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Spice It Up

Medical Herbalist Offers Alternatives to Menopausal Women

By Augusta Olsen | Posted 8/7/2002

Claudia Joy Wingo has seen it all when it comes to menopause--hot flashes, vaginal dryness, mood swings, and more. Wingo is a Silver Spring-based medical herbalist and a teacher at the University of Maryland School of Medicine in Baltimore, and her treatment of menopausal symptoms has helped hundreds of women in the Baltimore-Washington area searching for an alternative to pharmaceutical hormone-replacement therapy. As questions and fears arise around the safety of long-term hormone-replacement therapy--a popular treatment choice for many doctors--Wingo is sticking with the same answers she's been giving her patients for the past 23 years. Now, it seems, more people than ever are ready to listen to her advice.

Last month, The Journal of the American Medical Association released a report on hormone-replacement therapy that suggested that long-term use of pharmaceutical hormones may put women at greater risk for developing other health problems. Among the conditions listed were heart disease, strokes, and breast cancer--problems that drug companies and doctors once thought hormone-replacement therapy would help prevent. The report was part of a major study by the Women's Health Initiative of the National Institutes of Health.

"I hate to say it, but it's a little bit like, 'I told you so,'" says Wingo, 47, who treats her patients with natural herbal supplements and counsels them to combat their symptoms with healthy lifestyles. "People have to understand the risk-benefit ratio of any treatment. A lot of people want to just pop a little pill, but . . . there are always risks with pharmaceuticals, and we need to face it."

Menopause is the transition in a woman's life from fertility to infertility, and it is clinically defined by cessation of the menstrual cycle. As part of this process, the body decreases the amount of estrogen and progesterone usually produced as part of the female fertility cycle. As these hormone levels fluctuate, many women experience bodily changes in the years leading up to menopause, including irregular periods, excessive bleeding, hot flashes, night sweats, insomnia, mood swings, and heart palpitations. This time, referred to as peri-menopause, can be very disruptive and uncomfortable for women; since the 1960s, the mainstream medical community has believed hormone-replacement therapy--substituting the body's decreasing level of natural hormones with pharmaceutical hormones--was the most effective way to manage it.

"If it's completely disrupting a woman's life, I'm not totally against hormone-replacement therapy," Wingo says. "For some women I might recommend it for a short period of time to help them transition."

But in the past five years, many doctors started recommending it to women without severe problems because they thought it helped prevent diseases, such as breast cancer. "These women aren't sick, and in effect their natural body process was being treated as a disease state," Wingo says.

The recent shift in mainstream medicine's attitude toward hormone-replacement treatments has left the medical world and thousands of its female patients reeling. Wingo's menopause-management clientele has doubled in the past month, making menopause one of the most common health issues she treats.

Lindsay Beane, a nonprofit consultant who lives in Baltimore, has been to Wingo for treatment of insomnia, among other problems. Although Beane, 49, hasn't gone through menopause yet, she believes some of the health concerns she's dealing with could be the result of peri-menopause.

Beane herself never used herbal medicine before taking her 10-year-old son Russell to Wingo eight years ago for management of his cystic fibrosis, a fatal degenerative disease. The boy's health had been deteriorating, and Beane was searching for alternative treatments to the traditional ones they had already tried. Under Wingo's care, Russell's health improved dramatically, and his mother was encouraged. She decided to consider using alternative therapies for herself.

As Beane prepares to face menopause, she says, she has taken Wingo's advice to heart: She exercises, watches her diet, and regularly receives acupuncture and massages as part of her health regimen.

"I walk a lot and I try to eat well, and that's all I plan to do," Beane says. "If it becomes necessary, I'll use more herbs."

Wingo, a Washington native, began her unique career path in her own backyard, literally. When she was a child, she would explore plant life with her father, a botanist and cinematographer for the U.S. Department of Agriculture.

Officially, though, Wingo's herbalist career began in 1974, when she took her first class in herbalism at the Smile Herb Shop in College Park. Five years later she graduated from the New South Wales College of Natural Therapies in Sydney, Australia, with a degree in herbalism. In 1984, Wingo became certified as a registered nurse in Australia, where she spent years working in oncology, intensive care, and pediatrics. While practicing there, she says, she had many opportunities to use her herbalism training.

"It was quite common to use herbs like peppermint and dill water for nausea with chemotherapy," she says. "We would also use aromatherapy and reflexology on people who were terminal, using different relaxation techniques to help with pain relief."

These days, she teaches classes in herbalism at the Smile Herb Shop and as an elective course for medical students at the University of Maryland. She is teaching at the new Master of Arts in Botanical Healing program at the Tai Sophia Institute in Laurel, the first graduate program in botanical healing in the United States.

Wingo also collaborated on the development of Estro-Logic, an herbal supplement to treat menopause symptoms. Estro-Logic was born three years ago when Dr. Kathleen Fry, a gynecologist and homeopath who was then president of the American Holistic Medical Association, met Wingo at the association's national conference in Washington. At the time, Fry was working for the Mission Viejo, Calif.-based herbal-supplement company Wakunaga on an herbal menopause treatment.

"I had been tinkering around with formulas, trying things out with my patients," says Fry, who has been recommending herbs to the clients of her Scottsdale, Ariz., practice for eight years. "But it was never quite right. Meeting Claudia [Wingo] was an answer to a prayer."

Fry and Wingo collaborated on the project, and Wakunaga has now been manufacturing the patented formula they came up with for three years. "It's basically the same blend of herbs I have made into tinctures for menopausal women, except as a pill supplement," Wingo says.

In addition to black cohosh and wild yam, two herbs now widely recognized for their estrogenic and progesteronic effects in the body, the supplement contains sage to help with hot flashes and night sweats, vervain as a mild tonic for the nervous system, astragalus to support the immune system, and motherwort to allay heart palpitations.

Following the release of Estro-Logic, Fry and Wingo wrote a book, Menopause Naturally: A Holistic Guide to a Smooth Transition, published in 2000, that outlines possible solutions, treatments, and thoughts that apply to common menopause complaints. The recommendations the book makes are a far cry from the common one-pill-a-day regimen often prescribed in hormone-replacement therapy. Rather, it follows Wingo's holistic approach to menopause problems.

"I tailor programs individually for women," she says, including those who come to her to get off hormone-replacement treatments. "We look at diet changes, and I also educate them as to why their menopausal symptoms are so severe. We have to look at all the issues. For example, one of the reasons women are having problems is because they're stressed out, and their adrenal glands are taxed."

She says that the biggest benefit for women who choose herbs rather than pharmaceuticals is that they produce few side effects.

"They usually do take longer to work," Wingo says. "But in that way they seem to be nourishing or tonic in effect. Not all herbs can cure, but in a lot of cases they can effectively manage conditions long-term without a high risk of damage."

Wingo acknowledges that no treatment--not even herbalism--is risk-free, and she cautions against using herbs without education about their traditional uses.

"Not all herbs are benign," Wingo says. "People often think that if a little is good, then a lot will be better, and that's where we've seen problems with herbs in this country." She recalls the '90s controversy over kids taking supplements made with the herb ephedra as a euphoria-inducing party drug; the ephedrine supplements were linked to fatal heart attacks.

"But it's not the herbs' fault," Wingo says. "It's the person who's taking them."

Now that JAMA has publicly acknowledged that hormone-replacement therapy may not be the ideal treatment for menopause, practitioners like Wingo are hoping to see wider acceptance of their treatment methods--many of which are already being trumpeted by key medical organizations.

For example, on July 9, in response to the JAMA report, the North American Menopausal Society--an organization made up of physicians and scientists--released a list of suggestions for alternatives to hormone-replacement therapy. First and foremost, the group recommends that menopausal patients make "lifestyle changes" to manage their symptoms.

"There is not a universal answer for all women," says Pam Boggs, director of education for the North American Menopause Society. "But the best thing anyone can do is maintain a healthy lifestyle."

Of course, this is not news to Wingo, who's been saying the same thing to her patients all along.

"Most women come to me because they are having a major problem, like major hot flashes or night sweats, and it's disrupting their lives," she says. "I can say that, most of the time--85 to 90 percent of the time--I can get rid of that if they are willing to make some changes."

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