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New Drug To Stop Hot Flushes

A new menopause drug has been approved in the US since May (2023) and it is thought that it could be approved in the UK by the end of the year.

It is non-hormonal medication, made by Astellas Pharma called fezolinetant (brand name Veozah) and it is for those women who can’t take HRT because of a risk of breast cancer or clots.

The medication works directly on the brain to switch off hot flushes by blocking a protein the brain’s hypothalamus called neurokinin-3 which helps to regulate body temperature.

In one clinical trial, after 12 weeks, the fezolinetant reduced the frequency of hot flushes by about 60%.  But those taking the placebo also saw a reduction in hot flushes by 40%. The medication also helped improve quality of sleep.

According to the FDA in America, the most common side effects include abdominal pain, diarrhoea, insomnia, back pain, hot flush and elevated hepatic transaminases.   I have highlighted hot flush as this is one of the key side effects that this newly approved medication is designed to help eliminate!

And from the FDA, the prescribing information for Veozah includes a warning for elevated hepatic transaminase, or liver injury. Before using Veozah, patients are told they should have blood work done to test for liver damage. And that the healthcare provider should also repeat this blood test at month 3, month 6, and month 9 after you start taking Veozah.

The list of ingredients for this medication include the following:

Active ingredient: fezolinetant
Inactive ingredients: ferric oxide, hydroxypropyl cellulose, hypromellose, low-substituted hydroxypropyl cellulose, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol, talc, and titanium dioxide

If you are looking for a more natural way to help you through this stage in your life, rather than taking medication which can carry side effects, then see my book ‘Natural Solutions to Menopause’ available from  https://www.naturalhealthpractice.com/natural-solutions-to-menopause.html

Menopause Is Not An Illness It Is A Natural Event!

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Menopause is not an illness. If you subscribe to the standpoint currently held by the conventional medical profession, you’d be forgiven for thinking it was.

What is menopause?

In conventional terms menopause and its symptoms are viewed as a disorder caused by falling hormone levels. So, by giving menopausal women hormones in the form of hormone replacement therapy (HRT), the deficiency can be corrected and we have a ‘cure’. This argument is supported by the supposed similarity between the menopause and diabetes. When insulin levels are insufficient to maintain normal blood glucose levels, then insulin is supplied from outside and the balance is corrected.

But diabetes is different from the menopause in one important respect: diabetes is not a natural event. It is not expected that everyone will get diabetes; but all women will pass through the menopause. It is a natural stage in our lives and there is a wealth of scientific evidence that there are alternatives to HRT.

Women in many other cultures do not experience the menopause as a crisis demanding medical intervention. Many of them simply do not suffer the physical and emotional symptoms that women in the West are programmed to accept as inevitable. In our society the focus of the menopause is one of loss. Women are programmed to dwell on loss – the loss of periods, the loss of the ability to create life, the loss of hormones, the problems of the ’empty-nest’ syndrome. In other societies, this time in a woman’s life is seen as one of gain, a time of great wisdom. A time when the emphasis shifts away from doing the chores, working in the fields, to the role of lawmaker and counsellor to younger couples, where maturity and experience make a significant and valuable contribution to the family and society.

My approach is to take the menopause as a natural event. HRT is always there as the last resort, and it should only be used as such. Try the natural approaches first, and then assess whether you really do need HRT. The odds are that you won’t.

Dietary changes

A well-balanced diet is essential during the menopause as it enables the body to adjust automatically to the hormone changes.  Eating a good amount of fresh fruit and vegetables and also including phytoestrogens in the form of chickpeas, lentils, soya, kidney beans etc. is important.  Caffeine in tea and coffee etc. can bring on a hot flush for many women.  The same can apply to spicy foods and alcohol.

Phytoestrogens

Why is menopause experienced so differently around the world? Up to 85% of Western women will experience hot flushes compared to only 14% in some Asian countries.  As a result, scientists have been studying the benefits of phytoestrogens which occur naturally in certain foods such as soya, chickpeas, lentils. etc.

Almost all fruit, vegetables and grains contain phytoestrogens in varying strengths but it is the isoflavones (one of the classes of phytoestrogens) that are the most beneficial kind.  They are found in legumes such as soya, lentils, chickpeas etc.

Also pay attention to these points in your diet:

  • Stabilise blood sugar levels by reducing the amount of sugar and refined foods in the diet and eating little which helps to stop the mood swings etc
  • Reduce or eliminate caffeinated drinks such as tea and coffee which contribute to the blood sugar problem
  • Ensure a good intake of essential fatty acids from oily fish, nuts and seeds which help lubricate the joints, skin and vagina
  • Avoid soft fizzy drinks which contain high levels of phosphorus and increase the risk of osteoporosis by increasing calcium loss
  • Include a good intake of phytoestrogens in the diet from many sources and not just soya

Vitamins and Minerals

As well as eating a healthy diet, supplementation is beneficial during the menopause not only to ensure adequate nutrients for maintaining healthy bones but many can also help with the menopausal symptoms.

A good quality multivitamin and mineral, designed for the menopause, should form the foundation of the supplement programme.  This multi should contain good levels of antioxidants and also calcium, magnesium, vitamin D and boron.  (The one I use in the clinic is called MenoSupport FROM www.naturalhealthpractice.com.) And then particular emphasis should be put on the following nutrients:

Vitamin E

This is an important vitamin to consider at the menopause. Research has shown its effect on reducing hot flushes and night sweats.  Vitamin E is also helpful for vaginal dryness.

Vitamin C

Not only is Vitamin C important for preventing illness but it also has specific benefits at the menopause. It can help with hot flushes and also helps to build up collagen which gives skin its elasticity and it is therefore helpful in the prevention and treatment of vaginal dryness.  It can also help retain the elasticity in the urinary tract and so prevent leakage or stress incontinence, which is common at the menopause. Collagen is also important for your bones.

B Vitamins

These are called the ‘stress’ vitamins because they are enormously beneficial when you are under a great deal of pressure. Symptoms of B-vitamin deficiency include anxiety, tension, irritability, lack of energy and poor concentration which are often symptoms associated with the menopause.

Omega 3 fatty acids

Signs of an Omega 3 deficiency are dry skin, lifeless hair, cracked nails, fatigue, depression, dry eyes, lack of motivation, aching joint, difficulty in losing weight, forgetfulness, breast pain – all symptoms that could be ‘blamed’ on the menopause. They need to be supplemented around the menopause because they can help with many of the symptoms. Furthermore, because they help to ‘lubricate’ the body in general, they can help with vaginal dryness.

Herbs

There are a number of herbs that have traditionally been used at the menopause.

Black cohosh

From all the published research, the herb that has the most dramatic effect on hot flushes and night sweats is black cohosh.  It was originally used by Native North Americans and is very effective in helping with hormonal imbalances.  It has a generally calming effect on the nervous system and as well as the hot flushes and night sweats and can be helpful with other symptoms include anxiety, tension and depression.

Other useful herbs at the menopause include agnus castus, dong quai, sage and milk thistle.  It is better to get organic herbs where possible.  (I use a combination called Black Cohosh Support in the clinic see www.naturalhealthpractice.com.)

Women can now live 30 to 50 years past the menopause stage and you want to live those years in good health and free from symptoms.  By eating well, taking appropriate supplements and exercising, your health will improve, which enhances the quality of your life.  Good nutrition together with the right supplements, enables the body to adjust to the changes at the menopause automatically and keeps the skin and hair soft, minimises aching joints and stiffness, slows the ageing process, controls weight naturally without dieting, maintains libido and helps to prevent osteoporosis, heart disease and cancer.

Contact the Glenville Nutrition Clinic team to arrange a consultation with one of the Nutritionists.

Top Tips On How To Treat, Prevent And Reverse Osteoporosis

My top tips for preventing osteoporosis:

Your diet is important.  Calcium is stored in your skeleton and is used as a buffer to neutralise acid. This means that the more acidic your diet becomes the more calcium can be leeched from your bones and the higher the risk of fractures.  The most acid producing foods are animal proteins including meat and cheese.  Milk and yogurt are more alkaline.  Higher intakes of animal protein are associated with lower bone density.  For more information on diet and supplements for osteoporosis see my book ‘Osteoporosis – how to treat, prevent and reverse it’.

Vitamins and minerals are important for bone health.  The first nutrient that comes to mind is calcium. But many other nutrients are equally important.

Calcium –it not only improves bone density but also reduces the risk of fractures.  Choose supplements that contain calcium citrate rather than calcium carbonate for maximum absorption.

Magnesium – helps to metabolise calcium and converts vitamin D to the active form necessary to ensure that calcium is efficiently absorbed. 

Vitamin D3 – important for the absorption of calcium (it must be D3 rather than D2). D3 is 87% more effective in raising and maintaining vitamin D levels than D2. We have a wide spread deficiency problem in the UK, my recommendation is to do a simple home finger prick test for vitamin D available at Glenville Nutrition Clinic to check whether you are deficient and then you can be sure of how much vitamin D you need to take each day.

Vitamin C – important in the manufacture of collagen, the ‘cement’ that holds the bone matrix together.   Choose vitamin C as ascorbate rather than the acidic form – ascorbic acid.

Boron – an important mineral in relation to osteoporosis as it plays a crucial part in the conversion of vitamin D into its active form, which, in turn, is necessary for calcium absorption.

Exercise – It is better to have a combination of weight-bearing exercises like walking and dancing and weight resistance like bicep curls and lunges to create mechanical stress which helps put calcium into your bones.

Have a bone density scan to check the condition your bones are in now.   You may have to organise this scan privately as it is not easy to get one on the NHS but it will be worth it (my clinic team can also arrange a referral for you).

What Is Cystitis And Can A Change In Diet Help?

Cystitis is an inflammation of the bladder, and it can be the result of infection, irritation, or bruising, or even a combination of these three factors.What symptoms can you experience?

An overwhelming urge to urinate every few minutes, normally with little urine to pass.

Burning pain during urination.

What can cause cystitis?

There are two main types of cystitis: bacterial (infectious) and non-bacterial.

Bacterial cystitis is responsible for about 50 percent of all cases of cystitis. Bacteria (normally the E-coli bacteria, see below) enters the urethra in one of a variety of different ways. Once in, it can stick to the walls of the bladder and occasionally travels to the kidneys. The urinary tract itself is normally kept clean by the rush of urine when we eliminate waste products, but infection can develop in the urethra if the bacteria sticks to the walls and multiplies. It then travels up the urethra to the bladder causing inflammation and infection.

Women who use tampons are more susceptible to bacterial cystitis than women who use pads. The chemicals from tampons can irritate the delicate lining of the vagina, encouraging inflammation and bacterial infection which then travels to the urethra. Furthermore, the string on a tampon can act like the fuse on a stick of dynamite: providing bacteria with easy access to the body.

 Non-bacterial or non-infective cystitis is normally caused by bruising or irritation. This type of cystitis is often nicknamed ‘honeymoon cystitis’ because sex can irritate or bruise the entrance to the urethra, causing inflammation. This inflammation can also make infection more likely. Sex can also cause infectious cystitis; when body fluids are mixed, bacteria can more easily be transferred to the urinary tract.

Other causes of non-bacterial cystitis include: chemical irritants, including soaps and bubble baths. Even swimming pool chlorine can irritate the delicate lining of the urethra. Vibrations, such as riding a motorcycle, can also cause bruising, which leads to symptoms of cystitis. Drinking too little can make the urine over concentrated, causing irritation of the urethra and the bladder, which is never properly emptied. Some foods can also irritate the bladder and the urethra, including spicy foods, alcohol, strong coffee and any foods to which you may be allergic. Fresh fruit juice is also highly acidic, which can cause irritation in some people.

Some women experience cystitis during pregnancy because the urethra is relaxed by the extra progesterone produced by the body. In later pregnancy, urine can remain trapped in the bladder due to the size of the expanding foetus, also causing inflammation.

Cystitis is also more common around the menopause because, as oestrogen levels fall, the walls of the vagina become thinner and the walls of the urethra shrink, encouraging bacterial infection and making women more susceptible to irritants.

THE NATURAL APPROACH

Using your diet

Eating healthily will help to boost your immunity and encourage your body to overcome infection. In particular, pay attention to the following, which will help to kill off the bad bacteria, as well as restore balance in your system.

Avoid acidity
Acidic foods and drinks, such as tea, coffee, alcohol, sugar, meat, spicy foods and undiluted citrus juices, can trigger cystitis, so if you are prone to the infection try to avoid them, and if you are overcoming an infection eliminate them from your diet completely. Instead, six to eight glasses of pure, filtered or mineral water every day to help dilute the acid in your urine.

Drink barley water
Barley water makes a great anti-inflammatory agent for the urinary system. Buy whole barley, put 1.5oz (40g) in 2 pints (1.2 litres) water, boil and simmer for 20 minutes. Add a slice of lemon or the juice of one lemon and simmer for a further 10 minutes. Allow to cool, then sip the water throughout the day.

Eat live yogurt Organic
Live natural yogurt contains lots of beneficial bacteria to help recolonize your system, especially if you have been taking antibiotics.

Avoid all sugar
Sugar feeds bacteria and weakens your immune system. Avoid anything with sugar in it – this includes not only obvious sugar products, such as sweets and chocolate, but also refined carbohydrates, such as white flour (which is found in cakes, pastries, bread and so on), and sauces such as tomato ketchup.

Drink cranberry juice
As long as it is unsweetened, unpasteurized and wholly natural, cranberry juice will help overcome cystitis because cranberries are high in substances called proanthocyanidins. These prevent the E coli bacteria from attaching themselves to the mucus lining of the bladder and urethra. If they can’t attach, they can’t multiply and this means they simply get washed away in your urine. You can use cranberry juice as a preventative, if you are prone to bouts of cystitis. However, do make sure that it is unsweetened, unpasteurized natural cranberry. Or, take a powdered cranberry supplement, or eat handfuls of the fresh fruit if you prefer.

Eat garlic
A wonderful, natural medicine, immune-boosting garlic helps eliminate the E coli bacteria, along with others indicated in cystitis. Raw garlic is much more effective than cooked, so chop it finely and sprinkle it over salads or in dressings; or eat whole cloves if you can bear it. Alternatively, take it as a supplement.

Supplements

Bromelain (500mg, three times daily between meals) This is a digestive enzyme that is found naturally in pineapple and papaya. It has anti-inflammatory properties that help soothe cystitis.

Vitamin C (500mg, four times daily during infection) Studies show that immune-boosting vitamin C can prevent E coli from multiplying and taking hold. Take the supplement as magnesium or calcium ascorbate, which is less acidic than ascorbic acid.

Beta carotene (25,000iu dialy) The precursor to vitamin A, beta carotene is a potent antioxidant that can help your cells fight infection.

Zinc (30mg daily) This is another important antioxidant that can help prevent an infection.

Probiotics (22 billion bacteria, daily) Live yogurt contains lactobacillus acidophilus (healthy bacteria), but the concentration of bacteria in live yogurt is quite thin, so for the best levels of protection against infection eat yogurt and take a supplement.

For more assistance, make an appointment with a Nutritionist at Glenville Nutrition Clinic.

How To Avoid A Monday Morning Hangover

The fastest way to help the body recover from the effects of a hangover caused by alcohol, rich food and late nights, is to support your body’s detoxification process, restore your blood sugar balance and combat dehydration.

A whole variety of foods can assist these processes, but Dr Marilyn Glenville discusses some of the key players here:

Top tips to avoid a hangover

Drink Water! Even mild dehydration can lead to ‘hangover’ symptoms including fatigue, headache and bad moods. Nutrients cannot move into cells, and wastes cannot move out of the body, without water as a vital means of transportation. Alcohol and caffeine can cause the body to excrete too much water, along with nutrients such as Magnesium, Potassium and Vitamins B and C. These nutrients are particularly needed to help to restore your energy levels and support detoxification by your liver.

As Vitamins B and C are water-soluble, they can be absorbed and used by the body within hours, so they can help ease a hangover fairly quickly.

Take Magnesium, Vitamin C and B complex supplements, and eat fibre-rich wholefoods for a boost of these nutrients and to help balance the level of sugar in your blood.

Try oat porridge with cinnamon powder and fresh fruit for Monday morning’s breakfast. If you are feeling queasy as your body is still trying to digest last night’s takeaway curry, just try some oatcakes with some banana or apple. This also makes a tasty mid-morning snack when your blood sugar dips. It is important not to rely on sugary foods and drinks to ‘prop up’ your energy levels throughout the day, because although you may feel better quickly, you will rebound and feel even worse later on. Using sugar as a crutch to provide a temporary boost of energy to get you through the day, can lead to a bad night’s sleep. This starts off your next day badly and you can fall into the vicious cycle of using sugar and other stimulants daily.

So follow the 4 simple rules to balance your blood sugar and energy levels:

1)       Eat little and often (3 moderate meals plus 2 snacks. Avoids gaps longer than 2 – 3 hours between food).

2)       Avoid highly sugary & processed carbohydrates (‘white’ bread, pasta and rice; biscuits, pastries, etc). Instead choose wholegrain cereals full of fibre and nutrients, which will release sugar steadily.

3)       When eating carbohydrates, also eat foods containing protein and the good omega fats, as they ensure a nice steady release of sugar into your blood.

4)       Avoid  stimulants (tea, coffee, smoking, recreational drugs, alcohol, etc) which upset your blood sugar balance, leading to fatigue and poor concentration.

If you find you still need some extra energy to get you through Monday, then try some herbal supplements, such as Siberian Ginseng. This gently supports your adrenal glands to help them cope with the stressful effects of the hangover, and ensure they can assist steady energy production through the day. Drinking Green tea can also be helpful as it contains L-Theanine – a nutrient that enables calm but alert thinking, and can offset the small amount of caffeine in the tea. Freshly-squeezed lemon juice in some warm water can help to alleviate nausea and pep up your liver.

Your liver is also very important to help you prevent and overcome ‘hangover’ effects. Not only does it help to regulate your blood sugar, but it works as the ‘filtering factory’ of the body – cleaning out wastes and toxins from your blood. Your liver has to work extra hard for you after a weekend of alcohol and fatty food, so make its job easier by taking Vitamin C and herbal teas or supplements such as Milk Thistle, Artichoke and Dandelion. Include liver-supportive foods such as beetroot, broccoli, garlic, asparagus and also Omega fat-rich foods such as flaxseeds, walnuts and avocado. In the long-term, as Omega fats form the membrane around all your body cells, they are essential for your whole body’s health but especially for your brain function, mood and energy levels.

If the ‘Monday Morning’ feeling is a permanent fixture in your diary, then you should consider consulting one of our qualified Nutritionists to give you an individualised action plan, to help your body minimize and cope with the stress and damaging effects of overindulgence.

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