The natural transition from the reproductive years to the postmenopausal years is not necessarily a smooth one, even though it is a normal process of aging. No two women’s menopause transition is alike. Some women begin to experience symptoms long before menopause has occurred. This is called “perimenopause” and usually occurs around age 47 and can last for 4-5 years before menopause occurs. Symptoms of perimenopause include menstrual irregularities, hot flashes, vaginal dryness and thinning, decreased libido, mood swings, depression, changes in memory and cognition, sleep disturbances, hair loss on the head, hair growth and acne on the face, fatigue, nausea, palpitations, headaches, urinary tract infections, joint pains.
To determine the hormone levels in the body, naturopathic physicians will measure the amounts in blood or saliva. The saliva test measures the active unbound form of the hormone in the body and determines the levels of estrogen, progesterone, as well as cortisol, testosterone, and DHEA. Cortisol is measured four times a day to show a cortisol curve which is an important indicator to determine the health of the adrenal glands. As women transition through menopause, the adrenal glands are extremely important as they start to take over the role of hormone secretion as the ovaries slow down production. Women who are burnt out or tired usually have low adrenal function, and thus have a harder time transitioning through menopause and worse symptoms of hot flashes, night sweats, insomnia, irritability, hair loss, etc. I typically advise women with adrenal fatigue to slow down, rest more, and take important B vitamins and herbal remedies to restore adrenal cortisol production. This will inevitably help their menopausal symptoms as well.
Naturopathic treatment involves balancing the hormones through whole foods diets (avoidance of sugar, white flour, caffeine, and alcohol), stress reduction techniques to optimize the adrenal gland function, and certain vitamins, minerals, and herbs. Herbs such as black cohosh, red clover, and chasteberry are helpful for increasing and balancing estrogen and progesterone. To minimize osteoporosis risk, vitamin D status should be tested and as much as 5000-10 0000 IU/day of Vitamin D can be prescribed.
Bio-identical hormones are derived from natural plant sources (ie. soy or wild yam) and are more recognizable to the human body then those derived from traditional HRT (horse urine). Bio-identical hormones can be prescribed by a naturopathic doctor in order to balance hormones and alleviate menopausal symptoms with little or no side effects. Often, I find that progesterone cream prescribed in minute doses can help reduce the effects of anxiety, insomnia, hot flashes, night sweats, and depression associated with menopause. Estriol cream can be applied topically to the vagina to help with dryness or pain during intercourse. These trans-dermal applications of hormones can be prescribed by a naturopathic doctor. It is important to have hormone levels tested first to determine appropriate dosage requirements of these hormone creams.