Menopause marks a significant phase in a woman’s life, bringing changes that can be both challenging and transformative. If you’re seeking natural, effective strategies to manage menopausal symptoms and support your overall wellness, you’re not alone. Here, we explore the top naturopathic approaches that can help you navigate this stage with confidence and vitality.
Common Menopause Symptoms
Menopause can present a range of symptoms that vary in intensity and duration. Some of the most commonly reported issues include:
Hot Flashes and night sweats
Chronic Fatigue
Mood Swings and irritability
Weight Gain, especially around the trunk and changes in metabolism
Sleep Disturbances
These symptoms are primarily driven by significant hormonal changes. As a woman approaches menopause, the ovaries gradually reduce their production of key hormones—particularly estrogen and progesterone. This hormonal decline affects various body systems and can lead to the following:
Hot Flashes and Night Sweats: The decrease in estrogen impacts the body’s temperature regulation, leading to sudden feelings of intense heat and sweating, often disrupting sleep.
Chronic Fatigue: Hormonal imbalances can result in energy fluctuations, making it challenging to maintain normal levels of stamina and alertness.
Mood Swings and Irritability: Estrogen plays a role in regulating serotonin, a neurotransmitter that affects mood. Reduced levels of estrogen can cause mood swings, irritability, and even anxiety or depression.
Weight Gain and Changes in Metabolism: Lower estrogen levels can lead to changes in how the body stores fat, often contributing to weight gain around the abdomen. Additionally, the body’s metabolic rate can slow down, making weight management more difficult.
Sleep Disturbances: Hormonal shifts can disrupt the sleep cycle, leading to insomnia or frequent wakefulness, which in turn exacerbates fatigue and mood issues.
Understanding these hormonal changes is the first step in crafting a plan to manage symptoms effectively and improve overall quality of life.
Hormone Replacement Therapy (HRT) in Menopause: Medical Overview and Latest Research
Hormone Replacement Therapy (HRT) is a common and effective medical treatment used to manage menopause symptoms by replenishing the hormones—primarily estrogen and progesterone—that the body no longer produces in significant amounts. The main goal of HRT is to alleviate the distressing symptoms of menopause, such as hot flashes, night sweats, mood swings, and vaginal dryness, and to prevent long-term health issues like osteoporosis and cardiovascular disease.
Types of HRT
HRT can be administered in various forms, including:
Oral tablets: One of the most common forms of HRT, typically containing estrogen alone or a combination of estrogen and progesterone (for women who still have a uterus).
Transdermal patches: Patches applied to the skin that deliver estrogen directly into the bloodstream, avoiding the liver and potentially reducing some risks associated with oral HRT.
Topical gels or sprays: Applied to the skin, these provide estrogen in a similar manner to patches, offering an alternative for those who have difficulty with oral medications.
Vaginal creams, rings, or tablets: These are localised treatments for vaginal dryness and urinary symptoms, delivering low-dose estrogen directly to the vaginal tissues.
Medical Benefits of HRT
Alleviation of Menopausal Symptoms: HRT is well-documented in clinical research for its effectiveness in reducing hot flashes, night sweats, vaginal dryness, and sleep disturbances. According to a 2023 review published in Menopause (the journal of The North American Menopause Society), HRT significantly improves quality of life during menopause and is considered the most effective treatment for vasomotor symptoms (hot flashes and night sweats).
Bone Health: Estrogen plays a key role in maintaining bone density, and its decline during menopause is a primary driver of osteoporosis. Studies show that HRT can reduce the risk of osteoporotic fractures. The 2021 Cochrane Review found that women who began HRT around the time of menopause had a significantly lower risk of fractures, particularly in the first 10 years after menopause.
Cardiovascular Health: Estrogen has protective effects on the cardiovascular system, including its role in maintaining healthy blood vessels, regulating cholesterol, and reducing the risk of atherosclerosis. However, the relationship between HRT and cardiovascular risk is complex. Recent studies, including the Women’s Health Initiative (WHI) 2020 update, have shown that HRT started in the early stages of menopause (within 10 years of the onset of menopause) may have a protective effect on heart health, reducing the risk of coronary heart disease and stroke. However, the benefit decreases if started later, particularly for women who are at a higher risk of cardiovascular disease.
Risks of HRT
While HRT is beneficial for many, it does come with potential risks that need to be weighed against its benefits. Recent research highlights the following:
Breast Cancer Risk: Studies have shown a slight increase in the risk of breast cancer, particularly with combined estrogen and progesterone therapy. A 2021 meta-analysis published in Lancet Oncology found that women using combined HRT for 5 years or more had a modestly increased risk of breast cancer. However, the risk is lower with estrogen-only HRT, which is typically prescribed to women who have had a hysterectomy.
Blood Clots: There is an increased risk of venous thromboembolism (VTE) with oral HRT, particularly among women who smoke, are overweight, or have other risk factors for clotting disorders. Transdermal HRT (patches or gels) may carry a lower risk of blood clots compared to oral forms, according to a 2022 BMJ study.
Endometrial Cancer: Women who still have a uterus and use estrogen-only HRT are at increased risk of endometrial cancer due to the proliferative effect of estrogen on the uterine lining. This risk is mitigated by using combined HRT, which includes both estrogen and progesterone to protect the uterus.
Emerging Trends and Research
Bioidentical Hormones: There is growing interest in bioidentical hormone therapy (BHT), which uses hormones that are chemically identical to those produced by the human body. Research on bioidentical hormones is still in its early stages, but some studies suggest they may offer fewer side effects and a more personalised approach to HRT.
Personalised HRT: Advancements in genomics and hormone testing are paving the way for more individualised HRT treatment plans. By tailoring hormone therapy based on genetic makeup, personal health history, and specific menopausal symptoms, it may be possible to optimise the benefits of HRT while minimising risks. Personalised medicine in HRT is a growing area of research, as seen in the 2022 Journal of Clinical Endocrinology & Metabolism review.
Naturopathic Strategies for Symptom Relief
Balanced Nutrition: Eating a menopause-specific diet can significantly impact your menopause experience. Incorporate foods high in phytoestrogens like flaxseeds and soy, which help balance hormones naturally with phytoestrogens. Ensure your diet includes ample leafy greens, lean proteins, and omega-3-rich foods like salmon to reduce inflammation and support energy levels.
Herbal Remedies: Many herbs have shown promise in relieving menopause symptoms. Key examples include:
Black Cohosh: Known for reducing hot flashes and mood disturbances. Research suggests that Black Cohosh may support the reduction of hot flashes and other vasomotor symptoms by influencing the body's estrogen receptors. It is also thought to have anti-inflammatory properties and may support mood and well-being, potentially alleviating anxiety and irritability.
Evening Primrose Oil: Supports hormonal balance and reduces night sweats. Evening Primrose Oil is often recommended for menopause due to its high content of gamma-linolenic acid (GLA), an omega-6 fatty acid that plays a crucial role in reducing inflammation and balancing hormones. It is believed to help alleviate common menopause symptoms such as hot flashes, night sweats, and mood swings by promoting hormonal balance. Evening Primrose Oil may also support skin health by improving moisture levels and reducing dryness, a common concern during menopause. Some studies suggest that it can help reduce the frequency and severity of hot flashes and may improve overall quality of life during this transition.
Adaptogenic Herbs (e.g., ashwagandha, rhodiola): These herbs can help the body adapt to stress and support hormone regulation. For example, ashwagandha is known to enhance DHEA (dehydroepiandrosterone) levels, which can help balance sex hormones such as estrogen and testosterone. DHEA acts as a precursor to these hormones and plays a role in maintaining energy, mood, and libido. Rhodiola helps manage cortisol levels, indirectly supporting hormonal balance by reducing the impact of chronic stress, which can otherwise disrupt DHEA production and overall hormone equilibrium.
Increased Cardiovascular Risk and Osteoporosis During Menopause
As women enter menopause, the drop in estrogen levels not only affects cardiovascular health but also significantly impacts bone health. The interconnectedness between cardiovascular disease and osteoporosis during this phase of life is an important aspect of overall health that should not be overlooked. Understanding how low estrogen contributes to both conditions and exploring natural treatment options can help women take proactive steps to manage their health during menopause.
The Link Between Cardiovascular Health and Osteoporosis
Estrogen is crucial for maintaining the strength and density of bones. It helps regulate the activity of osteoclasts (cells that break down bone) and osteoblasts (cells that build bone). When estrogen levels decline during menopause, this balance is disrupted, leading to a loss of bone density and an increased risk of osteoporosis.
Osteoporosis is a condition characterised by weakened bones that are more prone to fractures. It is often referred to as a "silent disease" because bone loss can occur without symptoms until a fracture happens. The connection between osteoporosis and cardiovascular health lies in the shared role that estrogen plays in both systems. Here's how:
Estrogen Deficiency and Bone Health - Estrogen helps to preserve bone mineral density by inhibiting the activity of osteoclasts. When estrogen levels drop, bone resorption accelerates, and new bone formation slows down. This can lead to significant bone loss over time, especially in the spine, hips, and wrists. The risk of osteoporosis-related fractures increases as a result.
Cardiovascular Health and Bone Loss - Research has shown that women with osteoporosis may also be at higher risk for cardiovascular diseases, including heart disease and stroke. This may be due to a combination of factors, including the hormonal changes associated with menopause and the shared risk factors, such as inflammation and oxidative stress. Moreover, bone density loss can contribute to the development of arterial stiffness, a key indicator of cardiovascular disease.
Bone and Blood Vessel Health Are Interconnected - Both bones and blood vessels are made of similar components, such as collagen and elastin, and require similar nutrients for health. When estrogen levels drop, not only do bones lose density, but blood vessels also become less flexible, leading to increased blood pressure and cholesterol buildup in the arteries. The risk of atherosclerosis (plaque buildup in arteries) can rise, further compounding cardiovascular risk. Osteoporosis and cardiovascular disease can, therefore, be viewed as co-existing conditions that are both linked to hormonal changes.
Natural Treatment Options
The good news is that there are natural ways to support both bone and cardiovascular health during menopause. By addressing these issues holistically, women can reduce the impact of hormonal changes and improve their overall well-being.
Dietary Approaches for Bone and Heart Health
Calcium, Vitamin K2, and Vitamin D: Calcium is essential for bone strength, while Vitamin D helps with calcium absorption. Vitamin K2 is also critical as it directs calcium to the bones and teeth, rather than to the soft tissues such as the arteries, where it could contribute to plaque buildup and increase cardiovascular risk. Together, these nutrients work synergistically to support both bone and heart health. Good sources of calcium include leafy greens, dairy products, and fortified plant-based milks; Vitamin D can be found in fatty fish, fortified foods, and through sun exposure; while Vitamin K2 is primarily found in fermented foods like natto, as well as in certain cheeses (Brie) and pastured egg yolks. If supplementing, also make sure your supplement contains K2. (Read more on this blog)
Magnesium: Magnesium is another mineral that plays a crucial role in both bone health and cardiovascular function. It helps regulate calcium and vitamin D levels, supports muscle and nerve function, and helps lower blood pressure. Foods like almonds, spinach, and beans are rich in magnesium.
Quality lean protein: Protein is crucial for muscle repair, growth, and maintaining lean muscle mass, especially as we age. It also helps regulate hunger and stabilises blood sugar levels, promoting satiety and helping prevent overeating. For women, particularly during menopause, adequate protein intake can help manage weight, support bone health, and counteract muscle loss, which accelerates due to hormonal changes. It's important to include a variety of protein sources according to your own unique food intolerances and blood type, such as lean meats, fish, eggs, dairy, legumes, and plant-based options, to ensure you get a well-rounded intake of amino acids for overall health.
Healthy Fats: Omega-3 fatty acids, found in foods like flaxseeds, chia seeds, and oily fish, can help reduce inflammation, improve blood vessel flexibility, and support bone health. Omega-3s have also been shown to decrease the risk of bone loss in postmenopausal women. It is essential that you eliminate as much consumption of Omega-6 fats in the diet. These are found in vegetable oils (like sunflower, canola, corn, and soybean oils), processed foods, and fried foods. Excessive Omega-6 fats promotes inflammation in the body, which will counteract the benefits of Omega-3s. A high intake of Omega-6s, relative to Omega-3s, has been linked to an increased risk of chronic diseases. Therefore, balancing the ratio of Omega-3 to Omega-6 fats by reducing processed oils and increasing Omega-3-rich foods can help support both cardiovascular health and bone density, particularly during menopause.
Antioxidant-Rich Foods: A diet rich in antioxidants can help combat oxidative stress, which contributes to both bone degradation and cardiovascular disease. Berries, citrus fruits, leafy greens, and cruciferous vegetables are excellent sources of antioxidants.
Eat the rainbow and aim for 600 grams of non-starchy vegetables a day and your health will be golden!
Limit Sodium and Refined Sugars: Reducing sodium intake can help lower blood pressure, and avoiding excessive refined sugars can prevent insulin resistance, both of which are important for managing both bone and heart health.
Exercise to Support Both Bone and Heart Health
Weight-bearing exercises, such as walking, running, or resistance training, are beneficial for bone density because they stimulate bone formation and reduce bone resorption. Additionally, these exercises help maintain cardiovascular health by improving circulation, lowering blood pressure, and regulating cholesterol. Balance exercises, like yoga or tai chi, can help improve posture and prevent falls, reducing the risk of fractures associated with osteoporosis.
Herbal Remedies and SupplementsSeveral herbs and supplements may help mitigate the effects of low estrogen on both cardiovascular health and bone density:
Red Clover: Rich in phytoestrogens, red clover may help balance estrogen levels and support both bone health and heart function.
Black Cohosh: Known for its ability to alleviate menopause symptoms, Black Cohosh may also help support bone density and cardiovascular health by promoting hormonal balance.
Flaxseed: A source of omega-3 fatty acids and lignans, flaxseed can support both bone health by reducing inflammation and improving heart health by lowering cholesterol.
Vitamin K2: This vitamin plays a critical role in bone health by helping to regulate calcium and ensure it is deposited in bones rather than blood vessels. It also supports cardiovascular health by preventing arterial calcification.
Stress ManagementChronic stress can exacerbate both bone loss and cardiovascular issues. Practices like mindfulness, meditation, deep breathing, and yoga can help reduce stress and its negative impact on the body. Managing stress also supports hormonal balance, which is key in protecting both the heart and bones during menopause.
Summary:
Navigating menopause doesn’t have to be overwhelming. With the right strategies and expert guidance, you can manage symptoms like hot flashes, fatigue, and mood swings while also addressing the increased risks of cardiovascular disease and osteoporosis that come with hormonal changes. By incorporating a balanced diet, natural remedies, and regular exercise into your routine, you can support both your bone health and heart function, ultimately boosting your overall wellness during this transformative phase.
If you're ready to take charge of your health during menopause, book an initial appointment with an expert today. Together, we’ll create a personalised approach to help you thrive through menopause with confidence and vitality, with or without medications such as HRT. Book your Initial Appointment today!
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Written by registered Naturopath Tanya Kurzbock.
"My mission is to help women live healthier lives through hormonal changes that are commonly ignored and brushed aside as "aging"
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