A functional medicine approach to menopause
The change. The pause. Climacteric. The age of the crone.
Whatever you choose to call it, menopause can be a difficult time of life, in more ways than one.
Physical symptoms aside, menopausal women often have to navigate significant life changes, as they transition into this chapter.
This time often involves major shifts in life direction, from career changes or retirement to welcoming grandchildren, moving house or downsizing, embarking on travel, or picking up a new hobby or interest.
For most women, it’s still a very active and busy time of life, and no-one wants to be slowed down by the uncomfortable symptoms of menopause.
Yet millions of women suffer from perimenopausal symptoms for up to 10 years before experiencing their final period.
Thankfully, there is a growing number of treatment options available to help ease this transition into menopause, including gentle functional medicine options for those who prefer a natural and holistic approach.
What is perimenopause and menopause?
Also known as the ‘change of life’, menopause refers to the final menstrual period and marks the end of a woman’s natural reproductive capacity. Menopause usually occurs between 45 and 55 years of age, with an average onset around 50. Menopause is marked by a significant drop in oestrogen and progesterone levels as ovarian function ceases. This follows a period of often uncomfortable symptoms known as perimenopause, lasting two to ten years, caused by high oestrogen and fluctuating hormone levels as ovarian function gradually declines. When a woman has had no periods for 12 consecutive months, she is considered post-menopausal. About eight percent of women experience premature menopause before the age of 45, caused by premature ovarian failure, surgical removal of ovaries, or other causes such as chemotherapy.
Signs and symptoms of Perimenopause and Menopause
Up to 60 percent of women experience mild symptoms for four to eight years during the transition into menopause, while 20 percent will continue to live with severe symptoms well into their sixties, and another twenty percent may not notice any symptoms at all.
Increased life expectancy has put greater emphasis on improving quality of life for peri-menopausal women, with a focus on optimising diet and lifestyle to reduce the typically unpleasant hormone-induced symptoms, such as:
- Hot flushes
- Night sweats
- Lightheaded feelings
- Unloved feelings
- Mood changes
- Unusual tiredness
- Joint pains
- Muscle pains
- New facial hair
- Dry skin
- Crawling feelings under the skin
- Less sexual feelings
- Vaginal dryness
- Uncomfortable intercourse
- Frequent urination
Menopause treatment: common and conventional approaches
Conventional treatment options are available for menopause, but not without risks. Menopausal Hormone Therapy is available as either progesterone, oestrogen or combined hormone therapy. Research has found women who take combined hormone therapy, or oestrogen alone, are at an increased risk of stroke, blood clots and heart attack. Oestrogen-only therapy can also increase the risk of developing endometrial cancer. The risk isn’t permanent however and can return to normal levels after cessation of medication.
Due to these risks, RANZCOG has developed clinical guidelines on the prescription of Menopausal Hormone Therapy.
Progesterone: Progesterone-only hormone therapy is suitable for perimenopause, during which time there can be spikes of high oestrogen levels. Progesterone may provide relief from mood and sleep disturbances associated with perimenopause, including anxiety, insomnia, hot flushes and stress management. Prescription progesterone works by calming the brain and nervous system. It can also make periods lighter and provide an alternative to progestin-drugs such as the pill or hormonal IUD.
Oestrogen: Oestrogen only therapy is used for those who undergo hysterectomy or oophorectomy, while topical oestradiol is often recommended for women with mild symptoms like vaginal dryness and painful intercourse.
Bioidentical: Bioidentical forms of estradiol and progesterone are identical to the body’s own natural hormones and have become a popular option.
The Melbourne Functional Medicine approach to menopause
The menopause journey is unique for every individual, which is why our practitioners tailor their approach to supporting everyone we see. The beauty of functional medicine is its flexibility, and the ability to use it alongside conventional treatments, or as a more holistic natural menopause remedy alternative.
While Menopausal Hormone Therapy attempts to replace and replicate hormones, functional medicine acknowledges and honours menopause as a normal part of life, and supports this transition by restoring balance to the body where it’s needed most.
Our practitioners can use functional hormone testing to determine where you are in your perimenopause or menopause journey, and tailor a protocol to support the symptoms you’re experiencing, incorporating:
- Mood support
- Reducing inflammation
- Pain relief
- Sexual health and libido
- Skin care
- Sleep, rest and relaxation
It’s important to remember, everyone is different. But what this might look like is:
Food and nutrition: The foods we eat affect our health on a cellular level, and the foods you choose can either ease, or exacerbate, perimenopause symptoms. While it may be tempting to reach for comfort foods or deep-fried snacks, these foods can worsen inflammatory responses in the body. Instead, this is time to nurture yourself with anti-inflammatory whole foods such as fruit and vegetables and healthy fats, like fish, nuts and seeds. Cruciferous vegetables such as broccoli and cauliflower contain elements which naturally support hormonal balancing.
Supplements: Concentrated levels of nutrients in the form of supplements can bring about therapeutic benefits for supporting a wide range of menopause symptoms. Some of our favourites are magnesium, for its multitude of benefits including stress relief, GABA boosting, cortisol regulation, sleep promotion and support for muscular and joint pain, and taurine, which is an amino acid and neurotransmitter that relaxes the brain, and blocks adrenaline. Vitamin D intake is also critical for supporting bone mineral density, as most women lose 10 percent of bone mass within the first five years after menopause due to the drop in oestrogen.
Herbal medicines: Similarly, a range of herbal medicines can provide therapeutic support during menopause, including ashwagandha which reduces neuroinflammation to reduce anxiety and promote sleep, and black cohosh, which can help to reduce hot flashes. Herbal medicines can be in the form of a liquid or tablet, or even taken as a tea. A simple brew of fresh sage leaves steeped in hot water has been found to reduce hot flashes and sweating, calm the nervous system and improve memory function.
Lifestyle changes: Finding the right balance of activity and rest in menopause can be challenging. If you have a busy lifestyle, you might need support with finding time and inspiration for relaxation, such as yoga or meditation which can support hormones, mental health and bone and joint pain. For others, perimenopause might be the time for doing more, like introducing an exercise regime, which can prevent loss of bone mass, support healthy weight and protect cardiovascular health.
Remember, this is just a sampling of the possibilities, and the suggestions here may not be right for you. The most important element of functional medicine is that it identifies your unique symptoms and situations to determine the best plan for you.
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