Menopause is a completely normal and necessary end to your reproductive years. It's estimated that as many as 1.3 million women enter menopause each year in the United States. The transition is sometimes equated to a "second puberty" because drastic hormonal shifts lead to changes in your physical, mental, and emotional states. From an integrative medicine perspective, there are many things we can do to help ease the transition. In order to navigate this phase of female health, you'll need to understand what menopause is, the symptoms to be aware of, and how you can incorporate alternative therapies for support.
What is Menopause?
The end of a woman's fertile timeframe is the kickoff of Menopause. This natural part of reproductive aging is identified by going 12 consecutive months without a menstrual period. The average age of menopause is 51. You can start experiencing transitional perimenopausal symptoms as early as your mid-30s. But, the average time of this phase begins in your 40s. There are technically three stages to the menopausal process: Perimenopause, Menopause, and Postmenopause.
What are the Top Menopause Symptoms?
Menopause symptoms may begin slowly during the perimenopausal phase and then abruptly during menopause. The most common symptoms you'll want to be aware of are:
- Hot Flashes
- Missed periods
- Sore breasts
- Vaginal dryness
- Excess urination
- Emotional changes
- Sleep issues
- Dry eyes, mouth, or skin
- Low libido
Functional Medicine Labs to Test To Help Personalize Treatment for Menopause Symptoms
Functional medicine labs can help get to the root of common menopause symptoms. Here are the top tests that functional medicine practitioners run:
DUTCH Complete is a great analysis of hormones and metabolites for menopausal women. This test will comprehensively examine not only sex hormones but also cortisol, organic acids, and melatonin. Using this information in correlation to the symptoms picture can be helpful in treatment recommendations, especially if bio-identical hormone replacement therapy is an option.
During late perimenopause and early postmenopausal state, there have been documented changes in lipid levels in women. This study revealed that total cholesterol, LDL, triglycerides, and lipoprotein(a) all peak during phases of menopause. Following these changes would help you and your provider keep track of and support healthy cholesterol levels. You can get a Lipid Panel done through BostonHeart Diagnostics, which includes nine lipid markers.
Hormone metabolism occurs in the liver. As your hormone levels drastically shift during menopause, checking in on liver function would be beneficial to ensure everything is operating properly. Vibrant America offers a Hepatic Function test to analyze liver enzymes and other pertinent liver markers.
Hormonal changes can lead to nutrient deficiencies which impact organ systems. Osteoporosis and cardiovascular disease are two main areas of concern. Women also need different and varying amounts of micronutrients during different reproductive stages. Getting a comprehensive Micronutrient Panel like Vibrant America's can give insight into vitamins, minerals, amino acids, and fatty acids.
Many peri-to-post menopausal women experience mood changes. Your brain has receptors for both estrogen and progesterone. During the transition into menopause, you may experience the mental and emotional impact this can have on your brain as it's trying to figure out how to respond to the lack of hormones. Downstream effects can impact neurotransmitters such as serotonin, GABA, and dopamine. Doctor's Data offers a Comprehensive Neurotransmitter Profile urine test that evaluates the secretion and metabolization of 21 biomarkers. If micronutrient testing is relevant to your case, doing a Neurotransmitter + Micronutrients package for a one-stop shop would benefit you.
A complete Thyroid Panel by Precision Point evaluates hormones involved in thyroid function. This test includes reverse T3, which is important as it can provide insight into any thyroid hormone conversion issues between the thyroid gland and the liver. Hypothyroidism is also a risk factor for dyslipidemia in premenopausal and postmenopausal women and, therefore, should be assessed if you have cross-over symptoms.
Strategies for Managing Menopause Symptoms
Getting ahead of the menopausal symptoms by practicing preventative wellness care can help ease you into menopause. Establishing healthy habits for yourself with nutrition, lifestyle, and alternative measures can be a great avenue for symptom reduction.
Nutrition for Managing Menopause Symptoms
When you start to notice your menstrual cycle shifting, making dietary changes to nutrient-dense foods can help support your body. Implementing an individualized Perimenopause Diet, rich in phytoestrogens, protein, calcium, fat, and fiber, is a great way to help support organ systems most impacted by this hormonal adjustment. Phytoestrogen-rich foods have an estrogen-like capability on estradiol receptors. The great thing about phytoestrogens is that multiple studies have shown that they can reduce the occurrence of vasomotor symptoms like hot flashes. Some options for phytoestrogen-containing foods include peas, fruits, whole grains, some seeds, non-GMO soy, broccoli, and cauliflower.
Movement for Managing Menopause Symptoms
Moving intentionally benefits your mind and body. Exercise can help manage stress, maintain a healthy weight, stimulate the release of endorphins to boost your mood, strengthen your bones, and improve your libido. One small study gathered qualitative feedback from women that were recommended physical activity as a therapeutic intervention to treat vasomotor symptoms. All participants reported improvement in hot flashes, night sweats, and an ability to cope with changes occurring. From a doctor's perspective, it's important to note that they also reported that they would prefer their doctor recommend physical activity in their treatment plan.
Sleep for Managing Menopause Symptoms
Disrupted sleep affects many menopausal women. Discomfort from night sweats, hot flashes, and the emotional rollercoaster can make bedtime a challenge. Treating the symptoms that are disturbing your sleep through botanical medicine, BHRT, nutrient support, and tips for reducing body temperature is your best line of support here.
Stress Reduction Practices for Managing Menopause Symptoms
Women are known to be impacted by stress in all stages of life. Add in emotional disarray from the drastic hormone shifts, and it's a recipe for more stress. While there are many ways to cope with stress, Yoga and EMDR therapy have been proven to be beneficial for women's health. Additional stress reduction practices include breath work, implementing more relaxation into your day, and avoiding stimulant beverages.
Herbal Medicine for Managing Menopause Symptoms
Humulus Lupulus, AKA Hops, is the most potent phytoestrogen plant available. Randomized controlled trials like this one have shown Hops to be beneficial in reducing hot flashes, compared to a placebo.
Black Cohosh, Red Clover, Valerian, and Glycine soja (Wild Soybean) all have therapeutic benefits in menopause. Black Cohosh is commonly used to reduce hot flashes but can also support the autonomic nervous system and psychological aspects that menopause can affect. Red Clover and Glycine soja are both part of the isoflavone family, with the beneficial effects of reducing hot flashes. According to a double-blind study of 68 menopausal women, encapsulated Valerian Root has been shown to be beneficial in reducing the frequency and severity of hot flashes.
Vitamin Therapy for Managing Menopause Symptoms
Many vitamins play a direct role in supporting reproductive organs, bone structure, and neurological function. Menopausal women tend to need extra support in this area due to the fact the body has drastically changed in what it is utilizing for hormone signaling. According to this review of literature, Vitamins that are particularly important to monitor and support are B2, B6, B12, Folate, Vitamin C, and Vitamin D.
Bioidentical Hormone Replacement Therapy (BHRT) for Managing Menopause Symptoms
BHRT is a common treatment modality used amongst functional medicine practitioners to support hormones during the rapid decline in menopause. Bioidentical hormones are plant or animal-derived and mimic our own hormone structure as closely as possible. For menopause, practitioners prescribe BHRT to compounding pharmacies in the form of progesterone, estrogen, or androgen. A systemic review and meta-analysis of RCTs found that there were improvements in vaginal atrophy with the use of vaginal androgen therapy. While supporting your hormone levels during menopause will allow for ease into postmenopause, there is controversy on BHRT as not all forms are FDA-approved, and there is much variability in prescribing. It's best to talk with a trained practitioner that has worked with hormone replacement and menopause so you can get a clear understanding of all your options.
Acupuncture, Massage, and Yoga for Managing Menopause Symptoms
All three of these integrative medicine approaches can be an excellent support for menopause. Acupuncture can decrease vasomotor symptoms, while massage and yoga can improve sleep and help manage psychological symptoms that may arise.
Women spend a third of their life in the post-menopausal season. While the process of menopause may not be easy, it does not have to be dreadful. There are a plethora of conventional and alternative therapies to help support you along the way. Setting yourself up for success and minimal symptoms all starts with lifestyle modifications. To gain extra guidance and support, work with a supportive and holistic-minded practitioner who can be a great tool in this transitional phase of life.
Lab Tests in This Article
- Aghamiri, V., Mirghafourvand, M., Mohammad-Alizadeh-Charandabi, S., & Nazemiyeh, H. (2016). The effect of Hop (Humulus lupulus L.) on early menopausal symptoms and hot flashes: A randomized placebo-controlled trial. Complementary Therapies in Clinical Practice, 23, 130-135. https://doi.org/10.1016/j.ctcp.2015.05.001
- Bouchez, C. (2005, July 18). Your Brain on Menopause. website: https://www.webmd.com/menopause/features/your-brain-on-menopause
- Chen, N., Lin, C., & Liu, F. (2015). Efficacy of phytoestrogens for menopausal symptoms: A meta-analysis and systematic review. Climacteric, 18(2), 260-269. https://doi.org/10.3109/13697137.2014.966241
- Contributors, W. E. (n.d.). Sleep and Menopause. WebMD website: https://www.webmd.com/sleep-disorders/sleep-disorders-sleep-menopause
- Derby, C. A., Crawford, S. L., Pasternak, R. C., Sowers, M., Sternfeld, B., & Matthews, K. A. (2009). Lipid Changes During the Menopause Transition in Relation to Age and Weight: The Study of Women’s Health Across the Nation. American Journal of Epidemiology, 169(11), 1352–1361. https://doi.org/10.1093/aje/kwp043
- Fitness tips for menopause: Staying active. (n.d.). Mayo Clinic website: https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/fitness-tips-for-menopause/art-20044602
- Han, Y., Wang, C., Zhang, L., Zhu, J., Zhu, M., Li, Y., Teng, D., Teng, W., & Shan, Z. (2022). Menopausal Impact on the Association Between Thyroid Dysfunction and Lipid Profiles: A Cross-Sectional Study. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.853889
- Home. (n.d.). Retrieved from National Menopause Foundation website: https://nationalmenopausefoundation.org/
- How Hormone Depletion Affects You | Menopause. (n.d.). Retrieved from menopause.obgyn.msu.edu website: https://menopause.obgyn.msu.edu/content/how-hormone-depletion-affects-you
- Kenda, M., Glavač, N. K., Nagy, M., & Dolenc, M. S. (2021). Herbal Products Used in Menopause and for Gynecological Disorders. Molecules, 26(24). https://doi.org/10.3390/molecules26247421
- Liu, Y., Yuan, Y., Day, A. J., Zhang, W., John, P., Ng, D. J., & Banov, D. (2022). Safety and efficacy of compounded bioidentical hormone therapy (cBHT) in perimenopausal and postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Menopause. https://doi.org/10.1097/GME.0000000000001937
- Menopause and Stress: Help & Solutions | The North American Menopause Society, NAMS. (2019). Menopause.org website: https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/stress-getting-serious-about-solutions
- Menopause. (n.d.). WebMD website: https://www.webmd.com/menopause/guide/menopause-basics#091e9c5e800078f3-1-3
- Milart, P., Woźniakowska, E., & Wrona, W. (2018). Selected vitamins and quality of life in menopausal women. Przegla̜d Menopauzalny = Menopause Review, 17(4), 175-179. https://doi.org/10.5114/pm.2018.81742
- Mirabi, P., & Mojab, F. (2013). The Effects of Valerian Root on Hot Flashes in Menopausal Women. Iranian Journal of Pharmaceutical Research : IJPR, 12(1), 217-222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813196/
- Office of Dietary Supplements - Valerian. (2017). Nih.gov website: https://ods.od.nih.gov/factsheets/Valerian-HealthProfessional/
- Phytoestrogens - Breast Cancer Prevention Partners (BCPP). (2017). Retrieved from Breast Cancer Prevention Partners (BCPP) website: https://www.bcpp.org/resource/phytoestrogens/
- Thomas, A., & Daley, A. J. (2020). Women’s views about physical activity as a treatment for vasomotor menopausal symptoms: a qualitative study. BMC Women’s Health, 20(1). https://doi.org/10.1186/s12905-020-01063-w