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Managing Menopause

All women experience it, the completion of our reproductive years and menstrual cycle. The root cause of menopause is due to a decline in ovarian follicular activity. This results in the absence of egg production as well as declining levels of oesterogen and progesterone.



Defining Terminology

Menopause:

A woman’s last menstrual cycle. Generally occurs between the ages of 45-55 with an average age of onset around 50 years.


Causes:

  • Spontaneous (natural menopause)

  • Iatrogenic (secondary menopause) 

  • Surgical (removal of both ovaries)

  • Ovarian failure (from chemotherapy or radiotherapy) 


Perimenopause:

The transition from reproductive life to the first year of post-menopause, which occurs over several years and is characterized by hormonal fluctuations and biological changes.


Post-menopause:

A menstruation-free period of 12 consecutive months.



Menopausal Symptoms

Note, these will vary substantially between individuals so this is just for a guide only.

- Vasomotor: hot flushes, night sweats

- CNS: sleep disturbances, depression, anxiety, cognitive changes, migraines

- Skin/hair: reduced skin thickness, elasticity, hydration, hair loss, increased wrinkling

- Metabolic: weight gain, increased visceral adiposity, increased waist circumference

- Urogenital: vaginal dryness, vulvar itching and/or burning, urinary frequency/urgency, recurrent UTIs, low libido

- Muscular: joint pain, sarcopenia 


Depending on severity, physical and psychological symptoms of menopause impact differently on a woman’s physical, mental, social and professional life.




Naturopathic Treatment Aims

Note, treatment will be tailored based on an individual case-by-case basis. 

- Reduce and prevent hot flushes and night sweats

- Support nervous system, HPA axis and adrenal glands

- Relieve insomnia

- Address anxiety and depression if present

- Support liver function and lipid metabolism 

- Support cognitive function

- Support libido and sexual function

- Ensure healthy weight management 

- Support healthy aging

- Provide antioxidant support

- Improve/support bone health


A comprehensive naturopathic treatment approach to menopause incorporates the use of herbal medicine, nutrients/supplementation, and dietary and lifestyle advice in order to address the complex set of interrelated system imbalances. 



Herbal Remedies

- Black Cohosh: manages hot flashes, night sweats 

- Chaste tree: relieves excessive perspiration, hot flashes, night sweats, sleep disturbances

- Korean ginseng: supports nervous system/adrenals, cognitive function, libido and sexual function

- Sage: reduce hot flushes, night sweats

- Kava: relieve insomnia, address anxiety/depression if present

- Licorice: support nervous system, HPA axis and adrenal glands

- Rosemary: support liver function and lipid metabolism, improve antioxidant status

- Green tea: antioxidant, supports healthy aging

- Withania: support nervous system

- St John’s Wort/Saffron: reduce depression



Nutritional Recommendations

- Ensure healthy weight management through eating a whole food based diet following the principles of an Anti-Inflammatory Mediterranean style of eating as it includes an abundance of fresh fruit & veg, dietary fibre, oily fish, antioxidants and anti-inflammatory compounds to support overall wellbeing

- To support bone health and prevent the risk of osteoporosis (which commonly occurs due to the loss of oestrogen) - ensure sufficient intake of calcium, Vitamin D, and protein.

- Phytoestogens, including soy and soy isoflavones, have been shown to be effective in reducing the frequency and severity of hot flushes and vaginal dryness. 40-80mg of isoflavones per day (derived from soy-based products) are beneficial in reducing vasomotor symptoms

- Optimize intake of Omega 3 fatty acids to improve cognitive/brain health, cardiovascular health, reduces LDL cholesterol and triglycerides, and lowers inflammation

- Avoid processed/refined foods, sugars, alcohol as they tend to increase the severity of menopausal symptoms.



Lifestyle Recommendations

- Regular weight-bearing exercise in the menopausal transition can help to prevent bone loss. Weight-bearing exercises combined with other forms of training such as light strength training are proven to preserve bone mineral density (BMD) in perimenopausal and postmenopausal women.

- Relaxation techniques, e.g. controlled breathing exercises, nature walks, yoga, tai chi etc may help reduce the frequency of hot flushes and improve psychological symptoms and stress associated with menopause.

- Aromatherapy – especially lavender oil - reduces anxiety and increases relaxation, which may be beneficial in easing stressful menopausal symptoms as well as sleeplessness, hot flushes and depression 

- Prioritize sleep by creating a wind-down ritual


I hope this information will help you on your journey. Always remember to consult with your doctor regarding any changes to your diet, exercise or lifestyle changes.

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