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.
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 ginseng, red 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 NaturalMed.org, Better Nutrition's Naturopathic Health Hub, Medium, Thrive Global, and The Huff Post. She is the proud mother of 3 adult children.