Dietary components from the probiotic L. acidophilus to soy isoflavonoids may be of particular benefit for women's health conditions. PHOTO courtesy of smbi
Women are a primary market for health products, natural foods and supplements. Women are the main shoppers and the primary caregivers in families. And, they are reaching senior status with special needs in ever-increasing numbers.

Before last year, the women's health market was recognized as one of the most potentially lucrative markets in the dietary supplement, functional food, and over-the-counter (OTC) segments. However, the market took a bit of a setback after controversial findings of clinical trials on hormone replacement therapy (HRT) were published last July. Now, the market again is poised for expansion.

Increasingly, both foods and supplements are formulated with a selection of components that address specific health conditions. Here is an overview of this category.

Hormonal Balance: PMS and Menopause

Bioactives that augment hormonal balance have been popular in the past, but the controversy over HRT has resulted in more women seeking hormonal help from natural products. In 2000, there were 33 million women over the age of 55, and by the year 2020, that number is expected to increase to about 46 million. With an aging U.S. population, health conditions that affect mature women will become key issues in healthcare. All women go through menopause, and about 75% of those women experience hot flashes. Two conditions that are caused by the imbalance of female hormones are menopause and PMS.

Menopause is simply the natural point (sometimes induced by surgery, i.e., by a hysterectomy) at which women's bodies (ovaries) stop producing eggs. When this happens (usually in the late 40s), the menstrual cycle decreases and eventually stops, and the body decreases the amount of female hormone (estrogen and progesterone) production. Although this is a natural process, menopause may be accompanied by uncomfortable symptoms including hot flashes, vaginal dryness, changes in mood, and decreased sex drive.

Premenstrual syndrome (PMS) is a collection of symptoms that a woman may experience before her period. Symptoms may include psychological symptoms such as irritability, depression, anxiety and emotional hypersensitivity; gastrointestinal symptoms, such as bloating, constipation and abdominal cramps; skin problems, such as acne; fluid retention, with swelling of the extremities or periodic weight gain; and other complaints such as muscle spasms, diminished libido, and appetite changes. Approximately 20-40% of women experience PMS, but about 3-5% of women suffer so severely that it disrupts their daily activities.

This recently reformulated product from Twin Laboratories Inc. (American Fort, Utah) combines 22 nutrients of benefit for a mom-to-be and her child, and includes items such as calcium and folic acid.

Bioactives for Hormonal Balance:

Black cohosh (Cimicifuga racemosa) — This North American herb has a long tradition of use by Native Americans, and is one of the leading menopausal herbal supplements. It is used as an alternative to HRT or estrogen therapy. 1,2

Chasteberry (Vitex agnus-castus) — Chasteberry is one of the leading herbal supplements used for hormone balance and PMS and, sometimes, for menopause. The herbal preparation is made from the berry of a tree that originated in the Mediterranean. Chasteberry has undergone many clinical studies, especially in Europe.

Soy isoflavonoids — Today, tofu and soy products have become as popular as vegetarian or healthy protein substitutes, but not all soy protein isolate products contain these isoflavonoids. The isoflavonoids are phytoestrogens that have an estrogen-like (weak) function that is thought to help balance hormones and reduce menopausal symptoms.

Red clover (Trifolium pratense) — Another source of phytoestrogens, red clover is used to improve menopausal symptoms, such as hot flashes, and is available as a dietary supplement.

Damiana (Turnera aphrodisiaca) — Damiana is an herbal medicine from Mexico and Central America that, traditionally, has been used as an aphrodisiac, and for producing a feeling of calm euphoria (but is not a narcotic).

Dong quai (Angelica sinensis) — Dong quai is used in traditional Chinese medicine (TCM) for women's hormonal conditions, such as menopausal symptoms and PMS. There are no phytoestrogenic compounds in dong quai; rather, it is thought to exert its effects in relieving symptoms (hot flashes, cramps, etc.) though the combined effect of blood thinners and muscle relaxing compounds. 3

Emotional Support: Anxiety and Depression

Depression afflicts approximately 19 million people with twice as many women affected as men. According to the National Institute of Mental Health—NIMH (Bethesda, Md.), about 20% of women experience a depressive disorder that should be treated once in their lives. Although there are different types of depression, typical symptoms include sleep problems, a sense of hopelessness, decreased energy, difficulty remembering or concentrating, feelings of guilt, and loss of libido.

Depression often is accompanied by other conditions such as addiction, eating disorders, seasonal-affective disorder, panic and anxiety disorders. Anxiety disorders affect more than 19 million adults in the U.S. and twice as many women than men. The symptoms may include generalized anxiety or several other types of anxiety disorders, such as panic attacks and post-traumatic stress disorder (PTSD).

Bioactives for Emotional Balance:

St. John's wort (Hypericum perforatum) — This herbal medicine has reached superstar status in the U.S. for treating mild to moderate depression.

5-HTP (5-Hydroxy-tryptophan) — Extracted from an African medicinal herb called Griffonia simplicifolia, 5-HTP is a precursor in the body to serotonin production. It is used to treat mild to moderate depression, insomnia, weight loss and general muscle pain.

SAM-e (S-adenosylmethionine) — SAM-e is produced naturally in the body and used in numerous body processes. SAM-e levels have been found to be low in the elderly and in people with depression, and it is theorized there may be a dysfunction in the production of SAM-e internally. SAM-e is used as a dietary supplement for relieving depression, maintaining antioxidant status, and reducing arthritis.

A serving of 14g (1 1/3 tablespoons) blended into water of Nutravail Technologies Inc.'s (Chantilly, Va.) Passion Fruit Tea provides 20% of a woman's Daily Value for calcium, 100% each of folic acid and nine other vitamins, as well as 10mg of soy isoflavone.
Kava kava (Piper methysticum) — This herb is used in South Pacific ceremonies, and it helps people relax and socialize. Kava kava has become popular in the U.S. for relieving anxiety and promoting a state of relaxation without drowsiness. Recent controversy has stemmed from reports that it may be toxic to the liver, but there also are questions as to the validity of those reported cases.

Valerian (Valeriana officinalis) — Valerian is a popular herb for promoting relaxation, calming anxiety, and for helping reduce insomnia. Several clinical studies confirm its effect, and it is generally considered a mild tranquilizer. 1

Passionflower (Passiflora incarnata) — Although there is not much scientific evidence for the use of passionflower to help relieve anxiety, stress, and insomnia, it has a strong tradition in those areas. Passionflower often is used in combination with other "calming" herbs, such as valerian.

Osteoporosis

Osteoporosis is one condition that is experienced by both men and women, but is more common among women. One-third of all women will experience osteoporosis. Before the 1980s, osteoporosis did not have a high profile, but it is a mainstream concern today, thanks to the efforts of pharmaceutical education campaigning. Osteoporosis essentially occurs when the rate of bone loss (resorption) exceeds bone growth, and the bones become porous, brittle and susceptible to fracture.

Susan Brown, Ph.D., director of the Osteoporosis Education Project (East Syracuse, N.Y.) and author of the book Better Bones, Better Body, has been trying to steer people away from their limited view of osteoporosis being controlled by estrogen and calcium. She has promoted a new way treating and preventing osteoporosis by tipping the balance between diet and lifestyle factors towards bone-building activities in the body, away from bone-depleting factors. Coined the "total burden concept," factors such as endocrinology, diet, lifestyle, drugs, physical activity, organ disease, vitamin D deficiency and malabsorption all can tip this holistic balance towards or away from osteoporosis. Brown also stresses that vitamins D and K "have a lot of new research coming out, and needs are higher than we originally thought." Additionally, she warns that the new high-protein diets are dangerous because they promote bone depletion. Brown insists an alkaline diet (one that is high in vegetables and other alkaline foods) is key in keeping bone mass.

Bioactives for Bone Health:

Soy isoflavonoids — Again, soy isoflavonoids may be helpful in women's health because they promote a weak estrogenic effect that helps support bone building. 3

Ipriflavone — This is another phytoestrogen that has been clinically studied and is available as a dietary supplement for improving bone health, bone mass retention, calcium retention and promoting bone building. (Warning: There is a possibility of lowering white blood cell content with ipriflavone.)

Urinary Tract Infections

Urinary tract infections (also called UTIs or cystitis) are experienced by at least one in five women in their lifetime, and they are more common in women than men because of women's shorter urethras. UTIs occur when there is a bacterial infection in some part of the urinary tract (it can happen lower in the urethra, or ascend higher and become more serious in the bladder or kidneys). UTIs usually are identified by a burning sensation during urination and an urgency to urinate; however, it is important to see a doctor to have it confirmed and treated before it progresses. Other more serious symptoms (indicating involvement with the kidneys) may include fever, vomiting and lower back pain. It is not recommended to self-treat a UTI, but supplements and a good diet may help to prevent them.

Bioactives for Urinary Tract Health:

Cranberry — A strong extract or cranberry juice with low sugar content has been used popularly, and confirmed by science to help prevent and stop the growth of bacteria in the urinary tract. It is thought to work mainly by stopping the adhesion of bacteria to the walls of the urinary tract, thereby preventing infection, but may also help to increase the acidity of the urine, thereby creating conditions less favorable to bacteria growth. 4

Uva Ursi (Arctostaphylos uva-ursi) — Also called bearberry, its leaves are used to help disinfect and reduce inflammation of the urinary tract, and it is a diuretic.

Yeast Infections

About 75% of women are estimated to have a yeast infection during their lifetime. They are caused by an imbalance in the normal vaginal flora and fungal infection with Candida albicans. There is a new school of thought that believes that the development of yeast infections is intricately linked with diet, and a symptom that there may be a more systemic problem with Candida.

Bioactives for Vaginal Health:

Probiotics — Since antibiotics disrupt the gastrointestinal and vaginal flora, many are beginning to supplement with probiotics such as L. acidophilus during or immediately after antibiotic treatment to promote healthy digestive and vaginal flora. 5

Grapefruit seed extract — The extract is used as an antifungal support supplement for people with candidiasis. 6

Cat's claw (Uncaria spp.) — This South American vine is an herbal medicine used to stimulate the immune system, and it helps ameliorate many health conditions. There is some evidence that cat's claw is beneficial in the healing of yeast infections, probably due to the immune-stimulating action that helps the body to heal itself.

Cardiovascular Disease

Cardiovascular disease often is thought of as predominantly a man's problem when, in fact, after menopause, it is the leading killer of women! Young men are about three times more susceptible to heart disease than young women, but older women quickly catch up to this after menopause. There is about a 50% risk of women dying from heart disease.

Bioactives for Cardiovascular Disease:

Coenzyme Q10 — Also known as CoQ10, it is found naturally in all our cells and plays a role in the generation of energy from oxygen. It is used as a supplement for slowing the effects of aging, increasing energy, heart health, lowering blood pressure, and improving immune function. The antioxidant and cardiovascular benefits of CoQ10 have been well established through clinical studies.

Amerifit Nutrition's (Bloomfield, Conn.) Estroven PMS contains vitamins, isoflavones, chasteberry and other herbs to assist with relieving tension and other symptoms of PMS.
Essential fatty acids (Omega-3/Fish Oil) — The omega-3 fatty acids, especially EPA and DHA, have been found (clinically) to protect against heart disease.

Garlic — Some of the sulfurous compounds that give raw garlic its aroma also help to reduce cholesterol, lower blood pressure, thin the blood, and protect the heart.

Hawthorn (Crataegus oxyacantha) — An herbal medicine that is popular in Europe has clinical research supporting its heart health benefits by preventing atherosclerosis, lowering blood pressure and improving oxygen use.

Red yeast rice — This is a natural source of monacolins (compounds found in certain pharmaceuticals) that are shown to lower cholesterol and triglyceride levels and protect against heart disease.

Soy — Just about everybody has seen the claims associated with soy and heart health. Soy reduces cholesterol and triglyceride levels and reduces the risk of heart disease. 7

L-Arginine—This amino acid helps improve heart health by reducing cholesterol, lowering blood pressure and improving circulation.

Other Prominent Women's Health Conditions

There is heightened recognition and awareness about a few other health conditions that predominantly affect women: chronic fatigue, firbromyalgia, fibroids and cysts. Both chronic fatigue and firbromyalgia are difficult to diagnose because they are poorly understood, and not accepted as legitimate conditions by some doctors. However, they are becoming more recognized, and natural treatments often are the first pick of women sufferers. Fibroids and cysts, however, are fairly common and difficult to treat if they become problematic. Due to the fact that more and more women are finding they have fibroids and cysts, and do not want to endure surgery or hormonal treatment to lessen them, natural alternatives may become more well-known in support of these conditions.

References:

1 Tesch, B.J., 2002. Herbs commonly used by women: an evidence-based review. Dis Mon; 48(10):671-96
2 Mahady, G.B., et al., 2002. Black cohosh: an alternative therapy for menopause? Nutr Clin Care; 5(6):283-9
3 Russell, L., et al., 2002. Phytoestrogens: a viable option? Am J Med Sci; 324(4):185-8
4 Kiel RJ, et al., 2003. Does cranberry juice prevent or treat urinary tract infection? J Fam Pract; 52(2):154-5
5 Reid, G. 2002. Probiotics for urogenital health. Nutr Clin Care; 5(1):3-8
6 JP Heggers, et al., 2002. The effectiveness of processed grapefruit-seed extract as an antibacterial agent: II. Mechanism of action and in vitro toxicity. J Altern Complement Med; 8(3):333-40
7 Rivas, M., et al., 2002. Soy milk lowers blood pressure in men and women with mild to moderate essential hypertension. J Nutr; 132(7):1900-2

Also see:

Northrup, C. 1998. Women's Bodies, Women's Wisdom. Bantam Books: New York. Brown, S. 1996. Better Bones, Better Body. Keats Publishing: New Canaan, Conn.

On the Web: OMEGAS

• www.drkoop.com - Has a tab on the homepage for women's health
• www.womensurgeons.org/HerbalMed.PDF - Overview of herbs for women's health
• http://femina.com - Site for women on health
• www.health4her.com - Diversified site
• www.womens-health.com - US Health Benefits site
• www.supplementwatch.com - Information on supplements
• www.estroven.com/pms/indexpms.html - Amerifit's Etroven PMS website
• www.nimh.nih.gov/newdart/index.htm - National Institutes of Mental Health
• www.betterbones.com - The Osteoporosis Education Project
• www.nih.gov- Type "bioactives" in the search field