Updated: Apr 26
Today, women are at the peak of their professional and personal life. During this peak, the very natural process of menopause begins initially with perimenopause and then culminating with the cessation of menses for 12 months. After decades of regular periods and the hassle and joy (the child bearing years) they bring, menopause represents freedom! Some of my patients say hallelujah, while others express disappointment with the end of their periods, and the end of their reproductive cycle.
With menopause comes a very real reduction in hormones such as estrogen, progesterone, and testosterone. A normal stage of life, menopause is not a “disease” needing to be treated. Still some women are affected more than others by this drop in hormones.
The top five complaints that I see in my office are:
Sleep can be disrupted with menopause. In one study nearly half the women suffering with sleep disturbances compared it to same level of disruption of sleep they had raising a newborn! The most common cause of interrupted sleep during menopause can be attributed to night sweats or heat surges which can be as simple as needing to kick the covers off, only to pull them back on a few minutes later, to being fully soaked and needing a change of pajamas. While sleeping with the AC cranked up may help in the short term, it can get costly, paying those electricity bills and your partner may not like turning into a popsicle every night. Another cause of waking can be an increase in cortisol levels, which may wake you between 2-4 am, causing your mind to race with all of your worries. This can happen in women with high levels of stress or even after just a few nights of interrupted sleep. Melatonin may be another hormone affecting your sleep. Aging and chronic stress can decrease melatonin. This may be an important hormone to help support if you are having trouble falling asleep. Managing the night sweats and balancing cortisol levels are important in order to get a good night’s sleep. This can be done with some lifestyle changes such as trying 2 weeks without caffeine, following a sugar free diet, and exercising daily. Relora is an herb that I often use to help my stressed out menopausal patients balance their cortisol and get a good night’s sleep.
Hot flashes and night sweats
I will never forget my patient who for the life of her could not figure out why she was suddenly getting unbearable night sweats. We tried all sorts of interventions only to discover that it was her brand new mattress cover! If only all night sweats could be solved by changing a mattress cover! The good news is that there are some effective treatments for hot flashes and night sweats. Herbal extracts such as Black Cohosh, Vitex (Chasteberry), Red Clover and Wild Yam have been clinically proven to reduce hot flashes. (1, 2) In my practice, I try to use botanicals first. In some severe cases though, I may prescribe bioidentical progesterone cream, which may be the best option to reduce hot flashes, improve mood, sleep and osteoporosis.
The menopausal drop in hormones can result in some pretty significant mood swings and depression for some women. Disruptions in sleep adds irritability and fatigue to the list. My patients complain that they feel flat, are no longer excited about anything and lack motivation. Some women suddenly suffer from anxiety even though there are no significant changes in their life. In one study, nearly three in ten women reported menopause negatively affected their relationship with their spouse. For working professional women, hot flashes interfered with work for more than half and caused anxiety in the workplace for a quarter of respondents. It can be pretty anxiety provoking to give a presentation when you are exhausted from lack of sleep and worried that you are about to have a hot flash! By supporting your hormones and eliminating sleep problems, mood can improve. Omega 3 fats, from fish or supplements are a great place to start for mood support. They have been shown to reduce depression and improve mood. St John’s wort has also proven to be effective in treating depression. In thirty-seven out of thirty-nine clinical trials St John’s Wort has been shown to be superior to placebo or equivalent to antidepressant medications with minimal side effects as compared to some of the antidepressants (3) Please be sure to check with your Naturopath before you start St John’s Wort to be sure it does not interact with your medications, and that it is right for you.
I could write about this topic all day. See my recent article about weight loss and hormones. There are so many reasons why women gain weight as they enter menopause. Dropping hormonal levels, and their effect on thyroid function would be enough to have an effect on weight. Add interrupted sleep, which results in an increase in cortisol – high levels of which affect our insulin and result in belly fat; a decrease in growth hormone – resulting in muscle loss; and a drop in serotonin – which contributes to low mood and cravings and there are plenty of reasons for that stubborn weight. Treatment goals are aimed at healthy eating, controlling cortisol and insulin and supporting sleep. Exercise is a must and I discuss it more below.
Loss of libido
There are many reasons for a low or nonexistent libido. A decrease of estrogen and testosterone levels, hot flashes and fatigue from interrupted sleep all contribute to the loss of that “lov’n feeling”. Luckily there are some herbs that have been shown to help. Ginseng has been used for thousands of years to increase energy and sexual arousal. Some research suggests that it can help relieve hot flashes, fatigue, depression and cognitive impairments, and vaginal dryness. Maca Root is another herb used traditionally for lowering the effects of stress by reducing cortisol. It reduces hot flashes, improves energy and libido. If vaginal dryness is a factor and preventing you from intimacy bioidentical estriol suppositories can have a significant impact on dryness, and the fallout from that such as frequent urinary tract infections.
Exercise is KEY to a smooth menopausal transition.
Benefits of exercise:
Decreases the risk of osteoporosis
Improves cognitive function and enhances your mood
Improves your sleep
Eliminates the unwanted body weight and fat.
It has been my experience that making a few key lifestyle adjustments, and using herbal and nutritional support can make this transition a painless one.
For more information about what you can do to support menopause naturally or information about the benefits of bioidentical hormone replacement therapy please book in a complimentary 15 minute visit with Dr Berni.
(1) Shams T1, Setia MS, Hemmings R, McCusker J, Sewitch M, Ciampi A. Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis. Altern Ther Health Med. 2010 Jan-Feb;16(1):36-44.
(2) Geller, Stacie E., and Laura Studee. “Botanical and Dietary Supplements for Menopausal Symptoms: What Works, What Doesn’t.” Journal of women’s health (2002) 14.7 (2005): 634–649. PMC. Web. 25 June 2018.
(3) Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, Melchart D. St John’s wort for depression–an overview and meta-analysis of randomised clinical trials. BMJ. 1996;313:253–258.[PMC free article] [PubMed]
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