Natural Solutions for Menopause

Like death and taxes, for women, menopause is an inevitable part of life. It can be a time of highs and lows and confusion about how to address the symptoms. What about hormone replacement therapy? Do dietary supplements and herbal medicines work to relieve symptoms? Be assured there are natural solutions for menopause. 

For some women, the end of menstruation brings a sense of freedom from PMS, heavy bleeding, and premenstrual migraines. Some women find a more even mood and a release from worrying about birth control. The timing for menopause may coincide with fewer responsibilities at home or work or more time for creative or personal pursuits. That’s the bright side of menopause. 

Then there is any number of symptoms—from hot flashes to brain fog, to difficulties with intimacy and sex, to challenges with sleep and mood. And because heart disease, osteoporosis, and cognitive decline increase as circulating estrogen decreases, all women need to be proactive to prevent these and other common diagnoses, especially in the post-menopausal years. The average life expectancy of women in America is 81; the average age of menopause is 51, so there are decades to prepare with intentional, preventive care to optimize health and quality of life.

 With their emphasis on lifestyle and whole-person medicine, Naturopathic doctors are uniquely qualified providers, perfect to work with on natural solutions to menopause. 

Naturopathic Medicine and Menopause 

A licensed naturopathic doctor works with you to create an individualized plan toward better and sustained health. NDs take time to appreciate your genetic and personal health history and the hormonal and lifestyle factors that impact how you feel. NDs use modalities such as nutrition, nutraceuticals, botanical medicine, lifestyle counseling, exercise prescription, stress management, hormone therapy, and, when indicated, specific pharmaceuticals to help you find balance and address the specific symptoms or diagnoses you have.

Common Symptoms Associated with Menopause 

Here are some of the most concerning symptoms perimenopausal and menopausal women may experience:

Irregular or changed periods. Your periods may be closer together or further apart, and the nature of flow may shift. When you enter perimenopause, remember you may still be fertile, but your cycle may be more difficult to follow; take special care with birth control during these years. Also, be aware excessive bleeding may be due to uterine fibroids or polyps, and should  be assessed to rule out changes in cells that may be precancerous or cancerous.

Hot flashes. Most, though not all, women experience hot flashes and/or night sweats with varying intensity, length, and frequency. Triggers may include indoor or outdoor temperature , nutritional factors, emotional stress, alcohol, and smoking or vaping. Hyperthyroidism, anxiety, and acute illnesses with fevers may also cause hot flashes, so keep that in mind. 

Vaginal dryness and thinning. Decreased estrogen may cause vaginal tissues to thin and feel drier, which can be uncomfortable at any time and make penetrative sex painful. At the same time, you may be more prone to vaginal or urinary tract infections or the tendency to lose urine. Other ailments may cause these problems, such as cancer, infection, allergy, and other skin conditions, so an accurate diagnosis is always paramount.

Skin changes. Brown spots, dryness, easy bruising, and increased wrinkling all come with menopause to one degree or another. These changes run in families, and not everyone is equally impacted. Part of the reason for skin change has to do with a menopause-related decrease in collagen. During the first five years after menopause, 30% of skin collagen is lost. In addition, scalp hair loss may occur, and/or excessive facial hair growth may begin; there may be a new symptom or return of acne or acne rosacea. Lastly, you may see slower healing and be more prone to bruising in the menopausal years.

Natural Solutions for Menopause

Sleep challenges. Disturbance in sleep may be due to hot flashes, but even without hot flashes, some women experience difficulty falling or staying asleep, which, in turn, can lead to changes in energy levels during the day. 

Sexual health. Decreased libido and other changes in sexual response are common during perimenopause and menopause. Many things can contribute to a lack of satisfaction with intimacy and sex, from changing hormone levels to changes in the physical body to more psychological factors.

Depression, anxiety, and/or mood swings. Many, but not all, women experience some shift in mood, which might include depression, anxiety, or irritability. Sleep disturbances may contribute, as well, to changes in hormone levels and hormone balance.

Bone health. Bone loss is aggravated by declining estrogen levels and may increase the risk of osteoporosis and bone fractures.

Changing lipid profiles. Decreasing estrogen levels may lead to unfavorable changes in your blood cholesterol levels. There may be an increase in low-density lipoprotein (LDL) cholesterol—the “bad” cholesterol—which contributes— the “bad” cholesterol—which contributes to an increased risk of heart disease. At the same time, high-density lipoprotein (HDL) cholesterol—the “good” cholesterol—decreases in many women as they age. Some women will develop palpitations or headaches related to the onset of menopause.

Weight Gain. As if the above list was not long enough, we can add weight gain to the troubles some women experience in menopause caused by a decrease in insulin sensitivity putting t you at risk for diabetes.

What to Expect from a Naturopathic Doctor for Menopause 

NDs are interested in addressing both the acute symptoms of menopause, like hot flashes and sleep issues, while also keeping an eye on the long-term health impacts of menopause primarily related to the prevention of heart disease, osteoporosis, and cognitive decline

An ND may want to do blood work to check thyroid function, iron deficiency, vitamin D status, lipid profile, and HbA1c. Depending on your presenting symptoms, your ND might order more specialized blood tests to ensure there are no underlying chronic infections, food allergies, or leaky gut.

 Some NDs will use saliva testing to understand your hormonal levels. It’s not just about how much estrogen or progesterone is circulating; it’s a lot about the balance between the two and their interaction with other hormones. Your naturopathic doctor can help you understand what is going on inside your body.

Your ND may suggest tests to assess your digestive process by using stool analysis, as so much of our hormonal, immune, and digestive processes rely on a healthy, robust, and diverse microbiome. Gathering information about your various systems can help inform an individualized treatment plan.

NDs are also concerned about the various toxic exposures you may have, which may be part of your intake. Many chemicals in our environment can act as hormone disruptors, impacting health from head to toe.   

Your ND may prescribe an anti-inflammatory diet, as well as regular exercise.  

A well-balanced exercise routine includes three components: aerobic, resistance or weight training, and stretching.

All three are essential for helping with balance, cardiovascular and mental health, and for keeping calcium in the bones.

Alcohol can contribute to sleep disturbance, worsening hot flashes, and weight gain and should be kept to a minimum.

NDs may recommend medicinal plants containing phytoestrogens, such as ginsengred clover, and soy to reduce hot flashes, decrease vaginal dryness, increase energy, and improve mood. Other non-phytoestrogen plants like  black cohosh and kava can also help reduce hot flashes.

Vitamin D, calcium, vitamin K, collagen, and other nutrient supplements may be prescribed to help prevent osteoporosis and bone fracture. Weight-bearing exercise and removing items from the diet that pull calcium into the urine, such as refined sugar, alcohol, and too much salt will also help.

Natural medicine approaches to insomnia show great promise and relief. NDs have many suggestions to help you with weight loss that are culled from our various modalities and lifestyle recommendations.

Mind-body medicine such as stress reduction, meditation, and yoga for mild to moderate depression, cognitive decline, and hot flashes may be recommended. Saffron and St John’s Wort are other botanicals considered to help with low mood and sadness.

And the prevention of cognitive decline is paramount. Using an integrative medicine, whole-person approach to cognitive decline shows the most impact.

Based on your health history, genetic history, and presenting symptoms, bio-identical hormones, customized compounds, and/or conventional hormone therapy (HT) may be considered. In particular, if there is a strong family history or other risk factors for osteoporosis, cardiovascular disease, dementia, or other conditions where less circulating estrogen is a substantial contributing factor, then the use of a pharmaceutical may well be indicated. As state laws allow,  NDs are trained to use conventionally available hormone replacement options and specialty compounded hormone formulations. 

With a toolbox full of effective approaches, having a naturopathic doctor on your medical dream team can help support you through the change of life and beyond.

Use this Find Your ND portal to start your path to better health.

The INM would like to thank Tori Hudson, ND, for her contributions to this article.

Dr. Rothenberg is a contributor to INM and practicing licensed naturopathic doctor in Northampton, Massachusetts. Dr. Rothenberg is the American Association of Naturopathic Physicians 2017 Physician of the Year. Dr. Rothenberg's writing can be found on, Better Nutrition's Naturopathic Health Hub, Medium, Thrive Global, and The Huff Post. She is the proud mother of 3 adult children.

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.