Three Experts Offer Top Solutions for Seven Symptoms of Perimenopause
Since the sudden halt of the National Institutes of Health clinical study of the effects of the hormone Prempro, more women than ever are interested in how to create midlife health without the use of synthetic hormones. The Women's Health Initiative study was terminated in July 2002 because Prempro, which combines estrogen with progestin, appears to increase a woman's risk of breast cancer as well heart disease and stroke. "The NIH finding was unexpected. It has been a real negative for women, driving them to consider options besides hormone-replacement therapy," says Susan Lark, M.D., one of the nation's leading authorities on the use of lifestyle and nutritional Further fanning the flames was the release of a study in March 2003 (from the same Women's Health Initiative) showing that conventional hormone-replacement does not significantly improve mood, mental ability, sexual function or menopausal symptoms. Here's the good news, though. There are effective "do-it-yourself" alternatives to conventional-hormone formulations for easing the physical and emotional symptoms of perimenopause, the 10-15 years before menopause when a woman's monthly period comes to an end. Below is a "master plan" from which to create your own Here, Discovery Health Online presents top solutions for seven common
perimenopausal symptoms from three leading women's health experts: Susan Lark, M.D., nutritionist Ann Louise Gittleman, Ph.D., ( and Christiane Hot Flashes/Night Sweats: Occur in 70 to 85 percent of women and are triggered by falling
estrogen and above-normal FSH (follicle stimulating hormone) levels. Average age of onset =
48. Manifests as intense heat over face, scalp and chest for 3-5 minutes.
Vitamin E: Start with 800
Vitamin E: 400 to 1200 I.U.
2 percent natural
progesterone skin cream helps
black cohosh also have shown Bioflavonoids: 1,000 mg of
strong results. All can be used hesperidin daily. Like vitamin and tofu (aim for 45-160 mg of together or separately. E, bioflavonoids may work by soy isoflavones daily) may having a structure similar to herbs — black cohosh, dong quai or chaste berry. Lower Libido: Lower estrogen, progesterone and testosterone levels may dampen sexual desire.
Relationship, stress, illness, life events are also contributing factors.
L-arginine: Take 1,000 mg 1- Topical testosterone cream
with 250 mg of B -5 and 250-
350 mg of choline once daily
to the pelvic organs and tissue. deficiencies. Useful herbs :
See Dr. Lark below on vaginal damiana, horny goat weed and Women in love with their life dryness. She believes estradiol or testosterone. Check
hormone levels with salivary
hormone test. If one of these
hormones is low, supplement
with oral estradiol or patch;
take testosterone as capsule or
vaginal cream. In early
perimenopause, ¼ teaspoon of
natural progesterone cream
twice daily may help.
Vaginal dryness/itching: As estrogen drops, vaginal and urethral tissues can become thinner,
resulting in the production of less moisture and painful intercourse.
Vaginal lubricants or
Topical estriol (a natural
moisturizers plump up the
antihistamines as they dry out uterine tissue) "works mucus membranes. Regular
wonders." You need a doctor's (low-dose Premarin or Estrace sex relaxes the pelvic muscles prescription for estriol, which cream) or increased use of
& improves blood flow.
Practice Kegel exercises for
improved muscle tone and blood supply in pelvic area. Sleep Disturbances: Hot flashes or night sweats can cause sleep disturbances such as
awakening in the middle of the night and early morning.
Valerian root: 150-300 mg
Natural Progesterone: ¼-½
has a mild sedative effect, but imbalances in blood sugar. To also dries out tissues. Kava Kava: 150-210 mg 1
Passionflower: Maintains
Valerian: If kava kava does
meals. Breakfast could be a
smoothie) and a slice of whole product standardized to 0.8 of flaxseed oil. At lunch and
5-HTP: (5-
dinner include at least 3-4 oz.
Melatonin: 0.5-3.0 taken one
poultry, beef, lamb, seafood or hour before bedtime. Bedroom olive or flaxseed oil or nuts or seeds such as almonds, Chamomile: Reduces
5-HTP: Start with 100 mg 3
anxiety. Steep 2-3 heaping tsp. steamed veggies of various of chamomile flowers in 1 cup colors (spinach, squash or Kava root: A potent sedative
and anti-anxiety herb. Try 140 Dessert could be fresh fruit or natural aids are not drugs and
Aromatherapy with
lavender: Lavender increases Take 400 mg in oxide form
Melatonin: Produced by the
pineal gland, the hormone that
regulates the body's natural
rhythms. Take 1 mg at
Weight Gain/Food Cravings: Brain chemicals like serotonin also fluctuate close to menopause.
Diminished levels of serotonin may intensify food cravings, especially for carbohydrates &
high-glycemic foods+ like baked potatoes, white bread & rice, pasta, raisins, pineapple. Low-
glycemic foods include black beans, lentils, green veggies, peaches, strawberries, cottage
cheese, sweet potatoes, mushrooms, multi-grain breads.
L-glutamine, 1,000 mg daily
with almond or sesame butter. imbalance. Take both
cravings. Stevia is a natural
acid L-glutamine, 500 mg 2
sugar cravings. ALG's The Fat Stabilize blood sugar by eating point lifestyle plan for weight balance of protein & colorful Take 50-100 mg 5-HTP with
loss: 1. Detoxify the liver with fruits & vegetable. Aim for diet
25-100 mg of B-complex to
of 40 percent protein, 35
2. Eliminate gluten-rich
percent low-glycemic
grains and dairy foods that
carbohydrates+, 25 percent
healthy fats (flaxseed,
Eat fats that speed up fat
burning; 4. Combat excess
insulin with rainbow colored
fruits & vegetables; 5.
Balance blood sugar
eating every 3 hours before
you are hungry.
Irritability/Anxiety/Mood Swings: Symptoms can occur during perimenopause & menopause.
Estrogen acts on the brain as a natural mood elevator while progesterone has a relaxant or
sedative effect. As the production of these two hormones starts to diminish, mood imbalances
can occur.
For anxiety take Evening
primrose oil, 500 mg capsules, foods, bioidentical hormones, acid 500-1,000 mg, or licorice tools that can help depression. Take B6 as part of daily, is helpful as is a topical
much-needed change." Part of addressing perimenopausal symptoms, she writes, is acknowledging and listening to the inner wisdom and messages embodied in outward symptoms. Dry Skin: Production of collagen, the supportive fibrous structure that gives skin its strength,
decreases after 40 and as estrogen levels fall. Skin feels and looks thinner, less elastic, and drier.
The subcutaneous layer of fat also thins, thereby making the appearance of wrinkles more likely.
become "yin deficient" when (omega-3) EFA. Flaxseed oil
is the richest source of omega- Trienelle line formulated by a substances that restore or
yogurt. 3-4 Tbsp. of flaxseeds Sense from Usana Health rebuild yin include royal
royal jelly, ¼ tsp. twice a day. stabilizing effect on hormone- borage oil, a source of gamma with topical vitamin C ester or acids (EFAs) in your diet. Eat moisturizer. Borage oil is a (1-2 Tbsp. per day), raw
pumpkin seeds (2-3 oz. per
serving as a snack) and cold-
mackerel or halibut) three
times weekly.
proanthocyanidins (flavonoids extracted from grape seeds and maritime pine) and coenzyme Q10. * One cup of soy milk, for example, has only 20 to 40 mg of isoflavones; one-half cup of tofu has 35 mg. ** Salivary home-test kits measure a panel of hormones, including estrogen, progesterone, testosterone, DHEA and cortisol. The technology is not widely accepted by the medical community and your doctor ma y seek a blood test to compare the results of salivary testing. Aeron Life Cycles Laboratory, San Leandro, Calif. and Great Smokies Diagnostic Laboratory, Asheville, N.C., sell test kits. + High-glycemic foods rapidly raise blood sugar (glucose), which causes insulin production. Insulin transports sugars out of the blood stream and into fat cells and muscles. High-glycemic meals raise blood glucose so high that extra insulin is produced, quickly moving sugars into the body cells and causing blood-sugar levels to drop. Your body responds by producing hormones to increase appetite and balance blood sugar. Studies show that people are more successful at weight loss when they eat low-glycemic meals ( ).


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Tetrahedron Letters 49 (2008) 4461–4463Chemoenzymatic synthesis of 4-diphosphocytidyl-2-C-methyl-D-erythritol: asubstrate for IspEPrabagaran Narayanasamy *, Hyungjin Eoh, Dean C. Crick *Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences. Colorado State University, 1682 Campus Delivery,Fort Collins, CO 80523-1682, USAEnantiomerica

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