Perimenopause and Menopause

Latest Edit: Iva Lloyd, ND 2017-05-05 (EDT)

The word "menopause" comes from the Greek words meno, 'month' and 'pause', to end, thus meaning the end of monthly bleeding. Menopause is not a disease or condition it simply marks a period of time in a woman's life when she has gone 12 months without a menstrual period. It reflects the end of menstruation, ovulation, and represents a time when a women is no longer capable of reproduction. The average age of menopause is 51 years.

The transitional period to menopause, called perimenopause lasts about 4 years for most women, but can take up to 10. Menopausal symptoms result due to changing levels of hormones, estrogen and progesterone. Perimenopause typically starts with menstrual irregularity which can begin with shortened intervals between periods that eventually lengthen before ceasing. Although many symptoms are commonly associated with perimenopause the only normal symptom is a change in menstrual cycle and flow.

Menopause

Menopause
Causes	Dietary Factors, Smoking, Stress, Environmental Toxins, Prescription Medications
See Also	Women's Health, Uterine Fibroids, Depression, Anxiety, Insomnia
Books	Books on Women's Health
Articles	Articles on Women's Health

Naturopathic Assessment

Causal Factors

Article	A Comprehensive Review of the Safety and Efficacy of Bioidentical Hormones for the Management of Menopause and Related Health Risks , Alt Med; 2006;Vol11(3)

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. Menopause is an inevitable and natural process that happens to each woman, but it can also be triggered unnaturally by other factors and there are factors that can increase the symptoms associated with perimenopause.

Lifestyle

• Dietary Factors

• It is common for food intolerances to change or worsen during perimenopause.
• Many foods are known to worsen perimenopausal symptoms such as alcohol, sugar, spicy food, caffeine, simple carbohydrates.

Social

• Stress

• Chronic stress, especially if it is occurring simultaneously with perimenopause can result in a worsening of perimenopausal symptoms.

Environmental

• Environmental Toxins

• Many environmental toxins including environmental chemicals and heavy metals are known to have hormone disruption properties and can worsen perimenopausal symptoms.

External

• Smoking

• Smoking cigarettes increases the risk of early menopause.

Medical Interventions

• Medical Interventions

• The primary cause of early menopause is medical intervention, such as the surgical removal of the ovaries.
• Chemotherapy or radiation can cause menopause.
• Treatment of cancer in childhood may increase risk of developing premature menopause, if ovarian function is retained after treatment.

Diagnostic Testing

A women is considered to be in menopause when she has gone without a period for a full 12 months. Once in menopause a woman will stay in menopause for the rest of her life.

Perimenopause is diagnosed when a woman experiences changes to her menstrual cycle. To confirm that menstrual changes are due to perimenopause the following tests are typically done:

• Blood tests including FSH, Estradiol, Luteinizing hormone (LH), Testosterone

Related Symptoms and Conditions

The conditions commonly associated with perimenopause include:

• Depression
• Anxiety
• Insomnia
• Uterine Fibroids

Due to changes in hormone levels after menopause, a women may be at increased risk of the following conditons:

• Osteoporosis
• Cardiovascular disease
• Insulin resistance
• Type II Diabetes
• Breast
• Colorectal Cancer.

Characteristics

The symptoms that are common during perimenopause include:

• Irregular bleeding
• Hot flashes
• Skin flushes
• Night sweats
• Insomnia
• Racing or pounding heart
• Decreased libido and sexual response

• Desire may decrease along with reduced vaginal elasticity and lubrication

• Impaired memory and cognition

• Short term memory loss, decreased concentration and forgetfulness are common

• Mood changes

• Anxiety
• Depression

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Menopause is a significant change that happens in every woman's life.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

• Time of Change

• Perimenopause is often a time when a woman is reevaluates her life and become introspective and retrospective. It is helpful for woman to take the time to reflect on their life and to prepare the next phase of their life.

• Hot flashes

• Hot flashes are due to fluctuating levels of estrogen.
• Use fans, air conditioning, sip cold water, or wear light and layered clothing to help manage hot flashes.
• Avoid triggers to minimize occurrence. For example spicy foods, alcohol, caffeine, saunas, hot showers, etc. have been reported to trigger hot flashes.

• Sexual activities

• Continue having sex. Regular sexual intercourse can help increase blood flow to vaginal tissues.
• Use natural lubricants if sex is painful.

Lifestyle

Lifestyle recommendations to decrease the frequency and severity of perimenopausal symptoms include:

• Dietary recommendations:

• Consume a diet that focuses on whole unprocessed food (whole grains, legumes, vegetables, nuts and seeds).
• Eliminate alcohol, caffeine and sugar.
• Increase consumption of phytoestrogen containing foods including soy and flaxseed.
• Identify and control food allergies and food intolerances.
• Ensure you drink adequate water.

• Exercise

• Regular exercise elevates mood and may reduce frequency and severity of hot flashes.
• Weight bearing exercise is beneficial to bone maintenance and can help reduce the risk of osteoporosis.

• Sleep

• It is important to address any disruption in sleep as lack of sleep can worsen other symptoms associated with perimenopause.

• Baths

• Bathing, especially with the addition of alkaline salts can decrease the intensity and frequency of hot flashes and night sweats.

Naturopathic Therapies

Article	Menopause Support—On All Levels, 2013 June NDNR [1]

Article	Reduction of symptoms associated with menopause: the efficacy of BioGest , 2005 Summer;Vol2(1) IJNM

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for menopause include:

• Nutritional Foods include:

• Herbs and spices that can assist with menopause include: cinnamon stick

• Clinical Nutritional Supplementation includes

• Vitamins such as Vitamin B6, Vitamin C, Vitamin D.
• Minerals such as Calcium, Magnesium
• Other supplements such as Flaxseed oil, Omega 3 fish oil, Omega 6 Evening Primrose Oil, Hesperidin, Bee Pollen

• Botanical remedies such as Black Cohosh (Cimicifuga racemosa), Chaste Tree (Vitex agnus-castus), Dong Quai (Angelica sinensis), Ginseng (Panax ginseng), Hawthorn (Crataegus monogyna), St. John's Wort (Hypericum perforatum), Licorice (Glycyrrhiza glabra), Peppermint (Mentha piperita), Wild Yam (Dioscorea villosa ), Red clover (Trifolium pratense ).,

• Gemmotherapies such as Rubus idaeus, Vitis vinifera

• Homeopathic remedies such as Belladonna, Black cohosh, Lachesis, Sanguinaria, Sepia, Sulphur. ,

• Traditional Chinese Medicine & Acupuncture

• Acupuncture can be very beneficial in the management and treatment of perimenopausal symptoms including hot flashes, night sweats, insomnia, anxiety and heavy bleeding.

References

Reviewed by Iva Lloyd, BScH, RPE, ND [2]