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Understanding Menopause

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Cathy Kading

Gorgeous silver haired Asian woman sticking her tongue out in a playful way holding two ruby red grapefruit slices. She appears to not be wearing clothes so you can see her shoulders and top of her chest in a cheeky way. Understanding Menopause Photo Credit: Inside Creative House - iStock photos

“Menopause, is like being sent on a canoe trip with no guidebook and only a vague idea where you are headed — although the expectation is it’s awful,” writes Canadian-American gynecologist and author Dr Jen Gunter. Also known as “the great climacteric,” this “change of life,” is something we don’t talk about, let alone all the things that come with it. It happens to almost 50 percent of the world’s population, and we still don’t talk about it. I’m hoping to change that, one conversation at a time. After all, understanding menopause is the best way to navigate it. Menopause typically occurs in your 40s or 50s, and at 51 on average. It marks the end of menstrual cycles, but let’s begin with the basics.

Understanding menopause

Before you can understand menopause, it’s helpful to understand the definitions. There are three phases, but some doctors believe post menopause isn’t a thing. I think there is room for both, since it really depends on your definition.

Perimenopause

It “begins with irregular menstrual cycles — courtesy of declining ovarian function — and ends a year after the last menstrual period.” This can last anywhere from months to a decade, depending on the woman. The age of when your mother started perimenopause is a good indicator for when you may expect it, too.

Menopause

This is the “final menstrual period and is usually confirmed when a woman has missed her period for 12 consecutive months (with no other obvious causes).”

Postmenopause

According to Cleveland Clinic, this is defined as “the time after menopause has occurred. Once this happens, you’re in postmenopause for the rest of your life. People in postmenopause are at an increased risk for certain health conditions like osteoporosis and heart disease.” Some doctors don’t differentiate between menopause and postmenopause because menopause is the “switch,” or point in time, when the change is “official,” making the concept of postmenopause unnecessary, but both are correct.

Medical menopause

This refers to menopause that doesn’t occur naturally. It could be induced by drugs like “Gonadotrophin releasing hormone agonists – which downregulate the pituitary gland and lower estrogen levels to within the menopausal range.” Surgery is the other option. A “bilateral oophorectomy,” surgically removes the ovaries, inducing menopause. People with ovaries undergoing chemotherapy may also experience early menopause due to the drugs and radiation, but this is typically age dependent and usually related to the other reasons first.

Nutritional considerations during menopause

As we’ve talked about in the previous articles about perimenopause and early menopause, diet and nutrition play an important role in alleviating symptoms of menopause. Here are a few examples:

  • Calcium and Vitamin D: This is essential for maintaining bone health. The earlier you experience menopause, the more important this is, but go easy on the Vitamin D. It is possible to get too much of these, so pay attention to your dose and lab results. I really like this one and have taken it myself.
  • Phytoestrogens:Isoflavones specifically have been shown in studies to reduce the severity of hot flashes in peri and menopausal women, however not all women experienced the same benefits. Soy is the most commonly studied isoflavone, but you can also find these in other legumes, as well. Overall, there is little drawback to adding more isoflavones into your diet, unless you are allergic, as they are incredibly nutritious and beneficial.
  • Omega-3 Fatty Acids: Maintain a healthy diet rich in Omega 3 fatty acids. These contribute to healthy hormone production and hormone balance, which keeps your nervous system happy. Studies also show that diets high in Omega 3s have inverse relationships to depression, helping beat menopausal blues. You can find these in deep. cold water fish, like mackerel and salmon. The body doesn’t make these, so you have to get them in your diet or use a quality supplement. You can also find them in smaller amounts in nuts and seeds like walnuts and flax seeds.

Supplementation

If you’re looking for supplements, I’m a big fan of Metagenics OmegaGenics EPA-DHA 720. This is a really high quality supplement I have found great success with. I also like the  and you always get a 20%, or more, discount on my Fullscript site. Reducing processed foods and eating a diet rich in vitamins and minerals is always best, regardless of life stage.

Additional dietary considerations

Something else to consider is that “after menopause, [estradiol production from the ovaries] decreases rapidly, which causes not only sleep disorders, depression, osteopenia, and osteoporosis but also cardiovascular and metabolic diseases and obesity,” according to Hansongyi Lee of Kyung Hee University. In research conducted by Lee and team, they showed how the Mediterranean Diet was effective at reducing the risk of cardiovascular disease. This is due to it’s ability to lower total cholesterol, resting heart rate, low-density lipoprotein (LDL) cholesterol, triglycerides, C-reactive protein, and clustered cardiometabolic risk.

Understanding menopause means understanding how it relates to all impacts of your life, since they are all deeply interconnected. For example, it’s incredible how powerful food and diet are for helping us feel better. Hippocrates had it right when he said “let food be thy medicine.” For example, womxn who ate a vegan diet were less troubled by vasomotor symptoms compared to womxn with an omnivore diet. (Vasomotor symptoms is the fancy medical term for hot flashes and night sweats.) Sometimes, simple changes to your diet can lead in big improvements in your symptoms. Read about the foods to avoid, to learn more.

Foods to avoid

In understanding menopause and what alleviates symptoms, you will get all the ancillary benefits of these dietary changes. Not only do these changes help your menopause symptoms, they can support things like menopausal weight gain, insulin dysregulation, and high cholesterol. However, just as there are things to include, there are important things to avoid. These include:

  • Processed foods and sugars: Can exacerbate mood swings and weight gain.
  • Caffeine and alcohol: May trigger hot flashes and impair sleep. Contrary to popular belief, that daily glass of wine to wind down, may actually be responsible for winding you up before bed.

Hydration and balanced meals are crucial for managing menopause, since menopause introduces additional dryness that wasn’t previously there. Things like alcohol, coffee and sugar are all drying, which could exacerbate problems.

Exercise and physical health

We talk about exercise constantly but when moving into menopause it’s even more important.

  • Aerobic exercise: Activities like walking or swimming to maintain a healthy weight and reduce the risk of cardiovascular complications.
  • Strength training: If there is one thing you can do to ease menopausal transition, it’s to focus on strength training. It helps combat muscle and bone density loss. This has double duty because not only do we strengthen our muscles, but we become more resilient to falls and potential breaks when we have strong muscles and connective tissues surrounding our bones.
  • Flexibility and balance exercises: Yoga and Pilates improve mental well-being and physical stability. Again, as we get older, we become less elastic and steady, so solving for these is critical.

Mental wellbeing

It’s not just physical impacts accompanying the change, though. Part of understanding menopause is understanding all the facts, including the psychological and mental impacts. According to the North American Menopause Society, “some women find that hormone fluctuations in perimenopause create a feeling of being out of control. Reports of increased irritability, anxiety, fatigue, and blue moods are not uncommon.” However, there are effective and low/no cost methods for supporting your mental wellbeing.

  • Mindfulness and meditation: Mindfulness and meditation exercises are great at calming anxiety that can develop as we hit menopause.
  • Social support: Keeping in touch with friends and joining support groups can alleviate emotional challenges, as well. For example, menopausal depression is a thing, but you don’t have to go through it alone.

Medical management and pharmaceuticals

Since the US is driven by a for-profit system, naturally there are pharmaceutical interventions. Some of them you have likely heard of and others maybe not. Let’s be clear, though. Sometimes pharmaceutical options are the best options, so keep an open mind.

  • Hormone Replacement Therapy (HRT): Alleviates symptoms but has associated risks like heart disease and breast cancer, for candidates that are contraindicated. However, more recent research has shown that HRT is largely safe, as long as you aren’t one of the people contraindicated for it.
  • Antidepressants and other medications: For folks experiencing menopausal depression and they can’t recover, things like SSRIs may be helpful. Consult with your doctor to see if this could be right for you.

Alternative treatments

For those that prefer less pharmaceutical interventions there is good news. There are other ways to treat menopausal symptoms besides doing nothing and pharmaceutical drugs. For example, consider herbs, acupuncture and yoga.

Herbs

Traditional Chinese Medicine (TCM) and Western Herbalists have effectively been treating menopause symptoms for centuries. Keep in mind, just like drugs, herbs have contraindications and drug-herb interactions, so talk to your doctor and a qualified herbalist before going down this path. There are so many more, but here are a few to familiarize you with some options.

  • Black cohosh (Actaea racemosa) – Interestingly, this is known as the “menopause herb.” While it can be useful for treating hot flashes, herbs like Chaste Tree are better. It’s more effective for symptoms like menopausal anxiety, depression, and insomnia. However, it is a threatened species so use caution when purchasing. It should be sustainably cultivated rather than wild and not used as a stand-alone herb. (Mohammad, Jing)
  • Chaste Tree (Vitex agnus-castus) – This has been shown to be even more effective than Black Cohosh for treating menopausal symptoms like hot flashes and menopausal anxiety. It’s also one of the rare herbs that you can use alone and see results. (Molaie,Nasiri)
  • Cotton Root Bark (Gossypium herbaceum) – While cotton root bark is more useful for PMS and PMDD symptoms, this has been shown effective for treating menopausal anxiety or depression, in folk medicine. There is a LOT less data on this, so there are likely better options.
  • Shatavari (Asparagus racemosus) – I absolutely love Shatavari because it’s a really beautiful medicine and lovely plant. I grow it and make my own medicine from the roots, which is a lovely way to honor this fast-growing plant. Also a cousin of our grocery store asparagus, this has been used in Ayurveda for centuries, to treat women’s health issues like vaginal dryness and dry skin. It also combines beautifully with other plant tonics for optimal health. (Alok)

Additional alternative treatments

  • Acupuncture – Acupuncture has been shown to reduce the impacts of hot flashes and night sweats, improving quality of life.
  • Yoga – Leveraging things like strength building Asanas and Pranayama breathing exercises, you can improve overall quality of life, as well. Many aspects of yoga are excellent contemplative and mindful practices that can ease suffering from things like anxiety and depression.

Navigating your menopause Journey

Understanding menopause requires understanding its stages and what to expect. Once you know a bit more about what to expect, you can effectively treat your symptoms. Things like diet, exercise, mental health strategies, and medical care can each contribute to your overall quality of life. If you find yourself approaching menopause and would like some support, I invite you to a free breakthrough session where we can discuss all the ways Pomona Wellness can help. As usual, consult your healthcare team for medical advice. If you want more content around health, wellness, and wellbeing, check out Wellspiration the Substack. This last place is where I share my personal stories and even more about herbs and plants.

Medical Disclaimer

These statements have not been evaluated by the Food and Drug Administration (FDA). Information provided in this blog post is for educational and informational purposes only and should not be considered as medical advice. The content is not intended to be a substitute for professional medical advice, diagnosis, treatment, cure or prevention of any disease. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.

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