Perimenopause and Menopause

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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.[1] 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,[2] 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.


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.



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



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.[4]
  • Treatment of cancer in childhood may increase risk of developing premature menopause, if ovarian function is retained after treatment.[5]

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:

Related Symptoms and Conditions

The conditions commonly associated with perimenopause include:

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


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

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

  • Regular exercise elevates mood and may reduce frequency and severity of hot flashes.[3]
  • Weight bearing exercise is beneficial to bone maintenance and can help reduce the risk of osteoporosis.
  • 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:

  • Acupuncture can be very beneficial in the management and treatment of perimenopausal symptoms including hot flashes, night sweats, insomnia, anxiety and heavy bleeding.[14]


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

  1. Wylie-Rosett J (May 2005) Menopause, micronutrients, and hormone therapy Am J Clin Nutr;Vol81(5):1223S-1231S. PMID: 15883456.
  2. Al-Azzawi F (May 2001) The menopause and its treatment in perspective Postgrad Med J;Vol77(907):292-304. PMID: 11320271.
  3. 3.0 3.1 3.2 Pizzorno Joseph, Murray Micheal, Joiner-Bey Herb (2007) The Clinician's Handbook of Natural Medicine Churchill, Livingstone.
  4. Sklar C (2005) Maintenance of ovarian function and risk of premature menopause related to cancer treatment J Natl Cancer Inst Monogr; Vol(34):25-7 PMID: 15784817.
  5. Sklar CA, Mertens AC, Mitby P, Whitton J, Stovall M, Kasper C, Mulder J, Green D, Nicholson HS, Yasui Y, Robison LL (2006 Jul 5) Premature menopause in survivors of childhood cancer: a report from the childhood cancer survivor study J Natl Cancer Inst; Vol98(13):890-6 PMID: 16818852.
  6. Nicks KM, Fowler TW, Akel NS, Perrien DS, Suva LJ, Gaddy D (Mar 2010) Bone turnover across the menopause transition : The role of gonadal inhibins Ann N Y Acad Sci;Vol1192:153-60. PMID: 20392231.
  7. Innes KE, Selfe TK, Taylor AG (2008 Sep-Oct) Menopause, the metabolic syndrome, and mind-body therapies Menopause; Vol15(5):1005-13. PMID: 18779682.
  8. 8.0 8.1 8.2 8.3 Murray Michael (1996) Encyclopedia of Nutritional Supplements, The Essential Guide for Improving Your Health Naturally Prima Publishing
  9. Lu Henry (1986) Chinese System of Food Cures, prevention and remedies Sterling Publishing Co. New York.
  10. Godfrey Anthony, Saunders Paul Richard, Barlow Kerry, Gilbert Cyndi, Gowan Matthew, Smith Fraser 2010 Principles and Practices of Naturopathic Botanical Medicine, Vol 1: Botanical Medicine Monographs, CCNM Press, Toronto
  11. Boon Heather, Smith Michael 2004 The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, Robert Rose, Toronto
  12. Hershoff Asa 2000 Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
  13. Ullman Robert, Reichenberg-Ullman Judyth 1997, Homeopathic Self-Care, the quick and easy guide for the whole family. Prima Publishing
  14. Kim KH, Kang KW, Kim DI, Kim HJ, Yoon HM, Lee JM, Jeong JC, Lee MS, Jung HJ, Choi SM (Mar 2010) Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women--a multicenter randomized clinical trial. Menopause;17(2):269-80. PMID: 19907348.