Cessation of menstruation usually occurs, on average, around the age of 51 years old, and is thought to happen when there are no eggs left in the ovaries.
At birth, a female has approximately 1 million eggs, which drop to 300,000-400,000 at puberty – on average just 400 mature during the reproductive years.
Perimenopause is the period before menopause and during this time many women ovulate irregularly, indicating changes in the menstrual cycle, with or without other symptoms.
Symptoms can include:
Is there anything we can actually do to manage the menopause making it an easier transition?
Yes, there are lots of natural interventions which can make this often very difficult transition easier. Natural interventions can help alleviate most common symptoms. HRT may be recommended for women at a high risk of osteoporosis who already had significant bone loss and menopause symptoms or who do not tolerate osteoporosis medications.
Natural interventions which can help to make the transition easier include:
Three of the most effective nutritional interventions include:
My go-to Phytoestrogen-containing foods, include:
Nutritional Supplements can also be of a great help, and these include:
Vitamin E: relieves hot flushes and menopausal vaginal symptoms and improves blood supply to vaginal wall when taken for 4+ weeks. Dosage: 400 IU q.d. for atrophic vaginitis.
Gamma-oryzanol (ferulic acid): growth-promoting substance in grains and isolated from rice bran oil. It enhances pituitary function and endorphin release by the hypothalamus. It is effective even in surgically induced menopause.
It also lowers cholesterol and triglycerides, and is an extremely safe substance with no significant side effects. Dosage: 300mg q.d.
Hesperidin and vitamin C: hesperidin improves vascular integrity and relieves capillary permeability. Combined with vitamin C, hesperidin and other citrus flavonoids may relieve hot flushes. Dosage: 900mg hesperidin, 300mg hesperidin methyl chalcone (citrus flavonoid), and 1200mg vitamin C q.d.
Plants that tone the female glandular system are termed “uterine tonics”. Phytoestrogens improve blood flow to female organs and nourish and tone female glands and organ system.
Plants for specific symptoms include:
Herbal phytoestrogens have no side effects and inhibit mammary tumours. Phytoestrogens in medicinal herbs, compared with estrogen are at most around 2% strong. The modulating effect is as follows:
Black Cohosh: Single most important herb for menopausal symptoms. It relieves hot flushes, night sweats, headache, insomnia, mood swings. It improves fatigue, irritability, vaginal dryness. However, it may not work in the presence of an antiestrogen, such as tamoxifen.
Red Clover: 40mg standardised extract reduce hot flushes.
Korean or Chinese Ginseng: Contains 13 triterpenoid spaonins (ginsenosides) and reduces mental and physical fatigue, enhances ability to cope with physical and mental stressors by supporting adrenal glands. Also, treats atrophic vaginal changes from estrogen loss.
Ginkgo biloba extract: Improves blood flow for cold hands and feet (improves peripheral vascular disease of extremities, such as Raynaud’s syndrome), also improves forgetfulness that accompanies the menopause. It increases blood flow to the brain, enhances energy production in the brain, increases uptake of glucose by brain cells, and improves transmission of nerve signals. It may take 12+ weeks to see the beneficial effects, although most report benefits within a 2-3 week period, some women do take longer to see the beneficial effects. The longer the treatment is continued, the more obvious and lasting the result.
Speaking to a qualified herbalist is recommended.
Natural Topical Preparations
Natural progesterone cream: can be quite effective in perimenopause by regulating the menstrual cycle, hot flushes, night sweats, mood swings, sleep disruption, and premenstrual syndrome symptoms.
Transdermal progesterone cream (1/4 tsp. containing 20mg progesterone applied daily to skin), plus multivitamin and 1200mg calcium for 1 year improved or resolved hot flushes in 83% of women.
Exercise: hypothesis is that impaired endorphin activity in hypothalamus may provoke hot flushes. Regular physical activity (30 minute walk a day is ideal) decreases frequency and severity of hot flushes. Exercise may also obviate the need for HRT. Women with no hot flushes spent 3.5 hours a week exercising, so walking every day for 30 minutes can be so beneficial, especially as exercise elevates mood.
Smoking: increases risk of early menopause and doubles the risk of menopause between ages of 44-55 years.
So what next?
I would advise following the below plan and introducing the foods suggested on a daily basis.
How to include these phytoestrogen-containing foods? I make a very quick juice of 1 apple, 3 stalks of celery, ¼ cucumber, some parsley and fennel, which is so quick and easy and includes some of the most powerful phytoestrogen-containing foods! You are also getting 4-5 of your daily portions of fruit and vegetables, so double whammy. I also sprinkle flaxseeds (a great phytoestrogen food) on my porridge or natural yogurt, which is packed with probiotics that help promote great gut health.
Additionally, chickpeas (another very powerful phytoestrogen) are a versatile legume, and hummus with 3-4 oatcakes is a fantastic quick lunch packed with phytoestrogens and protein. Add some sliced carrots and a piece of fruit and you’ve a great balanced meal there, even better as carrots are packed with phytoestrogens.
Summary: My go-to Menopause Plan
Diet: increase soy foods, legumes, flaxseeds, celery, fennel and parsley.
Supplements: vitamin E – 800 IU q.d. until symptoms have improved, then 400 IU q.d; hesperidin 900mg q.d; vitamin C – 1200mg q.d; Gamma-oryzanol – 300mg q.d.
Botanical medicine: Black Cohosh –standardised extract based on content of 27-deoxyacetine 20mg of 27-deoxyacteine b.i.d (tincture 1:5, 4-6ml or dry powdered extract 4:1 250-500mg); Ginkgo biloba extract – 24% Ginkgo flavonglycoside content 40mg; red clover – 40mg isoflavones extract b.i.d.
Lifestyle: 30 minutes walking every day, if possible.