Menopause. The transition. The change of life. Whatever you want to call it, all women go through it but that doesn’t mean you have to suffer through it. Functional Medicine has many tools to make the transition smoother and more tolerable. Let’s dive in!


Perimenopause Basics 

Perimenopause starts to occur when the production of estrogen and progesterone become less predictable. It typically begins with changes in the length of menstrual cycles and ends after 1 year without a menstrual cycle. The average length of “the change” is 4-8 years but can be shorter or longer. It typically will start in the mid 40s but changes can start occurring in the mid to late 30s. During the final 1-2 years of perimenopause the drop in estrogen accelerates. The average age for the menopausal transition to be complete is 51. Menopausal patterns can run in families so ask your mom or female relatives if you are able to when they went through menopause and about their experience with it!


Symptoms of menopause

    • Irregular periods
    • Mood changes
    • Vaginal and bladder problems
    • Decreasing fertility
    • Changes in sexual function
    • Loss of bone
    • Changes in cholesterol levels 
    • Hot flashes
    • Night sweats
    • Sleep problems 

Risk Factors for Early Menopause


    • Smoking
    • Family history
    • Cancer treatment (chemotherapy or pelvic radiation therapy)
    • Hysterectomy
    • Autoimmune disease
    • Toxins (endocrine disrupting chemicals)


Vasomotor Symptoms of Menopause


Hot flashes and night sweats are almost synonymous with menopause (up to 80% of women DO experience vasomotor symptoms) but not everyone will experience these and there are things you can do to help with this bothersome symptom. Vasomotor symptoms occur largely due to changes in neurotransmitters from glucose dysregulation and stress hormone imbalances. Hot flashes can also be accompanied by pressure in the head or chest, anxiety, nausea, changes in heart rate, crawling sensation on the skin and night sweats. 


Hot flashes and night sweats are generally characterized by lower estrogen levels, high FSH levels, low epinephrine and higher norepinephrine levels. Hot flashes are not just an uncomfortable nuisance (although they are this too) but they can lead to sleep disruptions, mood changes like anxiety and depression and may even be an indicator of stroke and cardiovascular risk. 


Before jumping to treatment, try to identify possible triggers and correct these underlying contributing factors first!


    • Hypoglycemia/low blood sugar
    • Stress/anxiety
    • Foods: spicy foods
    • Beverages: caffeine, alcohol
    • Smoking
    • Drugs: lupron, blood pressure medications, anti-anxiety medications, raloxifene, nitrates, sinus/allergy meds, niacin
    • Hyper or hypothyroidism
    • Toxins: endocrine disrupting chemicals, mycotoxins (mold). Candida (yeast)


Non-hormonal Management of Hot Flashes


      Herbal treatments:

      • Black Cohosh
      • Sage
      • Siberian rhubarb 
      • Chasteberry 



      • Inositol – for blood sugar and neurotransmitter function 
      • B vitamins
      • Vitamin C
      • Selenium
      • Zinc
      • Magnesium 


      Lifestyle factors:

      • Yoga
      • Acupuncture 
      • Biofeedback (Heart rate variability training)
      • Self care
      • Stress management 
      • Good sleep 
      • Diet – 
        • lots of leafy greens and colorful veggies (detoxification!) + ground flax, hemp and chia seeds 
        • limit caffeine, alcohol, sugar, refined carbohydrates 
        • pro/prebiotic foods to support the gut 

Hormonal Replacement Therapy for Hot Flashes

Many women assume hormone replacement in menopause is strictly talking about estrogen and while that can be helpful for some, many women benefit from progesterone or a combination of both hormones. Weighing the risk and benefits with an exerpeinced provider is the key!

Progesterone Therapy – (NOT synthetic progestins)

    • improves sleep 
    • treats vasomotor symptoms 
    • increases bone formation 
    • has cardiovascular protective properties 
    • does not increase risk of breast cancer


Estrogen Therapy 

    • helpful in some women but not all
    • carries slight risk of breast cancer
    • cardioprotective effects
    • has neurologic benefits


As you can see there is so much we can do beyond hormone replacement therapy OR in addition to hormone replacement therapy to make the menopausal transition easier and smoother. 


If you are looking for someone to partner with for your health, book a free 15 minute consultation now!