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Angela Lombard Nursing Practitioner View profile

Dear N

Many thanks for your question. You are in the correct age category for peri-menopause and menopause.Your low hormone levels would definitely be as a result of this. Menopause is a normal process for a woman, albeit not always a pleasant one. There are 8 different types of hormones. You do not mention your hormonal results, which I would need confirmation of in documented pathology format from a laboratory, prior to treating you. The main hormones in your instance are oestrogen, progesterone and testosterone. But to treat holistically, I would like results of any others done.

I suggest that you make an appointment to see me please, with your pathology results, or alternatively see one of our resident naturopaths or homeopaths. Your pathology results are important to see, so that the correct approach and products are recommended for you with your hormonal levels. We have wonderful remedies which work very effectively in assisting to make menopause more comfortable. At the same time I can assist you with your hair and skin problems.

I wish you a happy and safe festive season!

Warmest regards


Yesheen (dr.) Singh Medical Doctor View profile

Dear T

Thank you for your question. The Million Women Study from the UK studied the long-term effect of HRT on 947 546 women over the age of 50 over a five year period. What is showed was that women on HRT are at greater risk of developing breast cancer, endometrial cancer and to a smaller extent ovarian cancer, if they were placed on HRT. These risks change depending on the duration of HRT use and the type of HRT used (oestrogen-only or oestrogen-and-progesterone). It does not reflect the affect genetic predisposition would have.

Trisequens is a form of sequential combined oral hormone replacement therapy (HRT), i.e. containing both oestrogen and progesterone. It increases your risk of breast cancer and ovarian cancer, but may provide some protection against endometrial cancer if you have an intact uterus. Other side-effects of HRT which increase in severity the longer you use it include headaches, changes in appetite and sex drive and skin abnormalities.

I would reconsider the necessity for HRT in you case, and the possibility of weaning you off completely. If there is an ongoing need though then consider a bio-identical form of HRT that is associated with a lower risk profile. In that case I would also increase the regularity of my screening procedures for breast and ovarian cancer while you continue on the HRT. Adjuncts to the use of HRT could include Maca powder and a pharmaceutical quality essential fatty acid supplement.

Many thanks and warm regards


Yesheen (dr.) Singh Medical Doctor View profile

Dear M

Thank you for your question. I understand how distressing it must be to see your mother in ill-health and feel ill-equipped to help as much as you would like to. There are so many factors that play a role in the development of the symptoms you describe and it is quite difficult for me to offer a valuable response without getting a full history, looking at her test results and examining her personally. From the little I can get from your question it sounds like your mom may have something going on with her blood or haemoglobin levels. Have her doctors checked her for anaemia or pernicious anaemia? In addition there are several micronutrient deficiencies that may produce a similar picture.

When in doubt go green! In cases like this where the picture is generally quite murky and a clear diagnosis is difficult to reach I often go back to basics and build up a nutritional plan that provides adequate amounts of macro and micro nutrients to allow the body to heal itself. The first step is juicing. Get her a juicer and teach her to start the day with a glass of fresh spinach, broccoli and ginger juice which is packed with phytonutrients and minerals that support bone and blood systems. Another essential item is a good quality pharmaceutical grade Omega 3 supplement.

I'm sorry I cannot be of more assistance, but the information provided is too vague and the case sounds too intricate for a forum like this. You are welcome to consult me in a private capacity and you can find contact details on my profile.

Many thanks and warm regards


Yesheen (dr.) Singh Medical Doctor View profile

Dear G

Thank you for your question. As I see it you have two separate but interlinked problems at present. Firstly there is the menorrhagia or heavy menstrual bleeding for which you have been receiving Minerva for two years, and secondly menopause.

You don't mention what the reason for the menorrhagia is and this may affect your choice of future management. If the issue if hormonal then sometimes an oral contraception like Minerva is prescribed in an attempt to regulate the hormonal cycle and as such regulate the volume or duration of bleeding. Minerva is a combination of cyproterone acetate, an anti-androgen, and ethinylestradiol, a form of oestrogen. Apart from all the other risks associated with oral contraceptive use, which I sincerely hope your gynaecologist discussed fully with you, Minerva may also be masking many of the symptoms of menopause you say you currently do not experience.

Menopause is basically your body reacting to the natural reduction in oestrogen and progesterone as the number of eggs in your ovaries reduces as they get released through the years. These hormones are produced in association with the regulation of the "egg-release" cycle and if there aren't any eggs to release then there won't be as many hormone molecules released either. Your use of an oestrogen-containing pill has probably supplemented your diminishing oestrogen concentration, keeping many of the symptoms associated with a decrease in oestrogen at bay. Blood tests may not be able to differentiate between the levels of normal oestrogen and that provided by the Minerva, depending on the test ordered. And blood tests do not dictate at what level of oestrogen-drop you may begin to experience the symptoms of menopause.

My recommendation is dependent on the reason for the menorrhagia. If it is hormonal then as your hormone levels diminish the occurrence of the heavy bleeds should as well, and so to should the need for hormonal supplementation. But until that stage I would recommend thinking about changing to a bio-identical form of oestrogen such as an estradiol preparation which is identical to your own oestrogen composition and has fewer associated side-effects. If the reason for the menorrhagia is physical, such as problems with your endometrium or your ovaries then I would consider managing these and re-evaluating the severity of your menopausal symptoms after the Minerva was stopped. If you then still experienced symptoms of menopause that were challenging then we could look at the use of supplementation with either a bio-identical hormone such as estradiol, natural progesterone or the use of alternate therapies such as Black Cohosh or Accupressure. When considering the use of bio-identical hormones I would prefer you use a cream, skin patch or an oral drop form instead of a pill or capsule form. You need much less of the hormone as you don't need to bypass the stomach and the liver to get it into your blood system and to your ovaries.

Irrespective of which pathway you eventually follow the following are essential for any woman who is entering this period of her life:

1. Omega 3's in doses of over 400mg per day

2. Maca Root Powder, an adaptogen from the root of a Peruvian turnip variety which has been shown to regulate hormonal imbalances

3. Exercise, at least 30-40 minutes per day

4. A well balanced nutrition plan tailored to your body type that contains plenty of green fresh organic vegetables.

Many thanks and warm regards


Megan (dr.) Jones Homeopath View profile

A woman’s cycle can be affected by a large range of factors, including stress, diet, exercise and medication. Stress alone can cause you to miss an entire cycle. After periods have been established in a normal rhythm there shouldn’t be a deviation of more than 5 days either side. Usually concern is only warranted if this becomes a regular occurence or if there are other symptoms associated, such as heavier periods or excessive discomfort. You could very well be moving into perimenopause. If you have not begun your period yet I would suggest you visit a healthcare provider or gynaecologist for a general check-up, including hormone testing. Keep in mind that there are many homoeopathic and natural treatments for menstrual problems and menopause, but a check-up is in order to exclude any sinister causes. Warm regards, Dr Megan Jones, Registered Homoeopath

Megan (dr.) Jones Homeopath View profile

I completely sympathise with the very common quest you have been on for your menopause symptoms! Your rapid increase in blood pressure is somewhat concerning and I would recommend that you have a full check-up with your primary healthcare provider (GP or homoeopath). This is to rule out any sinister causes, to try find the cause, and find a solution to control it. It is dangerous to leave blood pressure at such high levels so please do not delay in having this seen to. I am glad to her that you are taking supplements. There are homoeopathic remedies, supplements and herbs for high blood pressure and menopause but your case needs to be carefully managed by a professional at this stage. Please don’t give up on natural approaches as they really are invaluable once you find the correct one for you. Kind regards, Dr Megan Jones, Registered Homoeopath

Felicia Rubin Pharmacist View profile

Remifemin is a herbal supplement for HRT & you should have some relief within a month. However, it is possible you stopped too soon. Furthermore I would suggest Sepia, a homoeopathic remedy, in addition to Remifemin.

Sepia takes care of the hot flushes exclusively, but not the lack of Oestrogen.

There are other natural options for HRT, and I would be very happy to assist you with the natural route before you resort to Oestrogen.

Please feel free to contact me at Wellness Warehouse , Kloof Street.

Kind regards, Felicia (Senior Pharmacist & Integrative Health Practitioner)

Angela Lombard Nursing Practitioner View profile

Thank you for your query and concern about taking Femolene. Having looked at all the Femolene products carefully, there is no record for the thickening of the uterine wall, as a side effect for Femolene. As a nursing practitioner with a degree in research, my instinct is to source clinical trials done on a product like this, but can not find the above listed at all as a side effect of Femolene specifically. The possible side effects, while uncommon, which are listed as reported are: nausea, stomach upsets and diarrhoea. It is important to note that Femolene is not to be taken by pregnant women, nor by a patient who is using blood thinning medication e.g. disprin, aspirin, ecotrin or warfarin. A client who is on antidepressant medication should consult with her medical doctor first, prior to taking Femolene as there could be a chemical reaction, depending on the type of antidepressant prescribed. Femolene does contain black cohosh, and it is this herb ingredient which does not always agree with a woman who has a liver disorder - otherwise, symptoms could very well develop as abdominal pain, dark urine, or jaundice. You could contact the company directly that markets and distributes the Femolene products - the address is: Kenzahealth, Suite 177, Private Bag x7, Northriding, 2162. The Customer Care Line is 0860103359. The website is www.femolene.co.za.

Kind regards, Angela, Nursing Practitioner.

Reena Sukdev Homeopath View profile

Please contact the Integrative Medical Centre (IMC) in Johannesburg. The contact number is (011) 4630036.

Regards Reena (Cavendish Homoeopath)

Reena Sukdev Homeopath View profile

I would recommend that you use natural hormone support under supervision and not merely use over the counter options in your case. However, if you were to use the two natural products in conjunction, there should be no adverse effects as they are natural products. The reason why the various products you have tried are not working is that your body’s needs might not be correctly identified. You need to start the process by doing a proper hormonal test and find the imbalances. Based on these findings you can then proceed to normalise these symptoms. There are many practitioners who now use the compounding pharmacy approach to prepare a very specific bio-identical hormonal formula according to your body’s needs. This supported by lifestyle and dietary changes should be explored. Also please view our healthnotes section which has information on lifestyle and natural remedies to assist with menopause. You can view this by following this link www.wellnesswarehouse.com/healthnotes.php?org=wellware&ContentID=1041009

Regards Reena

Reena Sukdev Homeopath View profile

There are many natural approaches to deal with hot flushes. It is a good idea to get your hormonal levels tested. You then can use the specific bio-identical hormonal cream to bring about regulation of your hormones. You may also use herbal remedies to bring about effective changes. Some herbal remedies include Black Cohosh, Red Clover, Vitex Agnus castus and Dong Quai but it is important to use these under supervision. The Chinese approach would be to address the imbalance of the meridians. There are two effective Chinese formulas to address this- Meno-Well and Clear Root Fire. There are many effective formulas in store to assist with menopause and I would recommend you come to see me for further in depth advice. It is important to address the emotions attached to the hot flushes and if we discount this we would not have correctly addressed the problem. Menopause often brings these out more forcefully. Some common
homeopathic menopausal remedies are Sepia, Lachesis, Ignatia and Pulsatilla. Try to identify some of the factors that aggravate or set off the hot flushes. You seem to already have the diet and exercise routine under control which is great. Some foundation supplements you would need would be a good source of essential fatty acids such as The Real Thing 3, 6 and 9. I would recommend you take Klamath, Blue Green Algae as a source of your nutrients. You should also take a good Calcium supplement such as Good Health Supercal. Please feel free to come and see me fo further advice. Regards Reena (Homoeopath, Cavendish)

Sean (dr.) Gomes Medical Doctor View profile

Your irregular periods could well be a result of Perimenopause (Perimenopause is referred to as a time of transition in which many
women ovulate irregularly due to either inadequate secretion of
oestrogen or a resistance of the remaining follicles to the ovulatory
stimulus. This phase reflects a biological change from being
reproductive to non-reproductive. For more of Dr Chase’s healh guide on Menopause please visit www.wellnesswarehouse.com/healthguides/healthguides.php?id=11).

I would however, recommend that you do see your doctor in order to rule out any other potential problems. This he would be able to do with an examination and possibly and ultrasound.

Kind regards

Dr Sean Gomes

Sameera (dr.) Abbas Naturopath View profile

PMS is difficult to treat with only one single remedy, because it comprises a host of symptoms. PMS is mainly triggered by changes in hormone levels. Diet, vitamin & mineral and essential fatty acid deficiency also play a role. Progesterone cream will help with your PMS because it stimulates and regulates the body’s natural production of hormones (estrogen, progesterone & testosterone). Add calcium & magnesium, vitamin B6, omega 3 (preferably from fish oil) and omega 6 (evening primrose oil or borage oil. Double your dose one week before and during your period) to your supplements as these help with improving mood. Herbs such as vitex agnus castus works well by regulating hormones, and improving PMS symptoms and it also helps with infertility.
Also, have a hormone test done to check whether you estrogen dominant/deficient or progesterone dominant/deficient. This will help you choose which nutraceuticals will be of more benefit to you.


Reena Sukdev Homeopath View profile

You are welcome to visit our natural dispensary for further advice in this area. We could tailor a programmer that suits your needs or refer you to one of our in-house consultants. Services are available at both our Kloof and Cavendish stores.

Regards Reena

Reena Sukdev Homeopath View profile

Whilst many women choose an allopathic approach to deal with menopause
there are various natural ways to deal with this important transition
in your life. Your body is going through some normal physiological changes at this stage of your life.
The levels of oestrogen and progesterone are in flux at this stage. You don’t need treatment unless your symptoms
bother you. However, you could make very effective preventative
choices now that could make menopause a more comfortable and
manageable experience. Keep up with your regular check ups. Nutrition
is a key area to menopause. Make sure you include foods that are high
in phtyoestrogens including legumes such as chickpeas, soya, whole
fruits and vegetables. Try and reduce the intake of alcohol,
caffeine, sugar and red meat.
Now is the time to start on high grade multi vitamin supplements that
provide all needed nutrients. Blue Green Algae is an excellent source
of essential nutrients. Take a good Calcium supplement to prevent bone
loss and degeneration. Taking a supplement like SuperCal is a good
idea as it is formulated for maximum absorption of Calcium into the
bone. Taking The Real Thing Omega 3& 6 will help you obtain your
essential fatty acids.
Exercise, meditation, yoga are areas of great benefit. Remember,
mental attitude is part of the solution. It’s an ideal stage in life
to reflect inwardly and create a balance in our life.

Regards Reena (Cavendish Homeopath)

Sameera (dr.) Abbas Naturopath View profile

Balancing your hormones will help with the mood swings. Eating a well balanced diet, moderate exercise and taking correct supplements are all very important during this natural phase of your life.

A vitamin B complex that is high in B6 (at least 50mg) is very beneficial to relax and calm the mood, as it helps balance hormones. B complex also aids the nervous system and the adrenal glands.

A diet rich in soy protein can help alleviate hot flushes. Eating plenty of fresh vegetables & fruit, especially greens, oats, legumes and minimising the intake of saturated fatty foods will help general well-being. A low intake of caffeine, sugars and alcohol should be followed.

Herbs that help balance the hormones by increasing the levels of oestrogen (as this is the hormone that decreases during menopause) are Dong Quai and Vitex Agnus Castus.

Black Cohosh also helps with balancing the hormones and is specifically indicated for hot flushes.

Hormone creams (oestrogen & progesterone)are also indicated to improve menopausal symptoms. These work by applying them to the skin and get absorbed by the body to regulate hormone levels.

Calcium & Magnesium complex should also be taken to help prevent osteoporosis (low oestrogen levels increases the risk of osteoporosis). It also helps to relax and calm the nerves and muscles.

5-HTP, an amino acid, can also be of help to alleviate mood swings. It is the precursor to serotonin (the natural feel-good hormone in your brain), and therefore will promote emotional stability and have mood-lifting effects.

The best way to treat and manage pre,peri or post menopause is to have a full medical (esp. gynaecological) and diet history. From this history an individualised treatment plan can be prescribed.

For further advise, please feel free to see me at the Natural Medicine Dispensary at our Kloof Street branch.


Sameera (Naturopath, Kloof Branch)

Angela Lombard Nursing Practitioner View profile

You may well be in the menopausal phase of life. Your age category indicates this along with you menstrual irregularity. You do not mention what your bone problem is - should it be due to the menopause phase, then the hormone prescribed by your doctor could either be oestrogen or progesterone based, depending on your physical profile and the signs and symptoms experienced by yourself. You do need to be a little more patient in waiting for your hormonal cycle to start regulating properly again. The hormone therapy prescribed for you will do this and will assist in preventing bone loss. Menopause is a perfectly normal stage of life to experience for a woman, even though the signs and symptoms are not always pleasant. Please read the information listed under MENOPAUSE for our wellness website as compiled by Dr. Chase Webber. This will further assist you. Kind regards, Angela, Nursing Practitioner.

Chase (dr.) Webber Naturopath View profile

Menopause normally lasts for around 4-5 years in regards to symptoms. It is a natural change and not something to be afraid of. Please read through my Health Guide on menopause for natural remedies to help with the symptoms. best regards Dr Chase Webber ND

Please Note:

The Wellness Q & A is for informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your health, you should always consult directly with your healthcare professional. Wellness Warehouse will not be liable for any errors in the Wellness Q & A, or for any actions taken in reliance thereon. The advice on the Wellness Q & A is not comprehensive and does not replace the assessment and advice of your own healthcare professional. Consultation with your healthcare professional is extremely important if you are experiencing persistent or severe symptoms.


Consult your doctor, healthcare professional, and/or pharmacist before using any supplements or before making any changes in prescribed medications. If you have a chronic illness or routinely take prescribed or over-the-counter (OTC) medication, or you are pregnant or breastfeeding, it is extremely important to consult your doctor, healthcare professional, and/or pharmacist before taking any new medication. Do not stop taking any prescription medication without consultation and guidance from your doctor.

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