Menopause Book Reviews

by Pamela Lee, from the May 1999 Newsletter

With millions of baby boomers reaching middle age, menopause has become a prevalent topic and a media phenomenon. Over the last 10-15 years, I've been noticing a proliferation in the number of magazine articles and books discussing menopause and the controversies surrounding estrogen replacement therapy. I've also noticed that fewer of us are resorting to euphemism when discussing menopause. For 4 out of 5 mid-life women, menopausal symptoms remind us of the distinctly physical aspects of this biological change.

The Co-op has a good selection of books on natural approaches to menopause. When I was asked to write on this subject, I selected four books, and in the week and a half that I've had them, I've read between one-half to three-quarters of each. I wish I could tell you that I've found a quick way to relieve my hot flashes, or that I have found the book to answer all my questions on menopause. But, I haven't. I still dress in easily shed layers, and while I feel better read on the subject than I was two weeks ago, I am even more aware of the controversies and disagreements over treatment to relieve menopausal symptoms.

I'll discuss the four books in the same order that I read them.

Estrogen the Natural Way by Nina Shandler is an eminently useful book containing over 250 recipes for the menopausal woman. Ms. Shandler's recipes incorporate generous amounts of soy and flaxseeds, natural sources of phytoestrogens and lignans. Prestigious medical journals, including the New England Journal of Medicine, Cancer Research, and the British Medical Journal, have published articles citing the health benefits of eating soy and flaxseed. These plant foods offer estrogenic benefits without the (cancer) risk of pharmaceutical estrogen replacement therapy (referred to as ERT).

The book contains useful charts, such as one diagramming the nutrients in soy vs. dairy and meat, and another charting how much of these estrogenic foods one needs to eat in order to reap their beneficial properties. For the soy novice, Shandler unravels the differences between silken tofu, firm tofu, or tempeh. She explains why she uses flaxseeds in her recipes, rather than flax oil. (Though flax oil is high in omega-3 fatty acids, it is not a good source of plant estrogens called lignans. Lignans are not only estrogenic, but they also benefit the cardiovascular system and digestive regularity.) Both the information in the introductory chapters and the recipes intrigued me enough that I'll purchase this book.

Menopause Naturally, by Sadja Greenwood, M.D., is very informative and easy to read. The author is a practicing physician and professor whose chief interests are gynecology and women's health care. Because Greenwood suffered and survived breast cancer in her early 40's, she had a vested interest in nonhormal methods (not HRT) for lessening menopausal symptoms, as well as in finding ways to lessen the risk of long-term low-estrogen conditions, such as osteoporosis.

I was intrigued to learn that hot flashes occur because menopausal women are not able to manage any subtlety in maintaining their skin temperature. We all shiver to keep warm and sweat to cool off in order to maintain an average body temperature of 98.6 degrees. Estrogen plays a key role in helping our skin's blood vessels expand and contract. With less estrogen, menopausal women's fluctuating efforts to maintain body temperature is dramatically pronounced. Greenwood writes that only about 10% of Japanese women (who eat soy daily) have hot flashes, compared to 80% of North Americans. My only criticism on this book is that it does not go into any single aspect of menopause in depth, but rather is a (successful) overview. This is a good first book for the woman preparing for this time in life.

Menopausal Years, The Wise Woman Way, by Susun S. Weed offers herbs and soothing words to assuage and to celebrate the midlife changes of menopause. Of the four books I took home, this was the one I liked the least. In fairness, there was a lot of useful information in this book, such as helpful sections on calcium sources from both food and herbs, the prompting for adequate loading-onto-the-skeleton exercise to prevent osteoporosis, and the advice to use only one herb at a time when trying herbal treatments. What alienated me was the heavy current of goddess language that ran through the entire text. I realize that what turned me off may very well be what most attracts the next reader. If you like talk of "wise woman ways", "crone's ceremonies" and such, this may be the very book for you. Or, if you are specifically interested in herbal treatments for the symptoms that accompany menopause, the author seems very knowledgeable. At the author's recommendation, I am drinking a fenugreek seed tea at night and in the morning in an effort to temper hot flashes. The author promises that (at least) my "sweat will smell like sweet maple syrup".

I regret that I left What Your Doctor May Not Tell You About Menopause by John R. Lee, M.D. until last. I've run out of time to read the entire book before this article's deadline. Now, I'll have to purchase this book, too! Dr. Lee, and co-author Virginia Hopkins, offers meaty information on the confusing subject of hormone replacement therapy and natural progesterone. This is not easy (or light) reading, but the authors' ideas on the benefits of natural progesterone seem intriguing and valuable. In brief, Dr. John Lee thinks that standard HRT is harmful and that many of the adverse symptoms of menopause are not due to low estrogen levels, but rather to the menopausal loss of our bodies' production of progesterone. Lee writes that the form of progesterone that is typically used in HRT is not natural, nor beneficial.

During the month of May, the Coop will offer special savings on EmeritaJ products. As the EmeritaJ Pro-Gest Natural Progesterone Cream is one of the recommended creams in Dr. Lee's book, I am going to finish the book and make an informed decision whether this is a product I'd like to try.

By Pamela Lee, from the June 1999 Newsletter

When I wrote last month's newsletter article, I had been hounded by months of unrelenting hot flashes. My hot flashes did not follow the typical pattern cited in the four books I reviewed in last month's article on menopause – worse in the evening and night hours. Rather, mine were occurring in an irritating 24-hour schedule, as if wacky unseen forces were flipping my internal thermostat between 95 and 50 degrees Fahrenheit. I'd resorted to an only-cardigan wardrobe, and given up wearing any pullover shirt or sweater, which couldn't be shed quickly enough. But I've found relief! In less than a month's time, my hot flashes have been tamed. Though they still warm me unexpectedly, they are far less severe and mercifully less frequent. I owe my comfort to eating flax and some soy.

Now guys, lest you think this article is just for us middle-age women, much has been written about scientific studies indicating the beneficial benefits for both men and women in eating more flax and soy foods. The lignins and the essential fatty acids in flax seed have been shown to lower the risk of heart disease and to play a role in cancer prevention. Phytochemicals in soy have been shown to interfere with the reproduction of prostate cancer cells. Not only is breast cancer lower in Asia, but rates of prostate cancer are also low among men eating traditional Asian diets which rely on soy products for protein.

I was afraid that food allergies would prevent me from making use of the beneficial benefits of soy. I used to eat a lot of tofu, back in my decade of vegetarianism. But I had since become sensitized to soy. I'm please to find that after leaving soy alone for years, I can now eat it occasionally (once a week or so), but still not everyday. My (hot flash) cure came by consuming 23 tablespoons of flaxseed, daily. Sometimes I ate my daily dose in crackers, cookies, or quick bread. But I found that a fruit smoothie was just as tasty and more efficient when I hadn't time to cook. Simply grind 23 T. of flaxseed in an electric coffee grinder, then blend it with fruit and rice milk, soymilk, yogurt, or milk. My favorite flax smoothie is: 1 banana, 1 cup blueberries (frozen until fresh is available), 2/3 cup rice milk, and 23 T. ground flaxseed. If you use soymilk, you'll increase the phytoestrogenic benefits of your drink. If your sweet tooth needs tickling, add 2 T. of blackstrap molasses and you'll be gaining more calcium as well.

This first recipe is what got me started with my daily dose of flaxseed. These bars are so tasty and easy to prepare, that I found the daily dose not only pain-free, but also pleasurable. When my home-dried supply of apples ran out, I made this cookie using (the Co-op's) organic dried figs. I added a dash of salt and 2 T. molasses, then renamed my version "Flax Newtons". The following two recipes are from Nina Shandler's book called Estrogen The Natural Way.

Apple Bars

Prep and cooking time: under 20 minutes
Equipment: electric coffee grinder and electric food processor.
Yield: Makes 8 bars

1/2 c frozen apple juice or orange juice concentrate
2 c dried apples
1 1/4 c flaxseed
1 T vanilla extract

1. Place the juice concentrate and dried apple rings in a saucepan. Cover and cook over medium-high heat for 5 minutes, until softened.
2. While the apples cook, grind the flaxseed in an electric coffee grinder 1/3 cup at a time. Pour the ground seeds into a food processor with the S blade inserted. Add the softened dried apples and vanilla.
3. Process until the mixture is dough-like. If the mixture rises above the processor blades, shut off the machine and push the mixture down with a spatula. Then, turn the machine back on. When the dough is fully mixed, it will form a ball in the well of the food processor.
4. Press the dough evenly into a 9x9-inch cake pan. Cut into eight bars. (Make three evenly spaced cuts in one direction and one in the other.) Remove from the pan. Place in a storage container or in plastic sandwich bags. Refrigerate.

These crackers are wonderfully good. They are darker and heavier than corn chips, but still taste great with dips or salsa. I suggest trying them with the hummus. You can use 1/2 to 1 t salt instead of the miso.

Corn Crackers

Prep and cooking time: under 10 minutes
Baking time: 25 minutes
Equipment: electric coffee grinder
Yield: 32 crackers

1 1/3 c unsweetened soymilk
1 c flaxseed
1 T yellow miso
1/2 cup cornmeal, plus additional cornmeal for rolling

1. Preheat the oven to 325 °F.
2. Bring the soymilk to a boil in a small saucepan. Remove from the heat.
3. Grind the flaxseed in an electric coffee grinder. Whisk into the hot soymilk. Stir in the miso and 1/2 cup of cornmeal to make a soft dough.
4. Divide the dough into four sections. Form into balls. Sprinkle cornmeal generously on a breadboard. Turn the dough onto the floured board. Dust the dough generously with cornmeal. Roll with a rolling pin into four 8-inch circles.
5. Fold and transfer to four 8-inch nonstick or oiled cake pans. Cut each circle of dough into 8 pizza-like pieces. Bake for 25 min, until lightly browned and crisp.

Once tofu is opened, it will keep for a week in the refrigerator, but the water must be changed daily.

At the Co-op, silken tofu is available fresh (in the northwest corner of the store) or in the asceptic packages (across the aisle from the array of chips).

Creamy Black Pepper Dressing

1/4 vegetable bullion cube
2 T hot water
1/2 c silken tofu, drained
1 small clove garlic, minced
1 T freshly grated Romano cheese
1 T fresh lemon juice
1 t canola oil
1/2 t black peppercorns
1/2 t granulated sugar
Salt to taste

1. In a small cup, dissolve bouillon in hot water. In a blender, combine tofu, garlic, cheese, lemon juice, oil, peppercorns, sugar and bouillon mixture; puree until smooth. Season with salt.
2. Transfer dressing to a tightly covered container and refrigerate for at least 1 hour.

The dressing will keep, in the refrigerator, for up to 3 days. It will thicken as it sits, so stir well before using. Makes about 2/3 cup.

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