Marijuana and…menopause?

I was intrigued when a colleague of mine sent me research galleys of a new paper he’s co-authored. The subject matter? Confirmation that marijuana has potentially been used for medicinal purposes for centuries.

The new research, published online in the advanced edition of the Journal of Experimental Botany,* focuses on the contents of a 2700 year old grave found in the Xinjiang-Uighur Autonomous Region in China. The grave reportedly belonged to a shaman of the Gushi clan. The current study expanded on earlier research to confirm the botanical, photochemical and genetic characteristics of the agent, and that it contained psychoactive components, thereby clarifying how it was likely used.

So, why is this important and what does it have to do with menopause anyhow?

Regular readers of this blog know that I am a huge proponent of integrative medicine, i.e. combining the best of western and eastern medicine to come up with an effective therapeutic approach. In fact, I’ve written numerous posts on the value of Chinese medicine to women in menopause who are looking for alternative strategies for their symptoms.

And so, this research lends further proof that herbal medicine has been practiced for centuries and for good reason: it works. Not for everybody (what drug does?) and not all the time and clearly, careful selection of standardized products is essential, as is consulting with a practitioner certified in herbal medicine. I provide links on this site to a few organizations where you can delve deeper into these alternative paths.

Personally, I would be thrilled if researchers discovered that cannabis can be effectively used to treat menopausal symptoms. But in the interim, I am happy to report that it has been shown to be effective in relieving the pain of migraines, reducing involuntary muscle contractions associated with multiple sclerosis and of course, calming nausea in people undergoing chemotherapy.

For critics who say that smoking a drug counteracts all of its potential benefits, I say, take a look at what GW pharmaceuticals is doing with their oral spray, Sativex.

Sativex removes the psychoactive components or cannabinoids and leaves the therapeutic form intact. Thus far, well designed clinical trials have shown it to be effective for pain of cancer, rheumatoid arthritis, multiple sclerosis, and nerve or neuropathic conditions.

So I salute Dr. Ethan Russo and his Chinese colleagues Hong-En Jiang,  Xiao Li and others, for their dedication and hard work and a wonderful paper.

Thank you for furthering proof that there is and has always been a place for alternative strategies.

*Note – this has not yet been posted  in the online edition of the journal. Full citation is:

Russo EB, Jiang HE, Li X et al. Phytochemical and genetic analyses of ancient cannabis
from Central Asia. J Experim Bot. doi:10.1093/jxb/ern260.

Abstract:
The Yanghai Tombs near Turpan, Xinjiang-Uighur
Autonomous Region, China have recently been excavated
to reveal the 2700-year-old grave of a Caucasoid
shaman whose accoutrements included a large cache
30 of cannabis, superbly preserved by climatic and burial
conditions. A multidisciplinary international team demonstrated
through botanical examination, phytochemical
investigation, and genetic deoxyribonucleic acid
analysis by polymerase chain reaction that this mate-
35 rial contained tetrahydrocannabinol, the psychoactive
component of cannabis, its oxidative degradation
product, cannabinol, other metabolites, and its synthetic
enzyme, tetrahydrocannabinolic acid synthase,
as well as a novel genetic variant with two single
40 nucleotide polymorphisms. The cannabis was presumably
employed by this culture as a medicinal or
psychoactive agent, or an aid to divination. To our
knowledge, these investigations provide the oldest
documentation of cannabis as a pharmacologically
active agent, and contribute to the medical and 45
archaeological record of this pre-Silk Road culture.
Key words: Archaeology, botany, cannabis, cannabinoids,
archaeobotany, ethnopharmacology,

Wednesday Bubble

I’m starting a new feature on Flashfree called the Wednesday Bubble. Every Wednesday, I plan to shed light on a popular misconception about a menopausal treatment or symptom, discuss research that proves or disproves a theory or simply highlight an important thought for hump day.

Onto today’s bubble!

In a recent post, I posted evidence debunking the beneficial effects of HRT with regard to pain during intercourse. Now, a Chinese herbal preparation has been shown to be ineffective.

Researchers from the Chinese University of Hong Kong have confirmed that the Chinese medicine herbal preparation, Dang Gui Buxue Tang (which contains the herbs Dang Gui and Huang Qi), has little effect on menopausal vasomotor symptoms such as hot flashes and night sweats.

Chinese herbal medicines containing Dang Gui and Huang Qi are commonly used in China for menopausal symptoms.  Neither preparation has undergone rigorous Western testing for efficacy or safety.

Over a 6-month period, 100 women with acute menopausal symptoms took either Dang Gui Buxue Tang or placebo.  The researchers found no difference in the frequency of mild, moderate or severe hot flashes between the study groups. In fact, Dang Gui Buxue Tang was found to be superior to placebo only for mild hot flashes. The researchers concluded that while Dang Gui Buxue Tang may be perceived as being beneficial for treating vasomotor symptoms, it is actually no better than placebo.

The placebo effect has been studied far and wide. Recently, it was attributed to the brain’s expectation of a future reward, meaning that if you think it, it will be. The findings of this particular study were interesting because the researchers actually expected these results. Keep in mind, however, that there are plenty of Chinese herbal medicine preparations that proving to be useful for menopausal symptoms. The most important consideration is that if you are considering using Chinese herbal medicine, consider the source. This means that you should consult a licensed practitioner and be sure any preparation you use is targeted for you and not simply purchased off the shelf or online without some sort of directive.

I want to hear from you. Let me know how you feel about the Wednesday Bubble. And if you have an idea for one, be sure to email me and let me know!

Navigating the Maze, Part 1

I always enter mazes with great anticipation. The thrill of navigating the corners and moving forward without interruption, the intellectual aspect of the “game,” and the forced retracing of steps when I hit a wall.

Maybe we should think about perimenopause like that? Anticipate, analyze, and step back each time we hit a wall.

I spoke with New York City-based acupuncturist and Chinese Herbal Medicine specialist Elaine Stern last week. We talked about common perimenopause complaints, what’s actually going on in our bodies, and with the proper guidance, steps that might be taken.

I learned a few things and hope that you will also. Please note that it is neither mine nor Elaine’s intention to provide medical advice or replace personal consultation with a private practitioner. Rather, we hope that our conversation will help you understand some of the the changes you may be going through.

p.s. Because our conversation was so lengthy, I’ve broken it into two parts.

What are the primary perimenopausal complaints that you see consistently in your practice?

There are a core group of complaints that are very common. Beginning in perimenopause, women start to have a lot more PMS, and more mood swings that worsen just before the period and sometimes don’t get better right away after, as they did previously. Sleep disturbances may occur, especially in the second half of the cycle. Note that these peripheral problems are influenced by hormonal changes.

What exactly do you mean when you say the problems are “influenced by” hormonal changes?

From the time women reach age 36 or 37, they begin to ovulate less often, i.e. instead of 11 or 12 times a year, maybe they’re ovulating nine or 10 times. By the time they get to age 45, they might be ovulating every two or three months. Women’s hormones, that is, estrogen and progesterone, have an important relationship with one another and keep one another in check. A decline in ovulation means a decline in progesterone production, leaving, for all intents purposes, an imbalance.

What happens as a result of this imbalance?

Women in perimenopause may have a low progesterone level, which leaves the estrogen in relative excess in comparison. If the estrogen is in excess in relation to progesterone, the body tends to retain water, metabolism slows, and the liver becomes more sluggish and this affects the digestive system. They may gain weight because they are not burning food as efficiently. Estrogen stimulates breast cells, meaning that breasts may feel more tender than usual. Additionally, it stimulates endometrial growth, so periods may be heavier. And because estrogen stimulates the nervous system, it can also cause anxiety.

What types of treatment do you recommend for women experiencing these types of symptoms?

I believe it’s important to consider three modalities: acupuncture, herbal medicine, and nutrition.

So, let’s talk about acupuncture. Why is it helpful and what are the drawbacks, if any?

Acupuncture is helpful for women in perimenopause because it has a very good effect on the regulatory system; it smooths things out so to speak. It can help lessen anxiety, promote the immune system and can even out digestive problems. It helps rebalance areas that are out of balance. But what it can’t do is reverse the process of moving towards menopause. And you have to go quite regularly to keep the effects going.

Meaning what? Do you have to continue treatments throughout the entire menopause?

Well, this is why I find it helpful to combine herbs and acupuncture. Because herbs stay in the system all the time, they can keep a woman at an optimal level or balance in between acupuncture sessions.

Speaking of herbs, the whole issue can be very confusing for lots of women. One study may say that they are effective,and another, that they’re not. And, there’s often a lot of product selection. Can you clear up the mystery?

It’s important to separate the idea of Chinese herbs and Western herbs. Simply speaking, Chinese herbs are based on a system of Chinese medicine diagnosis. So, they are prescibed in combinations that treat these diagnostic categories. In other words, there is no one-to-one correspondence between a single herb and a single symptom. Because they are almost always combined, you can’t simply pick something off the shelf.

Western herbs, on the other hand, tend to be targeted towards specific problems. And there are good ones available for menopause.

Can you touch upon some of those?

Well, for example, black cohosh is a terrific herb. It’s not as strong as hormones but its track record is very good. While there are some studies that show it’s not very effective and others that show it is quite effective, I think that that has to do with how the studies were done. The other issue is quality of product and the lack of regulation.

Then, how do you choose when you go to the drugstore or health store?

That’s one reason to see a practitioner. A good practitioner will have examined the studies and will understand a bit about the marketplace. In this way, she or he will be able to direct you to a good product.

But if you live in a rural setting and don’t necessarily have access to a good practitioner, what are your options?

Almost all the studies that have shown good results have been conducted using a particular blend. We refer to these herbs as “standardized” because they are created using a percentage of one or two specific ingredients that are essential to creating an effect.

Where can you learn more about which products have been used in studies?

I recommend looking at Medline or even searching for “standardized X extract” on the American Botanical Council websites. A simple rule of thumb is that the least expensive product is not always going to be the best. While it’s hard to generalize, if you can find the product that was used in studies, well, it’s a great start.

Tomorrow, I’ll post the rest of this interview, which includes more information on Western herbs, a brief discussion about nutrition, and some overall advice.

Mama’s Little Helper

There’s a new cocktail in town! Won’t necessarily do its wonders for ‘all that ails’ but it’s a good start and worthy of consideration, even for the toughest constitution. Hmmm, I can only imagine eyes popping and chattering as all you Sixties love children excitingly talk about Ms. V and so sorry to disappoint. I’m actually referring to black cohosh, rhodiola, and three immortals with a twist (i.e., topical progesterone cream ). Sounds strange, eh?

True confession time. I started having major night sweats about four months ago. Drenching night sweats. Talk about a wet dream! My MD suggested a regimen of topical progesterone combined with a low-dose topical estrogen. Progesterone? Okay. But, estrogen and me haven’t done too well in the past.

So, Flashfree might be a blogger by night but by day, I’m a medical writer/health reporter so I read and read and read and write and write and write. And while I live and breathe and eat in the Western School of Medicine, I honestly subscribe to the East meets West way of life.

Mind you, I’m not recommending that you go out for happy hour. But what I would like to convey is that there may be an effective allternative if you are hormone-shy like me, provided that you consult the healthcare professionals in your life that are ‘in the know.’

Couple rules of thumb – standardized formulations rule the day, don’t try this at home without speaking to an expert first, and shaken, not stirred!

Any other combos you’d like to share? Experiences? Tell me more!