Menopause is the time in a woman’s life when it has been at least 12 months since her last menstrual cycle. It signals the end of our reproductive years and the start of a new phase in life. The average age for experiencing your last period is 51.
Note: the time prior to menopause is known as ‘perimenopause’. It generally occurs for women in their 40s. Menstrual cycles may start to become irregular, and you can start to experience many of the menopausal symptoms. This phase can last for months, or even years and can be quite the hormonal roller coaster for some.
Natural menopause occurs when the body’s natural secretion of progesterone, testosterone and oestrogen (oestradiol), is reduced due to the diminishment of the ovarian follicles. This prevents the endometrium from proliferating and then later shedding, AKA no more periods!
Although women may be happy to no longer experience periods, unfortunately some women experience some very unpleasant symptoms.
The most common complaint in menopause is hot flushes. Women may experience all sorts of other symptoms such as sleep disturbances, urinary leakage, severe tiredness, brain fog, depressive symptoms, joint pain, palpitations, weight gain, vaginal dryness and atrophy, painful intercourse, insomnia and mood swings, loss of hair, and diminished libido.
Some general considerations to keep in mind:
🔸Vitamin D & K
Vitamin D is extremely important for so many reasons as it influences more than 1,000 different genes and serves as a cofactor for many hormones including estrogen. It plays a role in immunity, regulating inflammation, and is highly indicated in menopause due to its role in calcium metabolism, and bone development. Estrogen plays an important role in regulating bone metabolism and so when estrogen declines with menopause the risk of bone fractures and osteoporosis increases. (Please note, your risk factor of this also depends on many other things such as smoking, alcohol and certain medications).
The best source of Vitamin D? Sun exposure! Aim to get around 20min of sunlight everyday. This will also help regulate your circadian rhythm (sleep wake cycle) and can improve your sleep. For some women, the sun alone may not be enough, and you may need to supplement. If supplementing we recommend taking it with Vitamin K. Vitamin K helps moves calcium from the blood and into the bones and teeth, and controls the amount of vitamin D made by the body and keeps it in homeostasis (aka balanced). Many supplements have combinations of Vitamin D and K already, otherwise make sure you eat lots of leafy greens. Also best to take Vitamin D in the morning as it has an inverse relationship with melatonin (sleep hormone), and it can ruin your sleep quality if taken before bed. Makes sense since we naturally get Vitamin D from the sun during the day.
As mentioned, bone density decreases at menopause, and therefore adequate intake of calcium and other bone building nutrients (such as Vitamin D & K) are important. Some sources of calcium rich foods include: Dark leafy greens (collard greens, kale, bok choy etc), almonds, chia seeds, sardines, white beans, & grass fed organic butter. Fun fact: Calcium is better absorbed from leafy greens (50%), compared to dairy products (approx 30% absorption).
Some more general considerations to keep in mind:
Great for all stages of life, but particularly helpful in menopause as it helps balance your hormones, reduces stress by lowering cortisol levels, and has been shown to help provide relief from hot flushes. Exercise may also help decrease bone loss and improve bone mineralisation, increase self-esteem, mood, and improve mindset. However, as menopause can be a tiring time, aim for more moderate to mild exercises, like tai chi, yoga, swimming, pilates, or simply walking (even better if out in nature and getting your Vitamin D). However, this is different for everyone! Listen to your body and find what suits you.
🔸Pelvic floor exercises
The onset of menopause can cause your pelvic floor muscles to weaken and result in pelvic floor problems. Women may experience symptoms of urinary frequency (constantly needing to go to the toilet) or urgency (needing to get to the toilet in a hurry and/or not making it there in time). Some women may also notice mild urinary incontinence when coughing, sneezing, or jumping. It’s important to do exercises to keep your pelvic floor strong, and also to avoid high impact exercises that can over-stretch or wear out your pelvic ligaments. Say hello to Kegels. You can do them anytime, any place without anyone even knowing. You can do them whilst reading this post. (Google kegels if you need to – and other pelvic floor exercises).
🔸Reduce Caffeine intake
Consider reducing or eliminating your caffeine intake. Caffeine can have a detrimental effect on your bone mineral density and put extra pressure on your adrenal function.
Adrenal, Liver & Hormonal Support with Herbal Medicines
Adaptogen and adrenal herbal medicines can be extremely beneficial during menopause. When your ovaries quit your adrenal glands pick up the work by producing DHEA and other hormones that support your health. Taking care of your adrenal glands with cortisol modulating adaptogenic herbs, (as well as vitamins and minerals) can be very helpful in reducing symptoms. Supporting liver health may also be beneficial during this time to assist with the metabolism and clearance of hormones. Other herbal medicines that have an oestrogenic effect have also been shown to have therapeutic benefits in menopausal women.
Red Clover (Trifolium pratense) – One of the most researched herbal medicines for menopausal health. Contains isoflavones (a phytoestrogen, which is a plant-derived compound that mimics the effect of oestrogen on the body). Red clover has been shown to reduce hot flush frequency, and improve vaginal health against atrophy, improving sexual well-being & libido. It’s phyto-oestrogen effect, is also thought to have beneficial effects on cognitive function, bone mineral density, and plasma lipid concentrations in menopausal women.
Zizyphus (Zizyphus spinosa) – Actions are mild sedative and anxiolytic. When taken before bed has been shown to help reduce hot flushes, night sweats, and improve sleep quality.
Black Cohosh (Cimicifuga racemosa) – Has oestrogen modulating (contains phyto-oestrogens) & uterine-ovarian tonic effects on the body. One of the most used herbs for the relief of hot flushes. It’s oestrogenic effects have been seen to be beneficial with bone metabolism and therefore likely helpful in the prevention of osteoporosis. Liver function may need to be assessed before considering this herb, as some cases of hepatotoxicity have been reported
Sage (Salvia officinalis) – Sage is popular in menopause where hot flushes and night sweats occur. Particularly for excessive sweating.
Ashwagandha (Withania somnifera) – Has tonic and adaptogenic actions. Particularly indicated for women who experience psychological effects such as stress and anxiety during this time.
St John’s Wort (Hypericum perforatum) – Actions include nervine tonic, thymoleptic (mood enhancing) and antidepressant. For women who experience psychological symptoms such as depression, anxiety, irritability, and emotional stress. To help improve general well-being, nervous system function, mood & sexual well-being.
Rosemary (Rosmarinus officinalis) – Actions include antioxidant, circulatory stimulant, and enhances phase 2 liver detoxification to help with the metabolism/detoxification of hormones. Also known to improve memory, concentration and mental performance.
Schisandra (Schisandra chinensis)- Helps support the liver metabolise hormones, but also greatly supports nervous and adrenal function. Actions include hepatoprotective, antioxidant, adaptogen, nervine tonic, mild antidepressant, and phase 1&2 liver detoxification enhancer.
Shatavari – (Asparagus racemosus) – Considered useful for hot flushes in menopause. It is also a general tonic, sexual tonic (improves libido), and adaptogen. Considered for rejuvenating the female reproductive organs.
As the experience of menopause can be very different from woman-to-woman, as there are many factors involved, it’s always best to see a qualified health professional who can help individually.