provide relief of troubling menopause-associated symptoms. In addition, hops extracts are now beginning to show important and promising benefits in the fight to prevent cancer, particularly cancers of the breast, which are most commonly dependent on estrogen for their growth.
The ability of hops as a plant-derived estrogen replacement therapy to prevent breast cancer is critical, especially since the mainstream’s standard animal-derived estrogen replacement therapy has produced concerns regarding the risk of promoting such cancers due to excessive estrogen.
An important step in estrogen’s initiation of cancer is its conversion into a number of active carcinogens by liver enzymes. These enzymes, normally part of the detoxification process for external toxins, act on estrogen to create new toxins that have DNA-damaging effects.11
Hops, and its natural active constituent 8-PN, inhibited these kinds of dangerous enzymatic reactions, reducing the amount of cancer-inducing DNA damage and blocking the malignant transformation of human breast cancer cells in culture.11,28 Quite recently, 8-PN has also been shown to inhibit growth of colon cancer cells in culture.29
Even more impressive anticancer effects are attributable to another hops-derived biomolecule, xanthohumol, a flavonoid that has been described as a “broad-spectrum” cancer-preventive substance because of its large numbers of potential targets and mechanisms of action.15 A closely related molecule, isoxanthohumol, also present in hops is capable of being converted to estrogen-like 8-PN by bacteria living in the intestine.14,23 Due to natural variations in the makeup of the intestinal bacteria in each woman, the amounts of protective 8-PN available from dietary sources may vary considerably, leaving 60% or more of women with sub-optimal protection.14,23
Can Drinking Beer Battle Breast Cancer?
With this discussion about hops, you might be wondering if drinking beer is a viable option for reducing the symptoms of menopause and preventing breast cancer. Unfortunately, the answer is no.
Since the concentration of beneficial hops molecules varies greatly between beer brands and styles, even regular beer consumption cannot guarantee adequate protection either against menopausal symptoms or against cancer.15 Beer also brings with it a sizable calorie load, and the alcohol content is not acceptable to many people.
Fortunately, hops extracts rich in 8-PN and xanthohumol are now available. Laboratory testing shows that these molecules accumulate in the liver and mammary glands following supplementation, where they induce important genetic control systems that protect cells.21 Following treatment with 8-PN and xanthohumol, breast cancer cells in culture showed decreased pro-oxidant production, improved mitochondrial function (a known factor in cancer prevention), and increased expression of the life-extending molecules called sirtuins.30,31
There may be additional benefits to supplementing with hops extracts, even beyond menopause and cancer prevention. 8-PN was shown in a mouse model to prevent the atrophy of skeletal muscle (sarcopenia) that is so common in older adults. Such beneficial effects on muscle might help older adults retain their strength, which in turn may help to prevent falls and other traumatic events.32
Hop extracts also show strong neuroprotective effects, promoting new brain cell growth and regeneration, and outgrowth of new neurites, the tiny spikes that brain and nerve cells use to contact and communicate with one another.16
Cut Hot Flashes In Half
The Norway spruce (Picea abies) produces abundant quantities of the plant lignan 7-hydroxymatairesinol, or HMR. In the digestive tract, HMR is converted to an active compound called enterolactone.18,33-35 Both HMR and enterolactone are mild phytoestrogens, and as such, offer additional support for women undergoing menopausal transition.18,35,36
In one important study, menopausal women supplemented with either 36 or 72 mg of HMR lignan per day for eight weeks.37 The supplement was readily absorbed and distributed in the women’s bodies, raising 7-HMR levels in the blood by 191% in the lower-dose group, and by 1,238% in the higher-dose group. The higher dose also produced a 50% reduction in the mean number of weekly hot flashes, from 28 to 14.3.
Safely Lower Breast Cancer Risk
In addition to drastically cutting the number of hot flashes, there is also exciting news about HMR lignan in the prevention of breast and other cancers. Several different epidemiological and laboratory studies have shown that diets rich in plant lignans are likely to reduce the risk of human breast cancer.38 This is likely due to the ability of HMR lignans to sharply reduce the concentrations of reactive oxygen species that damage DNA to trigger cancers, and also their ability to suppress inflammatory actions to slow promotion and progression of malignancies.39
Studies in rats with experimentally induced breast cancer show that HMR, at a dose equivalent to 180 mg/day in humans, decreases the number of growing tumors and increases the proportion of tumors that regress and stabilize.33 A lower dose (equivalent to 56.4 mg/day in an average human) given before experimental tumor induction was shown to reduce the size and growth of tumors, while the same dose given even after tumors were established inhibited their growth.36
Other studies show that HMR helps inhibit tumor development in liver cancer cells and helps stop the spread of tumors in rats carrying liver cancers.38 Toxicity studies have demonstrated no adverse effects at doses up to a human equivalent of 1,920 mg/day, making HMR lignan a safe supplement.40