Menopause: Making a Smoother Transition Naturally

Perimenopause:

The time prior to menopause that encompasses the change from normal ovulatory cycles to cessation of menses;

  • Average age of onset 46
  • Age of onset for 95% of women: 39-51
  • Average duration: approximately 5 years
  • Duration for 95 % of women: 2-8 years

Menopause:

Permanent cessation of menstruation due to loss of ovarian follicular activity

–After there have been 12 consecutive months without menses.

  • Average age: 51

Post menopause: the years following cessation of menses.

Influential Factors in the Age of Onset:

  • Family history
  • Body Type and Nutritional Status
  • Alcohol consumption: later onset due to increased circulating estrogens
  • Menstrual History / Late Menarche
  • Smoking: earlier onset due to decreased estrogens
  • Below normal cholesterol levels
  • Nulliparity (no term pregnancies)

Menopause IS a natural transition yet it represents imbalanced states at times, for women.

Naturopathic medicine provides an opportunity to evaluate and treat functional imbalances naturally.

Each woman presents with a unique history (previous health issues, chronic conditions, family medical history, stresses, lifestyles) and every woman experiences “menopausal symptoms” differently although there are many common threads.

Naturopathic medicine treats the individual, not just the symptoms. By examining past medical history, risk factors, diet, lifestyle, exercise habits as well as current health concerns, a treatment plan can be developed that is centered on providing support for restoring optimal function and eliminating symptoms as well as the prevention of osteoporosis and heart disease.

Natural therapies can be used in conjunction with bioidentical HRT.

NATUROPATHIC THERAPEUTICS – NUTRITION:

INCREASE:

  • Protein: legumes (see below), tempeh, tofu, hemp hearts, cold water fish, organically fed, free range meat
  • Complex Carbohydrates: brown rice, millet, quinoa, buckwheat, oats
  • Legumes: Soybeans, adzuki, lentils
  • Vegetables: broad spectrum of colours; greens: high in minerals, B vitamins
  • Fish-cold water: wild salmon, cod, herring, mackeral
  • Oils: good essential fatty acids (salmon, cod liver, flax)
  • Fiber: (flax, psyllium) (see phytosterols)

AVOID:

  • Animal fats (inflammatory leukotrienes (bad fatty acids))
  • Carbonated beverages (leach calcium from bone)
  • Refined Carbs and sugars (blood sugar problems, central weight gain)
  • Alcohol (increase circulating estrogen, tax the liver)
  • Caffeine (increase stress hormones, tax the adrenals
  • Smoking (creates oxidative stress and earlier menopause)
  • Spicy foods (increase hot flashes)

Botanicals

There are very specific plant extracts that can restore hormonal balance. Women who have hot flashes or mood changes find that they get improvements within a few weeks with the use of plant extracts. Several botanicals have been studied for their success with managing symptoms of menopause and alfalfa, red clover, black cohosh) or progesterone-supporting (eg wild yam, chaste tree berry, dandelion) activity and effects. A comprehensive plan using other naturopathic approaches is usually incorporated with the use of herbal medicines.

Bioidentical (HRT) Hormones

The use of these pharmaceutical medicines may be indicated, especially after urine or salivary hormone testing indicates hormonal imbalance In BC, naturopathic doctors have prescriptive rights and often prefer to prescribe these medicines over conventional (HRT) hormone replacement therapy because the types of hormones used are chemically identical to those produced by the human body.

Homeopathic Medicines

Homeopathic medicines gently help the body balance itself and help a woman make her transition more smoothly. If one has mental/emotional problems including depression, irritability, mood swings, anxiety etc., homeopathy can offer relief and stability with no side effects.

Mental Emotional Component/ Lifestyle Counseling

The menopausal period can often by filled with many changes and self-discovery in one’s life. The significant shifts that a woman experiences on this level can have a great impact on the experienced physical symptoms and overall health. Spending some time looking into this aspect is a critical component of maintaining energy and vitality and finding/re-establishing balance and zest in life.

Relaxation techniques and Movement

A balance between our own time for self-care. relaxation and work is essential. This needs to be part of our daily routine. Weight-bearing exercise, yoga, tai chi, meditation, rest, relaxation podcasts, massage and manual therapies.

EXERCISE

We know these benefits of exercise:

  • improved bone density (preventing osteoporosis)
  • cardiovascular health, (improving the lipid profile)
  • increases insulin action (blood sugar balance)
  • increasing the metabolic rate (weight loss)
  • improved cognition and mood (brain health)

ALSO helpful for many of the symptoms of menopause, reducing depression, mild insomnia (if done earlier in the day) and hot flashes: one study that looked at the occurrence of hot flashes in post-menopausal women and reported that 21.5 % of physically active women experienced hot flashes as compared to 43.8% of aged matched sedentary controls- 50% difference between the 2 groups.

GSM: Genitourinary syndrome of menopause

This is a term for all the vagina, bladder and pelvic floor symptoms associated with a lower estrogen state.

Used to be called vulvovaginal atrophy or atrophic vaginitis but has broader to include the following:

  • Vaginal dryness and loss of lubrication
  • Burning pain and itching or fissuring of the vulva
  • Pain or bleeding with sex or penetration
  • Painful urination
  • Recurrent UTI
  • Bladder urgency /stress incontinence
  • Loss of libido around or organs
  • Vaginal wall prolapse

– Many natural options for supporting the tissue and microbiome.

– bioidentical estrogen (topical and systemic) can be also supportive – and we can discuss this – but if you have a uterus must be used with progesterone and even if you have had a hysterectomy progesterone should be considered.

Tips for reducing hot flashes

  • Dressing in layers that can be peeled off as one gets warmer
  • Wearing natural, breathable fibers such as cotton and linen and avoiding synthetic fabrics
  • Wearing shirts with an open neck and loose clothing
  • Keeping cool water or beverages nearby for sipping
  • Lowering the thermostat whenever possible or keeping
  • a paper or battery-operated fan on hand
  • Wearing cotton pajamas or nightgowns to bed — after
  • a night sweat, nightclothes are easier to change than
  • sheets
  • Sleeping in cotton sheets
  • Investing in a bigger bed if sleeping too close to a partner creates excess heat
  • Taking a cool shower before bed
  • Gogi berries- 15 berries 2-3x/day (also delicious sweet treat)

Osteoporosis Prevention

Bone is constantly undergoing a remodeling process; old bone is broken down by osteoclasts and building up of new bone is done by osteoblasts. Osteoporosis occurs when osteoclasts break down bone at a faster rate than osteoblasts can build new bone, resulting in decreased bone density.

Risk factors for osteoporosis include:

  • low body mass or small frame
  • white or Asian descent
  • heavy alcohol use
  • advanced age
  • cigarette smoking
  • family history
  • inactive lifestyle
  • early menopause
  • amenorrhea
  • use of corticosteroids and anticonvulsants
  • frequent antibiotic use
  • fluoride use
  • hyperthyroidism
  • low mineral diet – eating inflammatory foods
  • history of disordered eating

FINALLY!

Some reasons to anticipate some of the positive that arises from the menopause transition:

Joan Borysenko, refers to perimenopause as MIDLIFE METAMORPHOSIS when a women begins in earnest to recreate her life in such a way that her values are lived out in her everyday activities and she is ‘’more apt to tell the truth and less apt to make excuses for others”. This also sounds a lot like having less F’s to give!

Interesting fact: In our PRE menopausal years, FSH and LH are 2 neurohormones that normally only peak for a few days around ovulation – this a short time frame when women are naturally fertile and maximally open to new ideas and cross pollination. However, the good news is after menopause these 2 stay at permanently elevated levels in the “ovulation range” for the rest of our lives which renders us more open to a continual flow of wisdom that was previously only available at for a short moment in our cycle!