Though hormone replacement therapy (HRT) represents a beneficial treatment during peri end post menopause, in some situations alternative options and solutions need to be considered. At present, HRT is the putative first choice of the gynecologist to overcome menopausal symptoms when no contraindications are present, but specific and effective natural compounds can be used as well. Such natural compounds are of great interest since most of them do not have estrogen-like activity and for this reason are a very good choice during the menopausal transition for those women that refuse hormonal replacement therapy either for personal choice or for objective reasons, such as a personal or familiar history of breast cancer, venous thrombo-embolism, severe cardio-vascular diseases, liver diseases or other pathologies.

According to our experience among the possible alternative choices to HRT the specific Klamath algae extract Klamin®stands out, which concentrates neuroactive molecules present in the unique wild blue-green algae, Aphanizomenon flos-aquae (AFA), which naturally grows in Upper Klamath Lake (Oregon, USA). The AFA extract is an completely natural product, with no side effects and that has shone to be with very effective on climateric complaints and symptoms (1).

The AFA extract concentrates phenylethylamine (PEA), a molecule  naturally present in the algae, endowed with a significant dopaminergic and serotoninergic activity. The extract  concentrates PEA to the point that it can act as a powerful neuromodulator and mood enhancer. However, since PEA is quickly destroyed in the body from the MAO-B enzymes, the extract concentrates also other molecules, like the AFA-phycocyanins and algal mycosporines (porfira and shinorine), that have shown to be the most powerful  selective MAO-B physiological inhibitors among all natural substances. It is this synergy pf PEA and MAO-B inhibitors that makes the extract effective as a general neuromodulator (1-3). In addition, the extract still retains some nutritional components of Klamath algae, such as B vitamins, chlorophyll and beta-carotene, whose antioxidant action is compounded with that of the AFA-phycocyanins, that among other things have proved to possess a powerful neuroprotective activity (4).

We recently reported our experience on a group of menopausal women treated with the Klamathextract for 2 months (5), evaluating the changes in the levels of oxidative stress and of several anti-oxidant factors. Our report demonstrated that the administration of 1.6 g of Klamath extract every day (2 tabs of 800 mg each: 1 at 10 am  and 1 at 4 pm) significantly reduced (-38%) the blood levels of malondialdehyde (MDA), a very significant marker  of oxidative stress as it specifically indicates the degree of lipoperoxidation (oxidation of the lipid components of the cells); while  increasing the concentration of liposoluble vitamins (α-, δ- and γtocopherol, retinol, lutein, lycopene, α- and β-carotene) as non-enzymatic antioxidants (5-8). No changes of gonadotropin LH, FSH and estrogen plasma concentrations were observed, thus confirming the absence of hormonal effects on the estrogenic milieu. Furthermore, the general gynecological Green Scale demonstrated a significant improvement of all climacteric symptoms, its score being significantly reduced after 2 months of supplementation (8).

It is important to remember that the so called “Climacteric Syndrome”is not only related to  hypoestrogenic conditions but also to the increase of oxidative and pro-inflammatory processes and to parallel reduction of the anti-oxidant factors (6-7). All these events are characteristic of the ageing process, and  indeed ageing runs parallel with the menopausal transition. The Klamin® extract supplementation has been effective in reducing oxidative stress,  thus both decreasing  the production of free radicals and saving the endogenous anti-oxidant vitamin from being consumed (8). The AFA- phycocyanins (AFA-PC) are a highly significant component of  the Klamath algae extract, as they have shown to be the most powerful anti-oxidants among all natural molecules (13), but they also possess significant anti-inflammatory properties. Together, the reduction of MDA caused by the supplementation with the AFA extract is particularly relevant both because MDA is the an endogenous toxic and mutagenic agent of proteins and NDA; and because it harms the cardio-vascular system by participating in the atherogenic processes that damage the cardiac muscle and arterial walls (9).

However, while the anti-oxidant activity contributes to the improvement of the climacteric symptoms, even more important is the extract’s activity on the CNS, due to the synergic effect of the PEA and MAO-B inhibitors on the dopaminergic and serotoninergic pathways, which are heavily affected by the menopausal transition, together with the neuroprotective action of the mycosporines  and AFA-phycocyanins (4, 8).

The antioxidant and anti-inflammatory effect of the product is an additional bonus that adds  important anti-aging effects, but the central effect of the extract is its action on the brain and nervous system, an action that is manifested in the general improvement of the  menopausal condition, and especially on mood swings, anxiety and self esteem (5, 8). This general neuromodulation has in itself a deep anti-aging action, which emerges as especially relevant during  menopause (10 – 12).

In conclusion the hypothesis of an integrative approach to menopausal transition using this specific Klamath algae extract is confirmed by the extract’s efficacy on all oxidative processes induced by ageing and the menopausal transition, as well as by its deep and general neuromodulatiing activity, producing significant effects on mood, self-esteem and the overall well-being of menopausal women. In sum, the Klamin®extract is a valid integration that the gynecologist may propose to all women who do not want or cannot undergo HRT. In addition, there are no contraindications on using the AFA extract together with HRT.

Alessia Prati, Alessandro D. Genazzani
Clinica Ostetrica e Ginecologica,
Centro di Ginecologia Endocrinologica,
Università di Modena e Reggio Emilia




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