Menopause: Balancing Women's Hormones Naturally

Menopause. Ah, that lovely time in a woman's life when she finally stops having to deal with monthly cycles and can celebrate her freedom from Tampax, Always and Diva Cup. No more monthly mood swings, no more tender breasts, no more cramps, no more birth control. Life is good!


Well, for some women this is definitely true. For others, menopause means the ending of a list of complaints they may have gotten used to, only to be replaced by an entirely new group of symptoms. Or, for those women who spent their reproductive years relatively free of any associated complaints, menopause can bring on their first experience with a whole host of unpleasant concerns.


What is Menopause?
The term menopause is derived from the words meno (month) and pausis (cessation). Thus, menopause means the end of menstruation. Menopause is strictly defined as the time after 12 consecutive months of no menses, following your last monthly period.  Natural menopause occurs as a result of the decline of ovarian function, and is characterized by a number of symptoms, including: hot flashes, fatigue, mood swings, decreased sex drive, insomnia, vaginal dryness, increased susceptibility to urinary tract infections, a decrease in bone mineral density and an increase in the risk of coronary artery disease.

Natural menopause typically occurs in women between the ages of 40 and 58, with the average age in the U.S. being 51 years.  Three crucial factors affect the age of menopause: genetic factors involving the estrogen receptors, current smoking, and familial factors. The timing of menopause may also be influenced by: toxic chemical exposure, being overweight, history of no pregnancy, more than one pregnancy, epilepsy, treatment of childhood cancers with chemotherapy or radiation, and cognitive scores in childhood (the higher the score, the later the menopause).

Where Do Our Hormones Come From?
During the reproductive years, women's ovaries and adrenal glands are responsible for producing the majority of the hormones that control fertility, libido and the menstrual cycle, with the ovaries playing the largest role.  As women enter menopause, their ovarian function begins to decline, resulting in significantly lower production of estrogen, progesterone and testosterone.

Estrogen: 
During menopause, the adrenal glands begin to play a more significant role. Along with the production of cortisol, adrenaline, noradrenaline, and aldosterone, the adrenal glands also manufacture DHEA, testosterone and a hormone called androstenedione, which is converted to estrogen in body fat, as well as in the muscle and skin. For some women, this source of estrogen is enough to prevent some of the common side effects of menopause, giving them an easier transition. In others, the lack of estrogen may lead to a number of symptoms, including:

• Changes in menstrual bleeding and regularity
• Decreased fertility
• Decreased memory and concentration
• Mood changes
• Vaginal dryness and thinning with associated pain with intercourse and decreased libido
• Decreased sexual sensation
• Urinary problems, including incontinence, urination at night and recurring urinary tract infections
• Increased bone loss
• Increased risk of cardiovascular disease: elevated cholesterol, high LDL, low HDL, elevated blood pressure
• Hot flashes (although scientists are still unsure of the exact cause of hot flashes)
• Poor sleep
• Aging skin and wrinkles

Progesterone:

As ovarian function declines in menopause, the adrenal glands also become the crucial producers of progesterone. This is another reason why it is vital to maintain proper adrenal gland functioning through out the menopausal years.

Symptoms of low progesterone:

• Fatigue
• Anxiety
• Insomnia
• Decreased libido

Testosterone:
In our bodies, approximately 50% of testosterone comes from the ovaries and adrenal glands. The other 50% are made from other tissues in the body, including the skin, brain and liver.  The ovaries and adrenals make precursor hormones that these parts of the body use to produce testosterone.

Although it is a blessing that the adrenal glands are a source of hormonal support, they can only function maximally when the ovaries are also fully functioning. This means that in women who have had their ovaries removed, their adrenal glands will not be able produce up to their maximum potential.

Symptoms of low testosterone:

• Fatigue
• Low motivation
• Poor memory
• Depression
• Low libido
• Lack of sexual orgasm
• Decreased sexual sensation
• Elevated blood pressure
• Loss of muscle mass

Remedies for Menopausal Symptoms:
The naturopathic management of menopause includes a variety of approaches, including:

Dietary Suggestions:

• Recognize and eliminate food allergies
• Reduce intake of refined grains and flours, salt, and sugar
• Avoid trans fats
• Reduce intake of saturated fats
• Avoid dairy
• Increase intake of fruits (1-3 servings per day), vegetables (at least 6 servings per day), legumes (especially soy unless there is a high risk of or current status of breast cancer), flax, nuts and seeds, olive oil and cold-water fish. 
• Avoid alcohol and caffeine
• Avoid dehydration by drinking an adequate amount of water for your body weight
• Eat regularly (every 2-3 hours).

Lifestyle Management:

• Increase exercise
• Stop smoking
• Decrease stress
• Avoid being overweight or underweight

Supplements:
Below is a list of some of the most common menopausal concerns, followed by the most commonly used supplements for treatment. How each of these supplements work is a wonderful question for your naturopathic doctor. Be sure to ask in order to keep us on our toes!

Nutritional Supplementation:

• For Hot Flashes: Vitamin C, vitamin E, soy isoflavones, fish oil
• For Bone Health: Calcium, vitamin B6, Vitamin C, vitamin D3, vitamin K2, boron, magnesium, manganese, zinc, copper, folic acid
• For Mood Health/Insomnia: Vitamin B6, 5-HTP, niacinamide, inositol, calcium, magnesium
• For Vaginal Dryness: Topical vitamin E, oral fish oil, flax seeds, evening primrose oil
• For Heart Health: B vitamins (especially folic acid, B6 and B12), vitamin C, vitamin E, calcium, co-q-10,  fish oil, magnesium, niacin, potassium, L-arginine, L-carnitine 

Herbal Supplements:

• For Hot Flashes: Black cohosh, dong quai, chaste tree, red clover, fennel, flax, licorice, curcumin
• For Mood Health/Insomnia: St. john's wort, passionflower, valarian, skull cap, melatonin, kava
• For Adrenal Support: Rhodiola, Withania, Eleutherococus, Licorice
• For Heart Health: Dandelion, hawthorne, red yeast rice, ginkgo, curcumin, plant sterols

Bio-identical Hormone Replacement:

• Estrogen, progesterone, testosterone and DHEA may be used in more extreme cases where diet, lifestyle and supplements do not provide adequate relief. 
• Estriol cream for vaginal symptoms

Non-Hormonal Prescription Medications:

The following may be prescribed if diet, lifestyle and supplements do not provide substantial relief:

• Thyroid medication
• Antidepressants
• Anti anxiety medication
• Blood pressure medication

As you can see, there are a number of remedies available to help you through menopause, and this blog is certainly not all inclusive! In addition to this list, there are also a variety of homeopathic treatments available, as well as a full-body approach, including treatment of the liver and other organs that your naturopathic doctor can discuss with you.

With a little bit of education, the right guidance, and some patience, you can make menopause into a comfortable, enjoyable transition! We look forward to working with you!




References:
www.mayoclinic.com
Menopause: Dr. Lorilee Schoenbeck, ND
Nutritional Medicine: Dr. Alan Gaby, MD
The Complete Guide to Women's Health: Dr. Sat. Dharam Kaur, ND
Women's Encyclopedia of Natural Medicine: Dr. Tori Hudson, ND