Menopause

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Updated: 7/5/2019

Understanding Menopause

Menopause happens. Even with the best of health habits, menopause still happens.

It is a natural process, but has the potential to adversely affect all of the hormonal systems of the body. The hormonal changes that occur with the natural cessation of reproductive function often throw a monkey wrench into the body’s entire hormonal balance.

Though hot flashes and night sweats are classic, almost any symptom that occurs at this point in a woman’s life can be attributed to menopause.

Though these hormonal imbalances gradually equilibrate over time, natural herbal therapies, sometimes coupled with properly dosed bioidentical hormone therapy, can help to smoothen the transition.

Common Symptoms

Hot flashes, night sweats
Mood swings
Feelings of anxiety
Difficulty concentrating
Aching joints or muscles
Weight gain
Poor sleep
Bone loss
Headaches
Vaginal dryness
Loss of libido

What Causes Menopause?

In a nut shell, menopause occurs because the ovaries run out of eggs.

Prior to menopause, each normal menstrual cycle starts with recruitment of a cluster of eggs in the ovaries (at that point called follicles). These follicles produce estrogen. Estrogen production steadily increases until it reaches a peak mid-cycle. The peak in estrogen initiates a hormonal cascade, with the result of the largest follicle rupturing and releasing an egg.

Once the egg is released, estrogen production declines and the place in the ovary from where the egg was released (called a corpus luteum) begins producing progesterone. Progesterone prepares the body for pregnancy. If pregnancy does not occur (most of the time) progesterone declines, initiating a period. And then the cycle starts over.

In general, estrogen is stimulating, and progesterone is calming and relaxing.

Leading up to menopause (perimenopause), there are fewer follicles left, so estrogen production in the initial phase is erratic. Erratic production of estrogen, a very stimulating hormone, is what causes hot flashes, poor sleep, and many other symptoms. It is also the reason for irregular periods.

All this leads to poor development of a corpus luteum and inadequate progesterone production. Inadequate progesterone and abrupt progesterone withdrawal are responsible for moodiness and depression.

As menopause sets in, not enough follicles are present to cause ovulation and periods stop (though a period can show up out of the blue many months after the perceived final period). Decline of all hormones intensifies symptoms. This can go on for awhile until the body equilibrates into a new normal state.

The Three Stages of Menopause:

Perimenopause

Perimenopause typically starts several years before the onset of menopause. As the ovaries run out of eggs, hormone fluctuations become more intense. Typical symptoms including mood changes, hot flashes, poor sleep, and highly variable menstrual cycles are associated with estrogen dominance and progesterone deficiency.

After periods have been absent for at least 6 months, it is defined as menopause. Estrogen is still being produced by the ovaries, but will gradually wane over several years. Classically, menopause is associated with hot flashes, night sweats, poor sleep, decreased mental focus, and feeling out of balance. Sometimes these symptoms intensify. Vaginal dryness is a key symptom indicating significant estrogen decline.

Another option is to talk to your healthcare provider about hormone replacement therapy (HRT).

Postmenopause

In the phase after menopause, symptoms such as hot flashes and night sweats usually begin to ease up for most women. However, postmenopausal women are at a higher risk of bone loss than the general public and should be proactive about slowing bone loss.

Tips from Dr. Rawls

Take herbal supplements for balancing hormones

Herbal therapy is a safe and effective option by itself or in conjunction with hormone replacement therapy.

Practice a healthful lifestyle

In general, women who practice good health habits have a smoother transition through menopause. During menopause, it is recommended that you consume a diet high in fruits and vegetables and low in meat, processed foods, and sugar.

Do your best to exercise regularly, avoid toxins and manage stress levels. The focus and concentration required to practice yoga is excellent for focusing your mind and relieving symptoms.

Add progesterone

Progesterone is soothing and calming. Most over-the-counter progesterone products provide 20 mg of natural progesterone per pump. Take 1-2 doses (pumps) of progesterone cream daily for two weeks prior to the expected time of the menstrual period.

As periods decrease, progesterone cream can also be used throughout the cycle. Progesterone cream is safe and can be continued indefinitely in individuals choosing not to use estrogen. Progesterone does offer some bone protection. Avoid use of yam creams, which do not actually contain progesterone.

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