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• Ovaries - production, storage and release of eggs into the fallopian tubes • Fallopian tubes ‘catch’ the released egg, transport it to the uterus, nourishing it

and providing optimal environment; place of fertilisation if sperm present• Uterus - strong muscular walls and a thick lining.; pathway for the sperm to reach

the egg in fallopian tubes: prepares for a potential pregnancy and support of the developing foetus.

• Cervix - strong and muscular neck of the uterus: nourishes sperm around time of ovulation but deters them with inhospitable environment at other times by producing thick acidic mucus.

• Vagina is an exit route for menstrual flow during menstruation: access for sperm deposited during sexual intercourse: passage for a baby during birth.

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• The menstrual cycle is a monthly cycle of approximately 28days which occurs from puberty to peri-menopause.

• The ovaries contain thousands of eggs and each month several eggs will begindeveloping within a sacs on the ovary called follicles. Only one will reach full maturity and, under hormonal influences, will be released in the middle of the monthly cycle.

• Fallopian tubes have ‘feathered’ ends which wrap around each ovary and ‘catch ‘ the released egg which then travels along the fallopian tube towards the uterus. The egg is then swept along the hair-lined fallopian tube to the uterus. The uterus has been thickening the inner lining in preparation for possible pregnancy.

• If egg is fertilised, it will implant in the uterus wall; change of hormonal patterns will stop further egg production and support the development of the pregnancy.

• If the egg is not fertilised the uterus lining is shed and is removed via the vagina during menstrual bleed. The unfertilised egg breaks down and is also expelled during menstruation.

• The start of menstruation marks day one of the female menstrual cycle.

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There are 4 key hormones which control the menstrual cycle:

• Oestrogen & progesterone are produced by the ovaries and FSH and LH are released from the pituitary gland..

• At start of the monthly cycle, the pituitary gland increases its release of FSH . . . follicle stimulating hormone is responsible for stimulating the follicles to develop eggs and as they do the follicles produce oestrogen. The level of oestrogen peaks at day 14. Oestrogen stimulates the uterus lining to thicken.

• Day 14 there is a surge of Luteinizing hormone from the pituitary gland = triggers the dominant mature follicle to release its egg. Once released, the egg will be captured by the fallopian tube and carried towards the uterus.

• The follicle which is left empty by the released egg will change under the influence of LH and become the corpus luteum. The corpus luteum produces the hormone progesterone.

• Under the influence of oestrogen and progesterone the uterus prepares for possible implantation of a fertilised egg. The corpus luteum will produce progesterone for about 14 days and if there is no implantation it starts to break down causing a sudden and rapid reduction in oestrogen and progesterone. With that the uterine wall breaks down too and is shed as the menstrual bleed.

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Here we see that same cycle as a chart. • Day one marks the first day of the menstrual bleed but during the first half of the

cycle FSH influence on the follicular development is evident and is called the follicular phase.

• Follicles produce oestrogen = levels rise. • Oestrogen production is at its greatest in the middle of the cycle and peaking with

a surge of FSH around day 14.• Ovulatory occurs day 14 with surge of LH which triggers the mature follicle to

release the egg. • After ovulation oestrogen levels drop but remain present to support the uterus

during the second phase . • Progesterone production starts: after ovulation the follicle which has released the

egg changes and produces the corpus luteum (which literally means yellow body’) and it is the corpus luteum that produces the progesterone.

• Luteal phase - progesterone and oestrogen are preparing the uterus for a possible implantation of a fertilized egg. If there is no fertilization the corpus luteumshrivels, progesterone and oestrogen levels drop and the uterine lining is shed. . . .

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There are several periods in a woman’s life when hormonal disruption may occur . . . .• PMS- symptoms come and go on a monthly basis generally occuring during the

luteal phase of their cycle.• Puberty- symptoms of disruption may 2-4 years• Pregnancy – natural alteration of hormones for a few months to sustain pregnancy• Peri-menopause/menopause - hormonal disruptions may last a few years as the

body changes to adapt to a new stage of life

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• During female puberty, typically between 10 and 14 yrs, hormones will start to develop the body and the female cycle. These are often eratic at first and may result in symptoms like mood swings until the hormones finally settle down.

• During reproductive years that monthly cycle should be nicely controlled by those pituitary hormones controlling the oestrogen and progesterone production until around the 40s when the perimenopause heralds the beginning of bigger changes of the menopause.

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• Here is our reminder of the orderly response of the oestrogen and progesterone production at the command of the FSH and LH .

• Premenstrual syndrome typically occurs during the luteal phase (*animate) so this half – the 10-14 days before the period.

• What is important is the ratio of oestrogen to progesterone – note in the diagram that progesterone levels are naturally more dominant in the luteal phase with a fairly regular ratio between the 2 as they rise and fall at this point in the cycle.

• Oestrogen will naturally be dominant around ovulation as the follicles have been producing oestrogen through the follicular stage and there will be no progesterone until after ovulation.

• If those ratios are not right & levels of a particular hormone are excessive = PMS symptoms.

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• PMS is estimated to affect around 80% of women to some extent and with up to 40% suffering symptoms severe enough to interfere with their daily lives.

• 4 most common groups of symptoms - classified as PMS A,B C & D• PMS A is dominated by anxiety, tension, irritability - due to excessive oestrogen

production around ovulation or oestrogen dominance during the luteal phase• PMS D is the opposite of PMS A, being linked to low production of oestrogen

which makes the progesterone dominant, resulting in low mood or ‘depression’ symptoms and is generally experienced in the latter half of the luteal phase

• PMS B is recognised by the excessive fluid retention often felt around the abdomen which causes the bloated feeling. This is influenced by the adrenalhormone aldosterone, the levels of which are normally controlled by good magnesium levels. When magnesium levels are low due to low dietary intake or during stress for example, aldosterone levels can rise and cause cells to retain fluid. Magnesium is a mineral in demand for many body functions and a simple effective supplement for PMS B.

• PMS C may also be affected by low magnesium as it plays a role in blood sugar control through supporting the metabolism of Carbs. Cravings are often linked with high hormone levels too, particularly during the peaks occurring in the luteal phase.

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• As we view the oestrogen: progesterone relationship over a woman’s lifetime, we see the huge changes and reductions that occur between 35 & 50

• In spite of these overall reductions, the greater decline in progesterone results in oestrogen dominance and this contributes to many of the symptoms experienced during the late 40s and early 50s.

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• The perimenopause heralds the sign of changes in the ageing organs of the reproductive system and consequently the production of oestrogen and progesterone.

• Periods often continue as normal with no obvious signs of the changes going on but as menopause approaches periods then become erratic and oestrogen decline becomes accelerated.

• When women talk about the menopause we tend to ‘lump together’ the perimenopause and menopause phase together and refer to it all as the menopause but officially the menopause is a short phase classified by an absence of periods for a continuous 12 months, and precedes post-menopause.

• Postmenopause is the phase when the menopausal symptoms like hot flushes and night sweats are said to decrease or disappear but for many women this can take a few years. Health risk reviewed later.

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• Perimenopause means ‘around menopause’ - refers to the transition time between the premenopause (or menstrual) phase and post-menopause. It usually starts in late 40’s or early 50s but may begin earlier under certain circumstances.

• The average length of perimenopause is 4 years - during which many of the signs of the menstrual phase may still be present e.g. menstrual bleeding – albeit erratic, . . . . breast tenderness and mood changes . . . . .but the perimenopausewill also bring the new menopausal symptoms of hot flushes, sleep problems and vaginal dryness.

• The charts show the results of regular hormone tests over a 6 month time-frame and clearly show a disruption to the normal regular hormone cycle. The resulting hormone chaos produces some of the typical peri-menopausal and menopausal symptoms.

• We should be aware though that symptoms often associated with the menopause could also be due to ageing . . .and mood changes are influenced by lack of sleep and stress as well as hormones.

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• Altered hormonal activity continues during the menopause too but there is now a gradual decline in levels of oestrogen & progesterone from the ageing ovaries as the number of follicles decline.

• The pituitary gland often responds initially by producing more FSH in an attempt to trigger follicle development.

• With no clear feedback from the sex hormones to the pituitary, both FSH & LH release is erratic and remains higher as these pituitary hormones attempt to stimulate something which can no longer happen. With no mature follicles LH cannot trigger ovulation. . .resulting in no progesterone production ……..eventually the excessive and erratic hormone release reduces and stabilises but often with FSH remaining elevated and LH production levelling out instead of just peaking in the middle of the month. . . .this is the post-menopause phase.

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The risk of early menopause due to family history is thought to be very low, possibly around 5% and would be indicated if your mother or grandmother had early menopause.Cancer treatment like pelvic radiation or chemotherapy may trigger early menopause .. . Complete hysterectomy includes removal of the ovaries, the oestrogen-producing organs, triggers menopause. Partial hysterectomy with only uterus removal doesn’t usually cause menopause as ovaries still release oestrogen however menopause may start earlier than usual.

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Smoking can increase the risk of early menopause with research showing that onset occurs 1-2 years earlier in women who smoke compared to women who don’t. The toxins in cigarette smoke have also been linked to increasing risk of breast & cervical cancer.Caffeine can increase menstrual flow, may exacerbate breast pain and may reduce the chance of conceiving as well as increase the risk of miscarriage. Caffeine can also exacerbate hot flushes .Alcohol compromises liver function. The liver detoxifies excess hormones like oestrogen which would otherwise increase the risk of oestrogen-related disorders like PMS and breast tenderness or pain. Alcohol can also reduce the female fertility and increase the risk of miscarriages. Regular high intake of saturated fats will impact on menstrual blood flow and increase production of inflammatory prostaglandins and block the absorption of essential fats.Fibre binds to toxins and promotes healthy bowel function for the removal of toxins, including eliminating excess oestrogen.Stress impacts on everything and the functioning of the female cycle is no exception. The pituitary gland which releases the FSH and LH to control the cycle also controls stress response so added pressure on this gland can affect endocrine function.

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Quality and quantity of sleep helps to reduce stress, giving much needed restorative time for the body. Weight control is important because white fat cells can store toxins and encourage further weight gain, particularly around the middle however, . . .although slowing of metabolism during menopause has some impact weight gain it may be more to do with ageing, diet and lifestyle than hormones!Exercise plays an important part in weight control but also helps to keep muscles stronger and build bone density both of which are at risk as we age and particularly during menopause and post menopause when the positive influence of oestrogen has declined.

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• Some effects on female health from 50s onwards are due to ageing and some to menopause.

• Studies into identifying those specific to menopause show that vasomotor symptoms like hot flushes, urogenital atrophy, osteoporosis and fractures are the most prevalent menopause-related health issues.

• Decline in oestrogen increases the production of inflammatory cytokines, reduces bone building activity and increases bone breakdown resulting in reduced bone density and increased risk of osteoporosis and bone fractures.

• Total cholesterol levels increase along with an increase in LDL and a reduction in the beneficial HDL which disrupts the preferred beneficial ratio.

• Oestrogen has beneficial effects on the artery linings and the muscles of the arteries and heart so as oestrogen levels reduce women are at higher risk of hypertension, diabetes and coronary artery disease.

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• Several symptoms reported by menopausal women with hot flushes and night sweats affected approx. 72%

• A clear need to support the body during these natural changes but also to help those suffering with the symptoms which can, for some women, be more than inconvenient.

• Low mood and depression can make social interaction more difficult and the hot flushes can be so severe that they can be a cause of embarrassment.

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• Remember this diagram where we talked about the pituitary hormones FSH and LH controlling the production & release of oestrogen and progesterone?

• Remember that post-menopausal FSH and LH remained level rather than fluctuating but at a constant high level?

• In effect these pituitary hormones are shouting at the ovaries to produce oestrogen and progesterone which they are no longer equipped to do.

• Many of the menopausal symptoms are thought to be due to these persistent high FSH and LH levels and exacerbated by some of those lifestyle factors we looked at e.g. stress, excess weight, alcohol etc.

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The Botanical Female complex combines a range of botanicals with broad approach to supporting female health, with a particular focus on perimenopause, menopause and post menopause phases. In our overview we recognised the need for oestrogenic support, liver support for detoxification and anti-inflammatory action. The antioxidant support for the ageing body – especially the reproductive organs and liver - are very important and the adaptogens support the adrenals .. . . So let’s see how the Botanical Female complex provides this comprehensive support

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This is the Solgar Botanical Female complex. . . .a comprehensive range of botanicals to support the menopausal woman. Lifenol® Hops – will be reviewed separately Isoflavones are the most extensively researched class of phytoestrogens and found in relevant amounts in soy or soy-based foods and in red clover. Red Clover• phyto-estrogenic activity of red clover is weaker than that of the Lifenol hops

extract but has been shown to reduce both frequency and severity of hot flushes • Red clover derived isoflavones - effective in helping to reduce depressive and

anxiety symptoms among postmenopausal women • Menopausal decline in oestrogen can increase the rigidity in the blood vessels and

increase the risk of vascular problems which can lead to inflammation in the vascular walls . Red clover has shown some support in these areas.

Sage• shown to help combat sweating and hot flushes.Broccoli• Supports oestrogen detoxification in the liver Flaxseed• Consumption of flaxseed is associated with cardioprotective effects due to the

components alpha linolenic acid, fibre and phytoestrogenic lignans*

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Liquorice Root• Weak phytoestrogenic activity; Adrenal tonic to support adrenal function during

chronic stress.

Turmeric Root• Anti-inflammatory: Supports detoxification in the liver: antioxidant support

protects the cells from oxidative stress.

Dandelion leaf• Liver tonic as a lipotropic agent & a mild diuretic

Grape Seed• Antioxidant and supportive of cardiovascular health

Schisandra Berry• Adaptogenic – increases tolerance to various stressors by modifying the stress

response: liver support

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• Hops - traditionally used as a mild sedative for insomnia: noted to support the urinary tract by reducing inflammation and exerting diuretic action.

• One study noted that hops ‘soften the uterus and stimulate menstruation’, which seems to be backed up by anecdotal reports of women experiencing menstrual periods after harvesting hops flowers.

• The Botanical Female complex contains no ordinary hops extract – this is the patented Lifenol® extract with studies supporting its efficacy for menopausal symptom relief with significant reductions in hot flushes. The phytoestrogenicactivity and the ability to reduce LH is the key to its effectiveness for menopausal symptoms

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• The key actives in the Lifenol are the oestrogenic prenylflavonoids and in particular 8-prenylnaringenin or 8-PN.

• Interesting here to note the other phenolic compounds within Lifenol® • Their conversion into oestrogenic compounds are dependant on the activity of our

beneficial gut flora. For now we will focus on the 8-PN because that’s where the research is.

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After only 6 weeks the results showed that when compared to a placebo, Lifenol was twice as effective at reducing menopausal disorders and 4 times as effective at reducing hot flushes.

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At 6weeks, 60% of the women in the treatment group had reduced hot flushes by 31% taking 85mg of Lifenol daily

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90% of the Lifenol users responded positively and reported improved quality of lifeand there was a strong response within 6wks.

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A similar double blind placebo controlled cross over study done over a 16wk period with 85mg Lifenol reported a 3 fold reduction in hot flushes and a 2 fold reduction in night sweats using 85mg.

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This raises a couple of questions. • first, do results get better the longer I take it?• Studies show that there is improvement when taken over a longer period but the

significant difference appears to come in the first 6 weeks • You may find some improvement after 6 weeks especially if you are a slower

responder so 3months minimum trial is recommended

• secondly, would I get better results if I took more than 85mg of Lifenol?• taking more will produce some small margin of improvement but at 2 ½ times the

dose. • 85-100ug is the optimal dose with relatively little to be gained by doubling the

intake of 8PN.

Always bear in mind the influence of lifestyle factors which cause vasodilation and would limit the effects of these botanicals and that their phytoestrogenic activity is also influenced by poor levels of beneficial gut bacteria. Ensure that you address gut issues and nutritional deficiencies and keep stress levels to a minimum.

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The botanical female complex contains 85mg of the Lifenol hops as recommended by the research and is ably supported by the other botanicals which we looked at earlier.

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• Our focused application for the Botanical Female Complex will be those perimenopause through to post menopause years, using it to address the key symptoms and the increased risk on bone health.

• Consider adding other products to the programme to address influencing factors or support specific body organs or tissues.

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• A good multivitamin and mineral provides a range of essential nutrients and the VM Prime for Women is specifically formulated with menopausal & postmenopausal women in mind with higher than normal levels of calcium and magnesium but also vitamins K2 and D3 for bone support . Because menstruation has stopped there is a reduced need for iron so this product has no iron however it does have good B6 and B12 levels to support red blood cell production and additional iron can be supplemented if required.

• The Female multiple with it’s higher iron content is designed primarily for menstruating women from 14yrs upwards. The 400mg magnesium is helpful in supporting the adrenals during stress and the fluid retention and bloating experienced by some PMS sufferers.

• Wild Alaskan Salmon oil is providing excellent levels of Omega 3 fats and fatty acids to support cell membranes and their ability to respond to hormones. The high Omega 7 content gives additional support to mucous membranes and, along with the Omega 3s, may be beneficial for vaginal dryness & dry skin.

• Ultimate Bone Support is the ultimate. . .it has a broad range of ingredients in excellent quantities, presents minerals in highly absorbable forms and includes the most bioavailable vitamin forms e.g. vitamin D3 and K2.

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• Cranberry - well known for it’s antibacterial support of the urinary tract and Lactobacilli are able to keep pathogenic organism at bay in the vagina and urinary tract which can reduce the reocurence of Urinary tract infections.

• Probiotics - conversion of some isoflavones are dependant on intestinal flora activity which may explain variations in response in some women. This was noted as poor in those with high alcohol consumption and antibiotic use. Lp299v is mentioned here because I think its immune-regulating and anti-inflammatory approach would be an added advantage for this patented lactobacillus plantarumstrain.

• Nettle leaf extract - diuretic action comes from its ability to relax the walls of the urinary tract & help increase the urine flow which aids the removal of bacteria from the bladder; Silica content supports the structure of the walls of the urinary tract ; Quercetin content helps reduce inflammation. Reported to be useful to women with heavy menstrual bleeding (as may occur during the peri-menopause)

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• Skin Nails and Hair complex contains some silica as red algae but MSM is main supporter of tissue strength. MSM is also an excellent detoxifier of old and excess hormones.

• Hyaluronic acid complex contains 120mg of hyaluronic acid which improves moisture retention in the tissues and flexibility and suppleness not only in the skin but also the connective tissues of the blood vessels and the body organs

• Stress and insomnia were lifestyle issues we mentioned which can impact on the mental and physical stamina of the menopausal woman. Balance Rhodiolacomplex supports the HPA axis and therefore the responsiveness of the pituitary gland and the organs it targets. Calming that response supports endocrine function and may help not only to reduce stress through its action on the adrenal glands but may also support modulation of FSH and LH. Rhodiola can also assist mental calm and improve agility, both of which can be menopausal symptoms.

• 5HTP is a precursor to Serotonin, our calming and mood elevating neurotransmitter which can convert into melatonin to improve quality of sleep which is restorative to the body.

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