Soundly Through Menopause
Acupuncture shows real
promise of providing nonhormonal relief from hot flashes and
sleep problems. In a recent Yale study, participants had nearly
50% less sleep disturbance. It takes at least two or three treatments
to see results, says Susan M. Cohn, a lead investigator. A few
HMOs, including Oxford, now cover acupuncture. (The American
Academy of Medical Acupuncture, at 800-521-2262, makes referrals.)
found black cohosh safely reduces night sweats and weariness,
with no side effects.
A single, evening dose of nonaddictive
melatonin (1 milligram) significantly increased actual sleep
time and sleep efficiency in a British study, with no hangover
effect. Lavender oil, a proven mild sedative, promotes drowsiness
and relaxation. The old folk remedy can even be used in an "herbal
Anything that induces relaxation
should encourage sleep. Learning to meditate--best done for 20-40
minutes, in late afternoon--trains people to sleep better. Experts
advise using a Worry Book to jot down any concerns that
interfere with falling asleep. Whether family issue or work problem,
it won't look half as bad in daylight. Try to think of a solution
or approach, and reduce your number of anxieties.
A Cognitive Behavioral Training
Program in Canada taught participants to:
- Leave their bedrooms if not
asleep within 20 minutes.
- Get up at the same time every
- Use their beds only for sleep
Naps, only before 3 PM, had
to be an hour or less. After only eight sessions, patients reported
a 55% reduction in sleep difficulties.
Choose absorbent cotton sheets
and bedclothes and keep the bedroom cool, suggests Joyce Walsleben.
"Have an extra T-shirt or nightgown nearby so you don't
have to find one if you wake up drenched. Turn your clock around:
You'll hear the alarm, but not seeing the time avoids that panic
of knowing you're awake at 3 AM. Simply tell yourself to go back
to sleep," urges the director of NYU's Sleep Disorders Center.
Start to quiet down 2-3 hours
before bedtime. Take a shower or bath; avoid radio or TV, which
may be too stimulating. Stay up until sleepy. At night, try drinking
herbal tea or milk--its L-tryptophan helps some people sleep.
Avoid caffeine and nicotine, which are stimulants, and alcohol,
which makes it hard to stay asleep.
Medication provides a sense
of control while one learns better rest habits, if all else fails.
Pick the night to use a prescription drug, says Walsleben, suggesting
short-acting sleeping pills like Sonata (generic name zaleplon)
or Ambien (generic name zolpidem tartrate). A sedative and hypnotic,
Sonata should not be taken for more than 10 consecutive days.
It has no hangover effect.
Both Megace (generic name megestrol
acetate--a synthetic progestogen) and clonidine (brand names
Catapres, Duraclon; originally used for high blood pressure)
decrease the incidence of hot flashes and may help women stay
asleep. Cenestin, a synthetic estrogen that reduces hot flashes,
was recently approved by the FDA for short-term use.
The same chemicals in the brain
regulate sleep and mood. A deficiency in serotonin, which brings
poor sleep, may also cause depression or hunger. Some new medications,
like Prozac (generic name fluoxetine) and Zoloft (generic name
Sertraline), increase serotonin levels, which could help with
sleep. Take them daily, in the morning.
How Soy Can Help
Can phytoestrogens--the natural plant compounds whose structures
are similar to that of estrogen--produce estrogen-like effects
in menopausal women? In current research, isoflavones in soy
protein are considered the most promising phytoestrogens.
Sleep is a research area being pursued in studies at Winston-Salem's
Wake-Forest University Baptist Medical Center. "People tell
us they're sleeping better with soy," notes study leader
Dr. Greg Burke. Investigators found women who added 20-34 grams
of soy protein to their diets experienced less intense night
sweats. Results were best if women consumed soy protein twice
"We believe soy may offer many benefits of estrogen replacement
therapy. It has a mild effect on number and severity of hot flashes--though
nowhere near the same magnitude as HRT," says Burke. "We're
investigating phytoestrogens because we think they may have different
properties and risk-to-benefit ratios than traditional HRT."
Burke cautions people not to think of soy as a drug, but as
part of a healthy diet. Besides eating fruits and vegetables,
add at least one serving of soy a day, he advises. "Find
a form that you can easily tolerate: soy milk, tofu, soy burger,
or soy protein in a shake, and use it regularly." He doesn't
recommend isoflavone pills due to lack of data about their benefit.
In Asia, where soybeans are a staple of the diet, women report
fewer hot flashes during menopause. They typically consume at
least 30-50 milligrams of isoflavones each day--the amount found
in half a cup of soy milk or tofu or one-quarter cup of roasted
Four of soy's most active isoflavones are also found in red
clover. Promensil, a red clover-based supplement, has 40 milligrams
of plant estrogen per tablet.
Israel Deaconess Medical Center. Reviewed for medical accuracy
by physicians at Beth Israel Deaconess Medical Center (BIDMC),
Harvard Medical School. BIDMC does not endorse any products or
services advertised on this Web site.
Copyright: © 2000 Medscape, Inc.
Posted On Site: Feb. 2000
Publication Date: Feb. 2000