Menopause: Understanding and Managing the Transition

Written and Medically Reviewed by Dr. Sarah Bonza, MD, MPH, FAAFP, Dip-ABLM, NBC-HWC

Menopause, once a subject whispered about or shrouded in mystery, is now a prominent topic for many women.

It is a universal transformation, marking the end of fertility and the beginning of a completely new chapter in a woman’s life. However, the change can come with a myriad of symptoms — hot flashes, night sweats, mood swings, and more.

Trisha Pasricha MD asked in the Wahington Post, Is Menopause Getting Worse? Scientists say it is. Today, we ask what can we do about it?

Source: Shutterstock

Menopause: What’s Causing the Surge in Symptoms?

To understand the apparent surge of menopausal symptoms, we first review what menopause is and how it’s evolving. Menopause is a natural biological process, typically occurring between the ages of 45 and 55, when a woman’s ovaries stop producing eggs, her menstrual cycle permanently ends, and her body produces less estrogen and progesterone.

While the biological process itself remains unchanged, various factors may influence the perception and reporting of menopausal symptoms. Cultural shifts towards open discussions about personal health, increased stress levels, as well as genetic and environmental factors, all play into the equation. There’s also the possibility of epigenetic changes — alterations in gene expression that aren’t caused by changes in the underlying DNA sequence.

This increased visibility and an apparent intergenerational shift in reported symptoms lay the groundwork for a new, more complex landscape of menopausal experiences influenced by a modern world.

Lifestyle Strategies for Hot Flash Relief

The good news is that while menopause is inevitable, the severity of symptoms doesn’t have to be. This life phase is a call to action, an opportunity to evaluate and optimize health and well-being. The following lifestyle changes can help alleviate the intensity of menopause symptoms:

Diet and Exercise

Healthy eating: Focus on a diet rich in fruits, vegetables, and whole grains. Limit caffeine, alcohol, and spicy foods, which can trigger hot flashes.

Regular exercise: Physical activity can significantly reduce the frequency and intensity of hot flashes, improve mood, and contribute to overall well-being. Aim for at least 30 minutes of moderate aerobic exercise most days of the week.

Stress Management

Relaxation techniques: Practices such as meditation, deep breathing exercises, and yoga can help manage stress and decrease the frequency of hot flashes.

Support network: Cultivating strong relationships and seeking support from peers or professionals can provide comfort and perspective during this transition.

Rest and Recovery

Sleep environment: Ensure your bedroom is cool and comfortable to reduce the incidence of night sweats. Consider using moisture-wicking sleepwear or bedding.

Napping: Short daytime naps can help offset the sleep disturbances caused by nighttime hot flashes.

By adopting these practices, women can take an active role in managing their menopausal symptoms, promoting a more comfortable and empowered transition.

Naturopathic Remedies for Hot Flash Relief

In addition to lifestyle adjustments, certain natural supplements and remedies have shown promise in easing menopausal discomfort:

Black Cohosh

A perennial herb that may help with hot flashes, mood swings, and sleep disturbances, though more research is needed to determine its efficacy.

Sage

Commonly used for its anti-inflammatory and antioxidant properties, sage is believed to reduce the frequency and severity of hot flashes.

Licorice

Licorice root may help balance estrogen levels and alleviate symptoms such as hot flashes and vaginal dryness, though it should be used cautiously due to its potential to elevate blood pressure.

Siberian Rhubarb

Extracts from the root of Siberian rhubarb, or Rheum rhaponticum, have been investigated for their potential to relieve vasomotor symptoms.

Pycnogenol

Derived from French maritime pine bark, pycnogenol is an antioxidant that has shown some success in reducing the frequency of hot flashes.

Folate

A diet rich in folate, or the consumption of folic acid supplements, has been associated with a lower incidence of severe menopausal symptoms in some studies.

The integration of these remedies should be approached with care, ensuring they do not interfere with any existing medical conditions or treatments.

Hormone Therapy: When the Heat Persists

Hormone therapy (HT) remains one of the most effective treatments for menopausal symptoms, particularly for hot flashes and night sweats. This treatment involves the administration of estrogen alone or in combination with progesterone.

One burgeoning area of interest is in bioidentical hormone replacement therapy (BHRT), which employs hormones that are chemically identical to those produced by the body. Oral micronized progesterone is most frequently administered orally. Estrogen has the highest safety profile when administered transdermally such as patches.

While hormone therapy offers significant relief, it is not without risks. It should be individualized, with the lowest effective dose used.

New Medication for Hot Flashes

For those who prefer pharmaceutical interventions, a modern class of medications has been developed for menopausal symptom management:

Veozah (Fezolinetant)

Veozah, FDA approved in May 2023, is an oral medication designed to treat moderate to severe vasomotor symptoms, including hot flashes, caused by menopause. It works by modulating specific serotonin receptors, offering a non-hormonal approach to symptom relief.

The development and approval of medications like Veozah provide women with more options than ever before, reflecting the growing recognition of the need for diverse and innovative approaches to menopause management.

The Path Forward: Navigating Menopause with Confidence

Menopause is not simply a destination; it is a passage to a new beginning. By understanding the changing landscape of menopause, women can approach this phase with confidence and resilience. It’s crucial to stay educated, maintain a dialogue with healthcare providers, and engage in treatments and lifestyle changes that support your unique needs and comfort.

Remember, you are not alone on this journey. Support groups, online communities, and healthcare professionals are valuable resources for sharing experiences and accessing support. Together, we can redefine the menopausal experience and empower women to thrive in this chapter of their lives.

This modern era of menopause is a call to action for the medical community and society to prioritize research, education, and healthcare services tailored to the needs of mid-life women. It’s not just about symptom relief; it’s about quality of life, dignity, and the celebration of a life stage that is as unique and individual as the women who experience it.

Join Dr. Sarah Bonza’s Fullscript Dispensary to access her doctor-recommended supplements to help you navigate perimenopause and menopause with more ease and confidence!