As a follow-up to my previous blog post on conventional hormonal therapy for menopause, I wanted to share the types of natural therapies—diet, lifestyle changes, nutrients and herbs—that have been proven to ease symptoms.

Menopausal symptoms, such as hot flashes, mood swings, and changes in libido should not be brushed aside as frivolous concerns, nor manufactured as a chronic illness. Postmenopausal women are often viewed as being fragile or volatile on TV, movies and even within their own family. But this can be an exciting phase in one’s life, coinciding with career advancements, growing extended family and more balance. Women can lead a healthy and happy life after menopause and when given the tools, can focus on optimizing their health, not addressing “disease”.

Entrance into menopause occurs naturally when the female body no longer produces a mature egg, causing a decline in hormones: estrogen, progesterone, testosterone, and DHEA, eventually leading to complete cessation of a period. From an evolutionary perspective, this prevents women from becoming pregnant at an age when fetal genetic abnormalities are more prevalent.

Perimenopause is the time prior to menopause, when the release and maturation of an egg is infrequent and the menstrual cycle becomes irregular. This occurs because of the fluctuations in progesterone and estrogen. Progesterone declines first while estrogen levels may experience significant increases before falling dramatically. Some of the symptoms of perimenopause are due to the rapid change in estrogen levels as well as the balance between progesterone and estrogen, rather than the absolute diminished level of estrogen itself. Women enter menopause when they have not had a period for 12 consecutive months.

In addition to the solo-Bahamian vacation-like hot flashes, women experience mood changes, poor memory and concentration, insomnia, fatigue, lower sex drive, painful intercourse, acne, and changes in hair texture and growth. Osteoporosis and heart disease become considerable health concerns.


In addition to a whole foods diet, consuming foods that are high in phytoestrogens can significantly improve symptoms. Phytoestrogens—specifically known as isoflavones—are plant-derived compounds that bind to estrogen receptors, having both a weak estrogen and anti-estrogen effect. This teeter-totter effect balances the body’s response to fluctuating hormone levels.

Soy is the most widely known isoflavone-containing phytoestrogen and has demonstrable benefit on hot flashes, vaginal dryness, lipid levels, mental function and even prevent breast and uterine cancer. Japanese women, who consume large amounts of soy, have the lowest incidence of menopausal symptoms. Unfortunately, many soy products are manufactured in a way that removes the beneficial isoflavones. In addition, some individuals may have difficulties digesting and processing soy supplements. Products that are standardized to the isoflavones, genistein and daidzein, are the most effective.

Flaxseeds can also be useful, as they contain high concentrations of lignans, another phytoestrogen.

Bioflavonoids Most often used for their anti-oxidant and anti-inflammatory effects, the bioflavonoids—hesperidin, quercetin and rutin—when consumed with Vitamin C, have reduced and even eliminated hot flashes.

Evening Primrose Oil Although EPO is ineffective at reducing hot flashes, studies demonstrate consistent relief from breast pain and tenderness that results from fluctuating hormone levels.

Pyridoxine This B vitamin is extremely important for the production and balance of serotonin, your feel-good brain chemical. B6 levels can be low for women experiencing depression or on HRT. And deficiency can lead to insomnia and irritability—symptoms common in menopause.

Herbal Medicine

Black cohosh has been extensively studied in Germany as an alternative to HRT. After 4 weeks of consuming 160 mg of a standardized extract, patients reported significant improvements on hot flashes, depression and vaginal atrophy. While black cohosh may cause side effects, such as digestive concerns, headaches and weight changes, studies have not shown proliferative or concerning effects on estrogen-positive cancers.

Stress Management

Addressing stress is an integral part to balancing hormones at any age and this becomes increasingly important in menopause when the adrenal glands are the primary source of steroid hormone production. The adrenal glands not only produce cortisol, your stress hormone, but also testosterone, and androstenedione, a precursor to estrogen. Progesterone, being the precursor to cortisol, is still produced in the adrenal glands and when stress is high, cortisol production increases at the expense of progesterone production. High cortisol levels also cause a reduced production of DHEA, the precursor to androstenedione. Chronically high cortisol production may lead to adrenal exhaustion, which further jeopardizes hormone production. For this reason, stress management, adequate sleep and gentle exercise are extremely important for the mature woman, as are adaptogenic herbs, which balance the stress response.

Ginseng is a common adaptogen that improves the body’s ability to cope with physical and mental stress. It has also been studied for its benefit on mental and physical fatigue, and vaginal atrophy.

Licorice is often the panacea of all herbs. Not only does it contain phytoestrogens and have progesterone-like effects, but it is also useful for the type of fatigue related to adrenal exhaustion and cortisol dysregulation. As a caveat, those with high blood pressure should avoid licorice as it can further elevate levels.

Focusing on the restoration of health allows a woman to experience perimenopause and enter menopause with grace and a quality of life that is not promoted when treatment focuses on disease. Dietary changes, lifestyle modifications, nutrients and herbs can ease the transition into a new chapter of life and vitality.