Hormones take women through many journeys in life. Puberty transitions us from children into fertile women, where we spend our young adulthood. Then, somewhere within a woman's mid-30s to early 50s, another transition occurs, taking us from a state of fertility to menopause, where we spend our late adulthood. Each year in the USA, 1.3 million women become menopausal.
Menopause is merely a new chapter in a woman's life. It is frequently associated with uncomfortable symptoms, although it doesn't have to be. Functional medicine can help detect specific imbalances and deficiencies that may be occurring at this time to create a holistic plan that can alleviate the discomfort so that women can move through the transitional phase and fully enjoy the late adult years.
What is Menopause?
Menopause is a phase in a woman's life that marks the end of her fertility, meaning that after menopause, women can no longer become pregnant. It starts after there have been 12 consecutive months without a menstrual period. There are typically many years leading up to this point when the "menopause transition" starts to happen. During this transition, monthly cycles become irregular, and other hormonal symptoms, such as hot flashes, may occur. The transition is known as perimenopause.
Menopause can happen in a woman's 40s or 50s. However, in the United States, the average age is 51. It is a natural biological process that all women will go through. The loss of ovarian follicular function and a decline in estrogen levels causes it to start. It can also be induced as a consequence of a surgical or medical procedure.
Menopause Signs & Symptoms
Symptoms of menopause typically begin during the transitional months or years leading up to it, known as perimenopause. The decrease in estrogen is typically responsible for most symptoms experienced. The most common symptoms are:
- Changes to the menstrual cycle, such as Irregular periods
- Vaginal dryness and low libido
- Temperature changes such as hot flashes, chills, or night sweats
- Sleep issues
- Mood changes
- Slower metabolism and weight gain
- Thinning hair and dry skin
- Changes in breasts, such as a loss of fullness
5 Functional Medicine Lab Tests for Your Menopause Patients
Comprehensive Female Hormone Panel
The DUTCH Complete test is the first go-to functional lab when thinking about peri and postmenopausal women. It assesses the sex and adrenal hormones to gauge the menopause transition. It also tests for cortisol and melatonin to gain a better understanding of sleep quality as well as organic acids, which can assess the metabolism as well as some nutrient and neurotransmitter deficiencies, which are associated with physical and emotional symptoms.
A more thorough look at nutrient deficiencies might be warranted as well. During menopause, women are more prone to certain deficiencies as their bodies and hormones shift. Osteoporosis and cardiovascular diseases are also at an increased risk, and the prevention of both requires adequate nutrients. The NutrEval® FMV panel by Genova Diagnostics gives an excellent overview of the body's nutrient status and oxidative stress levels.
Comprehensive Stool Testing
Studies show that the gut microbiome is significantly different between premenopausal and postmenopausal women, and menopause is correlated to reduced gut microbiota diversity. These studies also show increased potential for gut permeability in postmenopausal women due to the drop in estrogen and progesterone. A thorough evaluation of the gut microbiota's makeup can give us insight into the diversity and permeability potential. The GI-MAP test analyzes the gut microbiota DNA to detect various strains. With this information, postmenopausal women could take steps to increase beneficial strains that are deficient for improved gut and total health.
A Lipid Panel is another panel specifically indicated for menopausal women. As hormones change, cholesterol levels change, so monitoring them is a good idea.
Comprehensive Thyroid Panel
During menopause, thyroid dysfunction becomes common since it is in communication with the other reproductive hormones. A full Thyroid Panel will thoroughly screen the thyroid's health and function to ensure it is functioning optimally.
Functional Medicine Treatment for Menopause Related Symptoms
As the body and its hormones change, certain lifestyle choices also need to change.
When changes begin, and symptoms occur, it is a great time to adopt a perimenopause diet. This diet is packed with nutrients such as foods high in calcium, omega-3 fatty acids, plenty of protein, fibrous foods such as vegetables, fruits, and whole grains, and probiotic-rich foods such as fermented foods. Once menopause is official, it will be even more essential to carry these dietary changes throughout late adulthood.
These nutrients have been shown to help prevent conditions that women are more prone to post-menopause, such as osteoporosis and cardiovascular disease, and can help control symptoms such as weight gain and gut dysfunction.
Along with the diet, phytoestrogens have been shown to help improve several menopausal symptoms, specifically depression. Phytoestrogens are a category of plant nutrients that can have estrogenic effects when eaten, and some food examples are soy, beans, grains, and some fruits and vegetables. Phytoestrogens come in supplemental form as well.
Complementary and Alternative Medicine
Along with addressing specific nutrient deficiencies that come up on a NutrEval test, research shows that vitamins C, D, K, and Calcium should also be supplemented in menopause for proper maintenance of bone health since osteoporosis is more likely.
Several herbs have been researched to alleviate common symptoms of menopause. Black Cohosh has been shown to reduce night sweats and hot flashes and boost mood. Low libido is common during menopause, but Panax Ginseng is an excellent option for improving sexual desire and function.
Yoga is a gentle form of exercise, and it has been shown in research to help reduce menopausal symptoms.
Acupuncture has also been shown to be an effective modality in research to reduce vasomotor symptoms (night sweats and hot flashes) during menopause.
Menopause is not a condition or disease but a natural phase of life. All women will transition into menopause. While most associate this time with many uncomfortable symptoms as the hormones shift, a lot can be done to help minimize the discomfort, making the transition more manageable and enjoyable.
Functional medicine can help address some of the root causes of menopausal symptoms. Functional labs look beyond "routine bloodwork" the assess actual function. They are valuable tools that can be used to create holistic plans to help women feel healthy in this new chapter of life.
Lab Tests in This Article
- Befus, D., Coeytaux, R. R., Goldstein, K. M., McDuffie, J. R., Shepherd-Banigan, M., Goode, A. P., Kosinski, A., Van Noord, M. G., Adam, S. S., Masilamani, V., Nagi, A., & Williams, J. W. (2018). Management of menopause symptoms with acupuncture: An umbrella systematic review and meta-analysis. The Journal of Alternative and Complementary Medicine, 24(4), 314-323. https://doi.org/10.1089/acm.2016.0408
- Castelo-Branco, C., Navarro, C., Beltrán, E., Losa, F., & Camacho, M. (2022). Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement. Gynecological Endocrinology, 38(5), 379-384. https://doi.org/10.1080/09513590.2022.2056591
- Christie, J. (2023, January 19). An integrative medicine approach to perimenopause. Rupa Health. https://www.rupahealth.com/post/an-integrative-approach-to-perimenopause
- Christie, J. (2023, January 10). How to build a personalized nutrition plan for your Perimenopausal patients. Rupa Health. https://www.rupahealth.com/post/how-to-build-a-personalized-nutrition-plan-for-your-perimenopausal-patients
- Cramer, H., Peng, W., & Lauche, R. (2018). Yoga for menopausal symptoms—A systematic review and meta-analysis. Maturitas, 109, 13-25. https://doi.org/10.1016/j.maturitas.2017.12.005
- Dennehy, C., & Tsourounis, C. (2010). A review of select vitamins and minerals used by postmenopausal women. Maturitas, 66(4), 370-380. https://doi.org/10.1016/j.maturitas.2010.06.003
- Ghorbani, Z., Mirghafourvand, M., Charandabi, S. M., & Javadzadeh, Y. (2019). The effect of ginseng on sexual dysfunction in menopausal women: A double-blind, randomized, controlled trial. Complementary Therapies in Medicine, 45, 57-64. https://doi.org/10.1016/j.ctim.2019.05.015
- Jieyun, L., LI, H., Peijing, Y., Guo, L., Li, J., Han, J., Qiu, J., & Yang, K. (2020). Efficacy and safety of phytoestrogens in the treatment of postmenopausal depressive disorders: A systematic review and meta-analysis. https://doi.org/10.22541/au.160856238.85330974/v1
- LoBosco, S. (2022, September 1). 8 ways to reduce anger associated with perimenopause. Rupa Health. https://www.rupahealth.com/post/why-does-perimenopause-rage-happen
- Menopause - Symptoms and causes. (2020, October 14). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
- Menopause. (2022, October 17). World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/menopause
- Milart, P., Woźniakowska, E., & Wrona, W. (2018). Selected vitamins and quality of life in menopausal women. Menopausal Review, 17(4), 180-184. https://doi.org/10.5114/pm.2018.81742
- Peacock, K., & Ketvertis, K. M. (2022). Menopause. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507826/#!po=95.8333
- Peters, B., Santoro, N., Kaplan, R., & Qi, Q. (2022). Spotlight on the gut microbiome in menopause: Current insights. International Journal of Women's Health, 14, 1059-1072. https://doi.org/10.2147/ijwh.s340491
- Preston, J. (2023, January 19). 3 lab test that can help address low libido in menopausal women. Rupa Health. https://www.rupahealth.com/post/3-lab-test-that-can-help-address-low-libido-in-menopausal-women
- Uygur, M. M., Yoldemir, T., & Yavuz, D. G. (2018). Thyroid disease in the perimenopause and postmenopause period. Climacteric, 21(6), 542-548. https://doi.org/10.1080/13697137.2018.1514004
- What is menopause? (2021, September 30). National Institute on Aging. https://www.nia.nih.gov/health/what-menopause