Ms Sandra Villella1
1Jean Hailes for Women's Health, Melbourne, Australia
Biography:
Sandra Villella has been a naturopath and herbalist practising for over 3 decades. She runs a busy naturopathic practice, with a strong focus on women’s health and has a particular interest in midlife health. She has been the consultant naturopath and clinical leader for Jean Hailes for women’s Health, Australia’s leading women’s health organisation, since 1999. She consults in the Jean Hailes Medical clinic, as part of a collaborative health care team with general practitioners, medical specialists and other allied health professionals. She also creates recipes for the “Jean Hailes kitchen” which provide health based nutritional educational messages.
Abstract:
Menstrually related mood disorder, such as PMS/PMDD may be associated with an increased mood sensitivity to the declining ovarian hormones associated with the late menopause transition and early postmenopausal phase.
Oestrogen therapy is indicated to manage the low oestrogen symptoms associated with the menopausal transition as well as improve mood. However, in non-hysterectomized individuals, a progestogen must be administered to prevent endometrial neoplasia, and this may be associated with a return or exacerbation of the premenstrual mood symptoms. Other pharmaceutical and non-pharmaceutical interventions therefore need to be considered.
Targeting the GABA system to alleviate anxiety, with herbal medicine and nutraceuticals that modulate GABA, may provide a novel treatment alternative or adjunctive option to existing anxiolytic or anti-depressant medications. Serotonin sparing herbal medicines may also be a complementary consideration. Safety considerations regarding potential interactions with pharmaceutical interventions will be highlighted with clinical guidelines on co-prescribing.
Vitex agnus -cactus (Chaste tree), a proposed dopamine agonist, has demonstrated effectiveness for the relief of PMS. A discussion of the indications for this phytomedicine, specifically in the perimenopause, will be presented. The role of dietary phytoestrogens, to mitigate the premenstrual oestrogen drop, specifically in the management of menstrual migraines, will be explored