The "joys" of menopause

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In the U.S. alone, more than 2 million women every year reach menopause. That translates to about 6,000 women daily. If you count 81 years as the average life expectancy, as the Mayo Health System does, women spend more than one-third of their lives in the three stages of menopause: perimenopause, menopause, and post-menopause.¹

Perimenopause–when a woman’s ovaries start producing less estrogen and progesterone leading to fewer and irregular monthly periods–often starts to affect women in their early to mid-40s; however, some women show signs as early as their 30s.

After 12 months of a woman going without having her period, she is officially in menopause and can no longer become pregnant. This is followed by post-menopause, which lasts the remainder of a woman’s life.

Symptoms tend to be fewer and more mild during this period, but for some, they remain a significant challenge to their health and well-being.

Menopause is Not a Monolithic Experience

As we hear (too often these days) from political pollsters, demographic groups are not monoliths when it comes to voting; the same can be said about women going through the change of life.While they may experience similar symptoms during all three stages of menopause, the manifestation of those symptoms can vary from woman to woman in intensity, effects, and duration.

There is some good news, however, that goes beyond those physically exhausting, emotionally draining, and psychologically challenging symptoms. For example, some experts say the way our society looks at this time in a woman’s life is changing for the better.

Komal Baldwa, founder of India-based Waleria Healthtech, believes that “the perception of menopause has significantly evolved in recent years, but there is still a long way to go in addressing the gaps that remain from past neglect of women’s health. This evolution can be seen across various groups, although the pace and depth of change differ.”

The shift among consumers is remarkable, she says. “Women are becoming more empowered, seeking knowledge, and advocating for their health. Online forums and support groups are fostering self-education, and women are turning to alternative therapies and solutions.”

Izaskun Monsalve, PhD, global marketing manager for women’s and infant health, proactive health at Kerry Group (Tralee, Ireland), concurs. “In recent decades,” she says, “society has made significant strides in empowering and emboldening women to seek out the lives they want for themselves.”

However, Monsalve adds, “While women should be able to navigate life’s cycles with as much ease and clarity possible, there’s still work to be done.”

The demand for more comprehensive and accessible menopause care is growing, states Baldwa, and it’s “women who are driving this momentum, leading the charge and shifting the narrative around menopause.”

Herein lies an opportunity for the women’s health category for ingredients and dietary supplements, particularly for those companies committed to providing scientifically backed solutions.

Monsalve points out that “Women, and those who care for them, are eager for solutions that can bolster their health and allow them to live life to the fullest. As Kerry research has shown that 8 out of 10 consumers throughout the world have consumed supplements in the last year, it is the most direct way to provide positive health benefits to the masses.”

Further, Baldwa notes that “studies show that 77% of women remain hesitant to use hormone therapy despite experiencing menopause-related symptoms. With an increasing number of women seeking natural, non-pharmaceutical alternatives, the industry must develop effective, safe, and validated products.”

For example, she adds that “many women prefer non-hormonal options for symptom management, and ingredients like black cohosh, Shatavari, and omega-3s offer natural alternatives that support holistic health.”

A More Proactive Approach to Health

It seems like common sense—the healthier you are throughout your life, the healthier you will be as you go through the change of life.

As Monsalve explains, “Before, during, and after menopause are all times of great change in a woman’s body, and therefore life. Naturally, women have become more interested in a proactive approach to wellbeing with a focus on prevention, as 75% stated that they are adopting a long-term health plan.”

She suggests that by taking steps to prioritize wellbeing, women can set themselves up for success not just at their annual checkups, but year-round. “Early attention to the immune system, eyes, brain, and hormonal health through supplements and diet are easily accessible steps that can alleviate heath issues later in life,” says Monsalve.

“At Kerry,” she says, “we encourage and help women to take ownership of their own menopause journey and make informed decisions that can have long-lasting positive effects on their health, and we provide products which can help through this important life-stage. Taking charge and adopting proactive practices for all around health, like incorporating supplements into daily routines, can ease these years that have traditionally been painful for women.”

Symptoms and Science

Some of the more common and most complained about symptoms that occur during menopause are hot flashes, night sweats, fatigue, anxiety, and insomnia.

Fortunately, there are a number of natural, branded ingredients available in dietary supplement products for women to combat these symptoms.

One ingredient for relief from common menopausal symptoms is Libifem, a branded fenugreek extract from Gencor Pacific (Austin, TX).Maggie McNamara, vice president of global marketing for Gencor, pointed to a published study, funded by Gencor Pacific (who also supplied the investigational products), in which the standardized T. foenum-graecum de-husked seed showed what she said were “excellent outcomes to support [the reduction of] hot flashes and night sweats.”²

The double-blind, randomized, placebo-controlled clinical trial was conducted in a cohort of healthy women, aged 40-65, either perimenopausal or menopausal, who were experiencing symptoms such as hot flushes, night sweats and other related symptoms. Among the findings, the study authors noted that “over the study period, a gradual significant reduction (approximately 50%) in total flushes was observed in the active treatment group (p < 0.001),” leading them to suggest that the proprietary treatment ingredient was “an effective treatment for reducing vasomotor symptoms and associated menopausal symptoms in otherwise healthy women.”²

First introduced to the European market five years ago, Kerry’s branded ingredient, Luprenol, with 8-Prenylnaringenine (8-PN), is a scientifically backed phytoestrogen ingredient that has been demonstrated to safely combat these symptoms, offering relief through menopause, says Monsalve. She explains that “in a clinical study on the active ingredients in Luprenol, specifically 8-PN, one of the strongest known phytoestrogens, women who took the solution experienced a 40% reduction in hot flashes and a 32% improvement in symptoms of nervousness, fatigue, and excessive sweating.” ^{3, 4}

This past April, Waleria announced the results of a new study investigating its aspurūs Shatavari root extract for the management of menopausal symptoms and regulation of hypothalamic-pituitary-ovarian (HPO) axis.

The 8-week, prospective, randomized, double-blind, multi-center, placebo-controlled study enrolled 70 participants split between a test group receiving aspurūs Shatavari root extract and a placebo group. The participants were pre-and post-menopausal women between the ages of 40-65 years old who were experiencing menopausal symptoms such as hot flashes, night sweats, anxiety, fatigue, and mood swings. The primary outcome measure was the total score of Utian Quality of Life (UQoL).⁵

The study results revealed reductions in the test group compared to placebo in symptoms such as hot flashes, night sweats, anxiety, fatigue, and insomnia. Regarding the UQoL scores, improvements were significant in the test group indicating a tangible enhancement in overall well-being. When compared to placebo, the test group saw an 85% reduction in hot flashes in as few as 4 weeks, a 90% reduction in night sweats in 8 weeks, and 60% greater reduction of reported sleeplessness.⁵

“The findings demonstrate compelling evidence of the efficacy of aspurūs in supporting menopausal symptoms and enhancing overall quality of life,” said Danielle Greenberg, research consultant at Waleria Health, in a press release. “The significant reductions in hot flashes and night sweats coupled with the notable improvements in Utian Quality of Life scores show the potential of aspurūs to offer meaningful relief for women experiencing menopausal transition.” ⁶

Bone Health is Foundational During Menopause

Most often when we think about peri- and menopausal symptoms, it’s the one’s that give the “ick factor”—the night sweats, the hot flashes, the mood swings, the vaginal dryness—that are most often associated with the hormonal changes.

However, there are other symptoms that can be serious too. For instance, strong bones are foundational to a healthy body, and it’s no secret that aging makes us more prone to bone loss and bone breakage.According to Jennifer Gu, PhD, vice president, research and development at AIDP (City of Industry, CA), “It is well-known that menopausal women lose bone density at an accelerated rate. In fact, bone fractures are a major concern for aging women.”

One of AIDP’s foundational branded ingredients, KoAct, has been on the market for around 15 years, supported by clinical research and three U.S. patents for its unique composition as well as its application in improving bone mineral density and bone strength, according to Gu. She explains that the formulation “goes beyond calcium supplementation and other general bone supplements by providing calcium and bone collagen at the same time.”

In the ingredient’s earlier years, AIDP, Inc. funded the first long term-clinical trial to directly compare the effects of calcium collagen-chelated products (KoAct) to calcium and vitamin D in postmenopausal females. The 12-month, randomized controlled trial studied 39 postmenopausal women divided into two groups, one group taking calcium-collagen chelate, the other, a capsule mix of calcium and vitamin D. ^{7, 8, 9}

The study was led by Bahram H. Arjmandi, PhD, RDN, an internationally recognized expert in nutritional interventions for bone health and other health conditions. The investigation found that “the group taking the calcium-collagen chelate, saw a loss of 1.23% in bone mineral density, while the control group saw a 3.75% loss.”⁸

Further, Dr. Arjmandi commented at the time “that supplementation with KoAct may provide protection against bone loss and increased bone turnover for which supplementation of calcium and vitamin D alone could not achieve.” The study was published in the Journal of Medicinal Food.⁹

Hair, Skin and Nails Still Matter in Menopause

If it seems vanity-based only, consider that thinning hair, dry skin, and brittle nails can add to diminished confidence and emotional distress for menopausal women already dealing with other issues that may challenge their feelings of femininity.

Earlier this year, AIDP announced results from a randomized, double-blind, placebo-controlled study published in the HealthMed Journal on the effects of Keragen-IV oral supplementation on hair and skin. Although the study was not specifically conducted in menopausal women, the age range of 45-60 may give women in the change of life some hope.^{10, 11}

The 60-day trial studied 65 females with healthy skin and damaged or stressed hair, receiving either the keratin-based formulation (Keragen-IV), or placebo. At the end of the trial, the Keragen-IV group experienced significant improvements in reduced hair loss (43%) as well as a 17.61% improvement in the birefringence of the hair cortex, compared to placebo. These results suggest that the functional ingredient that shares homology with keratin naturally present in human hair may increase the structural integrity of the hair cortex in as little as 60 days.^{10, 11}

As for skin health, there were also some positive results. The treatment group saw a significant 10% increase in comparison to the placebo group in gross skin elasticity after 60 days. In addition, there were improvements in skin barrier function with oral Keragen-IV, after 30 days, measured by 12.5% lower levels of trans epidermal water loss, a non-statistically significant improvement when compared to placebo.^{10, 11}

AIDP’s Gu served as one of the principal investigators in the trial. She stated, in part, that “this study verifies Keragen-IV’s role in hair anchoring which is a concern for many women experiencing hair loss due to hormonal changes or stress.” ¹⁰

Putting Women at the Forefront of Research

Waleria’s Baldwa is energized by what she is seeing from the research community where, she says, “institutions like the University of Melbourne are leading the way with innovative approaches, such as focusing on preventive strategies and understanding menopause as a natural life stage rather than a medical condition to be treated.”

What’s more, she says that this signals a shift towards a more proactive and holistic approach. She points to the University of Leeds which she states “is known for its research into menopause, particularly in workplace support and the socio-economic impacts of menopause. Their work often highlights the importance of accommodating menopausal women in the workforce.”

Gencor has long been an advocate for studying ingredients in female (and male) populations and McNamara says that “one of the most pressing areas for advancement in the industry is the focus on female-only populations in clinical research.”That’s because, as she explains, “the biological differences between males and females are well-documented, and how ingredients are metabolized can be significant. For example, hormonal fluctuations, differences in body composition, and variations in metabolism can all play pivotal roles in the efficacy of natural products.”

She advocates that “this targeted approach is critical and necessary to understand better how functional ingredients can safely and effectively benefit female physiology. It also enables brands to develop supplements tailored to women’s unique needs rather than repackaging ingredients previously only studied in male physiology.”

Baldwa also finds it crucial for women to continue to speak out, especially openly discussing their menopausal symptoms and the need for relief. In that way, she says that “women can normalize menopause as a natural life stage, encouraging others to share their experiences, seek help, and prioritize their health.”

This is the kind of personalized advocacy that Baldwa believes can also drive medical research into underexplored areas like cardiovascular, mental, and bone health for women.

She adds that it is also “our responsibility [as an industry] to maintain that trust [sought] out by women, by investing in new research and collaborating with healthcare providers. This ensures that our products complement other treatments and contribute to more integrated care.”

Kerry’s Monsalve, too, believes that “it’s imperative that the industry as a whole fully recognize menopause as a global health issue, guiding women through options to optimize their own health.”

About the Author

Judy Blatman Communications LLCspecializes in writing for industry publications and clients, strategic counsel, and media training. Ms. Blatman spent 16 years as SVP, Communications, Council for Responsible Nutrition.

References

1. Pausing to learn more about menopause. Mayo Clinic Health System.November 30, 2021. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/too-embarrassed-to-ask-part-3 (accessed 2024-09-24).

2. Steels, E.; Steele, M.L.; Coulson, H.S. Efficacy of a Proprietary Trigonella foenum-graecum L. De-Husked Seed Extract in Reducing Menopausal Symptoms in Otherwise Healthy Women: A Double-Blind, Randomized, Placebo-Controlled Study. Phytotherapy Research. 2017, 31 (9), 1316-1322. DOI: 10.1002/ptr.5856

3. Heyerick, A.; Vervarcke, S.; Depypere, H.; Bracke, M.; Keukeleire, D.D. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas. 2006, 54 (2), 164-175. DOI: 10.1016/j.maturitas.2005.10.005

4. Chen, M.N. ; Lin, C.C. ; Liu, C.F. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis systematic review. Climacteric. 2014, 18(2), 260-269. DOI: 10.3109/13697137.2014.96624

5. Guidise, V.S.; Dasari, M.P.; Kuricheti, S.S.K. Efficacy and safety of shatavari root extract for the management of menopausal symptoms: A double-blind, multicenter, randomized controlled trial. Cureus. 2024. 16 (4), e57879. DOI: 10.7759/cureus.57879

6. Aspurus Root Extract May Minimize Symptoms Of Menopause. Aspurūs. July 22, 2024. https://aspurusshatavari.com/2024/07/22/aspurus-root-extract-may-minimize-symptoms-of-menopause/ (accessed 2024-09-24)

7. Elam, M.L.; Johnson, S.A.; Hooshmand, S.; Feresin, R.G.; Payton, M.E.; Gu, J.; Arjmandi, B.H. A Calcium-Collagen Chelate Dietary Supplement Attenuates Bone Loss in Postmenopausal Women with Osteopenia: A Randomized Controlled Trial. Journal of Medicinal Food. 2015, 18 (3). DOI: 10.1089/jmf.2014.0100

8. New Dietary Supplement Beats Calcium, Vitamin D for Bone Strength. Florida State University. November 4, 2014. https://news.fsu.edu/news/health-medicine/2014/11/04/new-dietary-supplement-beats-calcium-vitamin-d-bone-strength/ (accessed 2024-09-23).

9. New RCT: KoACT® beats calcium and vitamin D for optimal bone strength. EurekAlert. October 27, 2014. https://www.eurekalert.org/news-releases/851005 (accessed 2024-09-24).

10. Krawiec, S. Recent study finds that Keragen-IV may reduce hair loss and support skin elasticity. Nutritional Outlook. July 18, 2024. https://www.nutritionaloutlook.com/view/recent-study-finds-that-keragen-iv-may-reduce-hair-loss-and-support-skin-elasticity (accessed 2024-09-24). 

11. Kelly, R.; Gu, J.; Lim, J.; Lati, E.; Manna, V. Effect of keraGEN IV Keratin oral supplementation on hair, skin, and nail attributes. HealthMED. 2024, 18 (2), 35-45.