Women, Hormones & the Menstrual Cycle: Herbal & Medical Solutions from Adolescence to Menopause

680 Pages·2004·25.15 MB·English

by  Ruth Trickey

WOMEN, HORMONES AND THE
MENSTRUAL CYCLE
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Women,
hormones and
the menstrual cycle
Herbal and medical solutions
from adolescence to menopause
Second edition
Ruth Trickey
iii
For Kirrian
First published in 1998
This edition published in 2003
Copyright © Ruth Trickey 1998, 2003
© Botanical illustrations Lauren Black 1998
All rights reserved. No part of this book may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including photocopying, recording
or by any information storage and retrieval system, without prior permission in
writing from the publisher. The Australian Copyright Act 1968 (the Act) allows a
maximum of one chapter or 10 per cent of this book, whichever is the greater, to be
photocopied by any educational institution for its educational purposes provided that
the educational institution (or body that administers it) has given a remuneration
notice to Copyright Agency Limited (CAL) under the Act.
Allen & Unwin
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Crows Nest NSW 2065
Australia
Phone:[phone]
Fax: [phone]
Email: [email protected]
Web: www.allenandunwin.com
National Library of Australia
Cataloguing-in-Publication entry:
Trickey, Ruth, 1953– .
Women, hormones and the menstrual cycle: herbal and medical
solutions from adolescence to menopause.
2nd ed.
Bibliography.
Includes index.
ISBN 1 86508 980 X.
1. Women—Health and hygiene. 2. Menstrual cycle.
3. Hormones. I. Title.
618.172
Set in 11/13 pt Sabon by DOCUPRO, Canberra
Printed by Griffin Press, South Australia
iv
Contents
WOMEN, HORMONES AND THE MENSTRUAL CYCLE
CONTENTS
Figures and tables vi
Boxes viii
Acknowledgments ix
Introduction x
Section A SETTING THE SCENE
1 The history of natural medicine 3
Section B THE WAY THINGS ARE
2 Anatomy 23
3 Menstruation and the menstrual cycle 33
Section C MAINTAINING ORDER AND BALANCE
4 Hormones 53
5 Maintaining hormonal balance 65
6 Prostaglandins 86
Section D HORMONAL LIFESTAGES
7 Adolescence 97
8 The menstruating years and PMS 114
9 Menopause 153
Section E WHEN THINGS GO WRONG
10 The usual suspects 209
11 Menorrhagia 231
12 Metrorrhagia 251
13 Amenorrhoea and oligomenorrhoea 268
14 Dysmenorrhoea 289
15 Endometriosis and adenomyosis 305
16 Ovarian cysts 327
Section F SETTING IT RIGHT
17 Food for health 365
18 Oestrogen-like compounds in plants 394
19 Herbs 420
20 Drugs and surgery 500
Appendix Patterns of disharmony 537
Glossary 555
Notes 564
Index 645
CONTENTS v
v
Figures and tables
FIGURES AND TABLES
Figures
1.1 The humoral theory 6
1.2 The qualities 8
1.3 The elements 8
2.1 The anatomy of the female genitalia 24
2.2 Internal reproductive organs 28
2.3 Cross-section of the internal reproductive organs 28
2.4 Ovarian follicle maturation 29
2.5 The endometrial cycle in relation to plasma levels of
ovarian steroid hormones 32
3.1 The menstrual cycle 39
3.2 Pictorial blood loss assessment chart (PBAC) 43
3.3 Breast self-examination (BSE) 49
4.1 Steroid hormone pathways 54
4.2 The entero-hepatic circulation of oestrogens 59
6.1 Essential fatty acid pathways 89
10.1 The three phases of stress 211
16.1 Pathways to insulin resistance and polycystic
ovarian syndrome 336
16.2 Pathogensis and treatment of PCOS 341
16.3 Possible interactions between herbs and enzymes in the
pilo-sebaceous unit 354
A.1 Physiology according to the humoral theory 553
Tables
1.1 The three major medical systems from antiquity 4
1.2 The major differences between the old and new paradigms
of medicine and health 14
1.3 The most common natural medicine disciplines practised
in Australia and New Zealand 20
3.1 Standard classification for cervical cell changes 48
5.1 Basal body temperature graph 78
8.1 The common symptoms of PMS 116
8.2 Menstrual symptom questionnaire 127
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8.3 DSM-IV criteria for Premenstrual Dysphoric Disorder 137
8.4 Questionnaire for suspected functional hypoglycaemia 149
9.1 Normal ranges for FSH at various stages in the
menstrual cycle 161
9.2 Menopausal symptom index 162
9.3 Different recommendations for the treatment of peri-
menopausal PMS and menopausal symptoms 165
9.4 Common drugs and bone density 187
9.5 Bone density interpretations 189
9.6 Elemental mineral content in supplements 193
9.7 Sources of calcium 200
9.8 Osteoporosis questionnaire 201
11.1 Sources of iron 250
13.1 Medical evaluation of primary amenorrhoea when breast
development is normal 269
13.2 Normal ranges of serum prolactin
14.1 Uterine tone 304
15.1 Bitter foods and herbs 326
16.1 Sources of magnesium 362
17.1 Approximate levels of proteins in common foods 379
17.2 Amounts of common foods providing 10 g fibre 393
18.1 Different classes of common phyto-oestrogens 397
18.2 Relative oestrogenic activity of phyto-oestrogens 397
18.3 Coumestrol content of foods 398
18.4 Binding affinity of various phyto-oestrogens for
ERα and ERβ 405
18.5 Edible plants with recognised oestrogenic compounds 417
20.1 Factors associated with increased breast cancer risk 516
20.2 Factors associated with increased risk of cardiovascular
disease 518
FIGURES AND TABLES vii
vii
Boxes
BOXES
Signs of health 15
Natural medicine associations 19
The well woman’s check list 47
Case study: Relative oestrogen deficiency 71
Zinc for growth and development 112
Functional hypoglycaemia 149
Check list for the mid-life woman 180
Factors influencing retention of calcium in the bone 185
Calcium—essential for bones 199
Body mass index (BMI) 218
The common causes of menorrhagia 232
The importance of iron 248
Common causes of bleeding between periods 252
Abnormal tissue tone 267
The common causes of secondary amenorrhoea 269
Blood quality 287
Irritable bowel syndrome 296
Uterine tone 303
Case study: Treatment and diet for endometriosis 323
The liver 324
Peony and liquorice combination 357
Examples of low GI foods 360
Magnesium 361
Test methods for assessing oestrogenicity 417
The uterine tonics 422
Reasons to avoid HRT 519
viii WOMEN, HORMONES AND THE MENSTRUAL CYCLE
viii
Acknowledgments
ACKNOWLEDGMENTS
I am indebted to the many colleagues and friends who contributed to
the more than 70 000 words of new or updated information that was
necessary to complete the second edition of this book. Thanks firstly to
the other herbalist/naturopaths who I work with at Melbourne Holistic
Health Group. Sandra Villella helped with menopause, osteoporosis and
the latest information on the effects of declining androgens in women.
Jenny Adams took on the daunting task of researching and collating the
large amount of new information on phyto-oestrogens and Karen
McElroy collected an equally large volume of the latest herbal medicine
research. Sandra, Jenny and Karen also contributed information gained
through their clinical and professional experiences and the material
provided in the sections on the natural therapists’ approach has been
contributed to, in no small way, through insights gathered during
stimulating discussions at the clinic.
Other herbalists, too numerous to mention, helped in a myriad of
ways. Erin Collins helped with herbal research and gathering new
information on endometriosis; Nick Burgess provided photos from his
extensive collection of medicinal herbs for the front cover; and Michael
Thomsen lent some of his files on herbal medicine. Thanks also to Judy
Singer, Shu Yi Mann, Jill Birney and Kathleen McPherson.
Many gynaecologists have helped with information and chapter
reviews. Principal amongst these are Dr Claire Petterson, so vital for the
first edition of the book, who contributed information on drugs, surgery
and endometriosis; Dr Catharyn Stern for her generous help on poly-
cystic ovarian syndrome; and Dr Helena Teede for her valuable advice
on the amenorrhoea chapter.
Tracey Reeves was my personal assistant and general researcher
during a brief sojourn back in Australia and her practical, efficient and
good-humoured approach to all things professional and personal saved
the day during a two-month period of seven days a week and too many
late nights to mention.
Finally, I would like to thank Chris Cooke who helped with graphics,
the various computer dramas and who provided some of the best
resources of all—words of encouragement, a ready ear, and food on the
table.
Ruth Trickey
Melbourne
ACKNOWLEDGMENTS ix
ix
Introduction
INTRODUCTION
An earlier menarche, better nutrition, less pregnancies and a longer life
expectancy mean that today’s woman will have many more periods in
her lifetime than her ancestors did. The ‘average’ Australian woman can
expect to menstruate from the age of twelve or thirteen until she is
somewhere between 25 and 35 years old. She is then likely to become
pregnant two or three times about every two years, breast-feeding for
about three to nine months. Following her pregnancies, she can expect
her cycle to remain fairly regular until she is about 50 years old when
she will become menopausal.
All up, the average Australian woman will have about 30 years of
regular menstruation, totalling between 360 and 400 periods.
Compared to this, women from earlier ages started to menstruate
around fourteen or fifteen years old and were frequently married soon
after. Child bearing began earlier and it was common for women to give
birth many times if their fertility was not affected by sexually transmit-
ted diseases, poor nutrition or indifferent health; or if they didn’t die
in childbirth. Contraception was not as reliable as it is today, and the
spacing between pregnancies was influenced by breastfeeding—both
because breastfeeding naturally reduced fertility, and because it was
commonly held that a breastfeeding woman should abstain from sex.
(Sex was believed to bring on a woman’s period; and the return of the
period was thought to deprive the baby of sustenance by diverting the
breast milk—the ‘white blood’—from the breasts to the womb.) So, for
most of their fertile years, these women were likely to be either pregnant
or breastfeeding, and had an average of only 40 periods during their
lifetime.
Both the menstrual cycle and menstruation itself are easily affected:
diet, lifestyle and stress will all have an impact on the ease and regularity
of the cycle. These associations have become less obvious with the
modern-day tendency to take an aspirin or go on the Pill the moment
the first problem arises. But there is an increasing understanding of the
delicacy of the menstrual cycle, of its dependency on nutrition and
harmony. Many women want to control or treat their menstrual diffi-
culties with commonsense and commonplace remedies which they can
administer themselves, or use non-drug alternatives such as herbal
medicines.
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