Menopause is a time of big change for most women. The physical and emotional changes can be overwhelming, debilitating and frustrating. It occurs naturally in women usually between the ages of 45-55 when the ovaries cease to function, you no longer ovulate and your body will reduce its oestrogen production. In the few years before your final period (called perimenopause), hormone levels fluctuate as oestrogen production reduces. Eventually oestrogen levels decrease to such a point that menstruation stops completely. Once you have not had a period for 12 months you are officially menopausal.
Many hormone changes take place- oestogen levels decline, FSH increases, LH increases, androgens decrease and DHEA decreases. All of the hormonal variations orchestrate the physical and biochemical changes that accompany menopause. The most common symptoms caused by these hormonal fluctuations are mood changes, hot flushes, fatigue, cognitive impairment, vaginal dryness, night sweats and insomnia. These are a huge concern for so many patients that I see in my clinic. While menopause is something that all women will have to go through, it does not have to be a negative experience as there are many natural strategies we can implement to get your through menopause feeling your best.
Naturopathically, working on improving your adrenal gland function can help you to breeze through menopause. Post-menopausal women rely on the production of androgen hormones from the adrenal glands. This is then converted in the body to oestrone and is our main source of oestrogen hormones once the ovaries stop producing it. We can support the adrenal system with adrenal adaptogenic herbs. Adaptogenic herbs include Withania, Siberian Ginseng, Panax Ginseng, Codonopsis, Rhodiola, Schisandra, Astragalus.
Hot flushes are the most common symptom women experience. They can be different for every woman (e.g. transient episodes of feeling a bit hot and sweaty; or feeling drenched with perspiration, uncomfortably hot, heart palpitations or you may just feel red in the face). After a flush, a slight drop in temperature is often felt due to loss of body heat from sweating. These temperature fluctuations lead to the on-again, off-again problem with clothing and lead to serious disturbance in sleep patterns. Of course, this makes you even more tired!
There are herbs used for specific types of hot flushes and their associated symptoms e.g. flushing accompanied by severe sweating (Black cohosh, Sage, Zizyphus) or hot flushes and anxiety (Passionflower, St John’s Wort, Black cohosh). Including phytoestrogens into your diet such as soy or flaxseeds will help to balance oestrogen levels. Avoid caffeine, spicy foods and alcohol as these will all increase the frequency of hot flushes.
Depression, anxiety and mood changes are also a common complaint I hear from my patients. Often they feel that they have lost some control of their emotions, feeling teary one moment, anxious the next and then happy again. Mood changes around menopause appears to be related to changes in oestrogen and a decline in androgen hormones. Sleep deprivation caused by night flushing contributes, as do many of the uncomfortable symptoms such as palpitations, crawling skin, facial flushing; all symptoms that anyone might experience during an episode of anxiety. The adrenal glands are now working overtime to balance your hormones, and as they are also responsible for secreting your stress hormones cortisol and adrenaline, can cause an imbalance in stress hormones which further leads to mood changes. Herbal medicines can improve mood around menopause, and one of my favourites is St Johns wort. All the adrenal herbs mentioned earlier are vital, as are lifestyle changes for stress management such as diet changes, exercise, yoga, tai chi, pilates and meditation.
Diet tips to support you through menopause
Changing your diet can have a direct influence on menopausal symptoms. Increasing dietary intake of various foods containing phytoestrogens (oestrogen like compounds in plants) reduces hot flushes, improve energy and mood and can reduce vaginal dryness.
- Eat more phytoestrogen foods. These contain oestrogen like compounds that can positively influence hormone balance. Sources include soy products, flaxseeds/linseeds, alfalfa, rice, lentils, mung beans, barley, oats, sesame seeds, sage, carrots and apples.
- Adding 100gm of tofu (e.g.: in a stir fry) and 30-40gm of ground linseeds (e.g.: in breakfast cereals or in smoothies) to your diet every day can reduce hot flushes and improve vaginal dryness. Make sure the soy products are always organic and non-genetically modified! There are many commercially available soy products but a lot of these are made from isolated soy compounds such as isoflavone or soy protein and these should be AVOIDED. Always check the ingredient panel to ensure you are consuming a product made from whole soy beans.
- Soy and phytoestrogens are CONTRAINDICATED if a woman has an oestrogen dependent cancer such as oestrogen-receptor positive breast cancer.
- Wholegrain and legumes are also good sources of phytoestrogens
- Eat a variety of fresh fruits and vegetables every day- aim for 2 pieces of fruit and 5-6 handful of vegetables per day
- Foods that can aggravate hot flushes and should be avoided include alcohol, coffee and excessively spicy foods.
- Decrease caffeine intake- stick to 1 coffee or tea daily
- Eating foods at a lower temperature can also help.
- Drink 8 glasses of filtered water daily
- Limit alcohol to a maximum of 1 glass per day.