Lavender Flowers

Lavender Flowers

Lavender is often used to alleviate menopausal symptoms. To my surprise, it has been studied in 16 studies involving more than 1000 women. In one purported clinical double-blind crossover study, for example, 100 menopausal women were randomized to lavender aromatherapy, in which they smelled lavender aroma for 20 minutes twice a day for several weeks before switching to the “placebo” control substance, diluted milk. I don’t know how the women could have done that “blind” without the lavender scent, so there was hardly a placebo effect, but during the control weeks the hot flashes occurred about equally often, whereas during the lavender weeks only about half as often. Other menopausal symptoms such as reduced sexual desire, anxiety, and depression also improved during lavender exposure.

The scent of lavender essential oil did not seem to help postmenopausal women with insomnia, a common complaint. Can’t you just eat lavender flowers? In more than a dozen randomized controlled trials, lavender scent was found to help with anxiety, and that also appears to apply to eating lavender. 83 percent of the postmenopausal women who were randomly assigned to take capsules containing 500 milligrams of lavender flower powder twice a day (which I measure as one teaspoon of dried flowers) reported a good or very good effect on their anxiety, compared to only 44 percent in the placebo capsule group. The same researchers tested the same dose in postmenopausal women with sleep problems. 74 percent of those who, without knowing it, took lavender reported satisfactory improvements in subjective sleep quality, compared to only 31 percent of the control group. It is not clear whether the active component(s) is/are water-soluble and whether the same effect could therefore be achieved with lavender tea.

Fennel Seeds and Fenugreek

The nice thing about herbs and spices is that you can stuff whole servings into capsules and then run randomized placebo-controlled double-blind studies with them. For example, half a teaspoon of ground black cumin was found to improve menopausal symptoms significantly more than a placebo, with effects limited to psychological aspects such as less anxiety, increased vitality, and better mental health.

Fennel seeds, actually not seeds but the small fruits of the fennel plant, can help broadly, including with hot flashes and night sweats as well as other physical, psychological, and sexual symptoms. Details on this and on fenugreek, another galactagogic spice, at see.nf/fennelfenugreek. No, not yet another sci-fi reboot—a galactagogue is something that stimulates milk production in breastfeeding women. One and a half teaspoons of fenugreek per day can also alleviate symptoms of early menopause.

“Andropause”

Nowadays, aging men are being sold testosterone en masse to relieve nonspecific symptoms of an alleged andropause, the decline in testosterone levels. This process—also referred to as male menopause, penopause, climacterium virile, partial androgen deficiency of the aging male (PADAM), late-onset hypogonadism, or simply “low-T syndrome”—is a classic example of pathologizing, a showpiece for how to turn an alleged disease into money. Pathologizing means extending the boundaries of what is considered illness to ordinary life experiences in order to sell something. The medicalization of menopause brought Big Pharma billions. Why not extend the same concept to the other half of the aging population?

The “Low T” Tsunami

In 1889, physiologist Charles-Edouard Brown-Séquard, one of the first to postulate the existence of hormones, claimed to have “rejuvenated” himself with injections of testicular extracts from dogs and guinea pigs. The rejuvenation apparently didn’t work so well, since he died a few years later, but not before thousands of doctors had administered his “Brown-Séquard elixir” to their patients. One of them was the famous pitcher Jim “Pud” Galvin, the first to use an allegedly performance-enhancing substance in Major League Baseball. That was followed by rich old men who had testes from humans, monkeys, and billy goats transplanted, until testosterone was finally discovered in the 1930s.

Testosterone levels decline on average by about 0.5 percent per year, but that likely has more to do with obesity and its associated diseases than with age itself. In the Healthy Man Study, for example, there was no decline in testosterone levels among healthy men between 40 and 97. So it isn’t inevitable, but rather usually a consequence of chronic conditions such as high blood pressure, diabetes, depression, heart, liver, lung, and kidney disease, or simply lack of fitness or excess body fat. Of course, one could try to treat the underlying cause with changes in diet and lifestyle, but where’s the profit in that?

Low-T proponents within pharmaceutical companies used a sophisticated advertising campaign aimed directly at men to fool them into thinking testosterone deficiency was a cause of general symptoms such as “low energy, sadness, sleep problems, reduced physical performance, or body fat.” Guess what! They developed consumer tests and urged men to ask their doctor for testosterone if they noticed nonspecific symptoms in themselves such as “falling asleep after meals.” The correspondence between the answers and testosterone levels was so low that the questionnaires had a false-positive rate of up to 70 percent—that is, 70 percent of those in whom a testosterone deficiency was identified by the survey actually didn’t have one.

Only in two industrialized countries, the United States and New Zealand, is greedy direct-to-consumer drug advertising even allowed, but testosterone peddlers get around the bans by “educating” without naming any brands. Anti-aging clinics began advertising testosterone replacement therapy, and ordinary doctors were led en masse by sponsored CME (continuing medical education—or often more like: commercial medical education) into an “irrational exuberance in prescribing testosterone.” It worked. The billions spent on advertising came back annually through sales—a “global tsunami of testosterone prescriptions” led to a 100-fold increase in testosterone sales.

Testosterone “Replacement” Under Scrutiny

There are legitimate reasons to prescribe testosterone, but since testosterone was isolated in 1935 (for which the researcher received the Nobel Prize), there has been only one FDA-approved indication: “classical hypogonadism.” That is low testosterone due to missing or damaged testes or certain genetic anomalies. 25 percent of men who are prescribed testosterone nowadays may not even have had their testosterone level tested. Or they did get tested, and their levels were normal or even high, but they still got a prescription. But why do a test at all? Most “hypogonadal” symptoms have nothing to do with blood testosterone levels. One exception is some sexual symptoms, such as “low frequency of sexual thoughts,” which appear to be associated with testosterone levels under 320 nanograms per deciliter (ng/dl), but more than a quarter of men with normal testosterone levels had similar symptoms.