By Dr. Angela Hunt ND
Let us start this off by reminding everyone that menopause is NOT a disease but a natural cycle in a woman’s life. This life cycle can be a bit rough for some, but there are ways to navigate through it more easily. The definition of menopause is one full year without any menstruation[i]. It is important to note that numerous women start to experience menopausal symptoms even before their period has completely stopped, a time called “peri-menopause”. Peri-menopause can start up to a decade before menstruation stops, making this whole process a drawn out affair. I want to cover some of the natural options women have for managing symptoms during their menopausal years but first, let’s review the most common symptoms.
After helping many women with a variety of hormonal issues over the years, I have learned a few things. One important lesson was how individual and unique each menopausal experience is. No two women experience exactly the same thing. Most have hot flashes, but what triggers and helps these hot flashes are as individual as the women themselves. Here is a list of the most common complaints[ii]:
- Hot flashes
- Sleep issues
- Weight gain (predominantly around the waistline)
- Memory problems
- Mood fluctuations
- Low Libido
- Vaginal dryness
- Skin changes
It is also important to mention that after menopause, due to decreased estrogen, women are also at a higher risk for osteoporosis, cardiovascular disease, and cognitive decline. So it is essential that treatment plans include proactive steps to prevent future illness as well.
What Does Stress Have to Do With It?
One aspect of menopause that keeps getting ignored in mainstream medicine is the importance of adrenal health. When the ovaries retire and no longer produce female hormones (estrogen and progesterone) it is the adrenal glands that pick up most of the slack. The adrenal glands sit on top of our kidneys and do a lot for us. Not only must they produce most of the estrogen post-menopausally, but we also depend on them for producing cortisol (a stress hormone), testosterone, aldosterone, adrenaline, and others. This is where stress comes into play. If a woman is taxing her adrenal glands because of chronic stress, she is demanding a lot of cortisol and adrenaline from them. This can lead to adrenal fatigue and can result in lowered sex hormone production as well. All of this equates to more menopausal symptoms.
This is why a small study published in the journal Menopause showed that stress relieving techniques, such as deep breathing and meditation, reduced hot flashes by 45% and improved quality of life overall by 28%[iii]. It is vital that the adrenal glands be supported and stress management techniques implemented in order to navigate the stormy waters of menopause. Adrenal support is an integral aspect of all hormonal support plans I create for my patients. I usually start discussing adrenal health with women even before they hit menopause.
Options, So Many Options.
There are so many natural options that can support women through menopausal ups and downs. As I have already eluded to, the treatment plans are as unique and individual as the women themselves. It seems that each patient needs their own personalized plan of lifestyle support, dietary changes, stress management ideas, nutrients and botanicals. When we find the right combination the results are night and day. Here are some of the treatment options we have to choose from:
Research suggests that women who eat a vegetarian diet may have fewer hot flashes and tolerate menopausal changes better. The reason for this difference remains elusive. It may be the lack of animal fat or high vegetable intake that benefits the hormonal balance. Women with diets high in soy products, vegetables and some fish also seem to avoid the woes of menopause[iv]. Actually in Japanese, a word for “hot flash” doesn’t even exist.
This is one area that gets missed a lot when building a menopausal support plan. Factors like stress management and exercise are so important to the hormonal landscape and should not be underestimated. It is true that these changes are also the hardest to implement but there is no better time in one’s life to make them. As heart disease risk dramatically increases after menopause, cardiovascular exercise plays an even stronger role in health. In addition, research shows that women who exercise regularly experience half the number of hot flashes compared to women who do not.
It seems that some nutrients play an indirect role in relief of menopausal symptoms, particularly through the adrenal glands. Certain nutrients like magnesium, B vitamins and vitamin C all support adrenal function in different ways, which in turn can reduce menopausal symptoms.
There are so many wonderful medicinal plants that can support women through these years of hormonal change. Finding the right combination of botanicals can be a trial and error process. Plants like sage, dong quai, black cohosh and chaste tree have been used for centuries to help mitigate hormonal symptoms. I find it is important to blend these herbs with adaptogenic (adrenal support) like ashwagandha and licorice. It is very important to discuss taking herbal medicine with your healthcare provider (i.e. naturopathic doctor or medical doctor) as they can have side effects and interactions with pharmaceuticals.
Most of my patients want to avoid taking synthetic hormones. Research over the years has shown an increase in cardiovascular risk, breast cancer, and blood clots in women who take synthetic estrogen. However, there are times when all the above natural treatment options are not providing enough relief and we need to bring in something stronger. Bioidentical hormones, which mimic a woman’s own sex hormones, can be a reasonable solution. This option is nice because they are generally well tolerated and can be used in lower dosages compared to the synthetic versions. It is imperative to note that bioidentical hormones come with their own risks, though some research suggests that they don’t carry the same risks as their synthetic counterparts. In general, I leave bioidentical hormones as a last resort, only to be used when we have exhausted all other options. The main goal is always to treat the “whole” person and support a woman physically, mentally and emotionally as she journeys through this time of change. Luckily we have a lot of tools at our disposal – it is all about finding the right combination that will work for you.
[i] Larsen PD et al (eds): William’s Textbook of Endocrinology, ed 10, Philadelphia, Saunders, 2003.
[ii] Larsen PD et al (eds): William’s Textbook of Endocrinology, ed 10, Philadelphia, Saunders, 2003.
[iii] Carmody J et al: A pilot study of mindfulness-based stress reduction for hot flashes, Menopause. Sept/Oct(13): 760-769, 2006.
[iv] Setchell KD. Phytoestrogens: the biochemistry, physiology, and implications for human health of soy isoflavones. Am J Clin Nutr. 1998;68(6 Suppl):1333S-1346S.