Written for Sage Wellbeing Co by Jenna Carroll | BHSc Naturopath & Nutritionist 

How to Naturally Support the 3 Stages of Menopause

Menopause is a right of passage for all women privileged enough to live beyond the age of 55, but each woman’s experience will be unique. The age menopause begins will vary according to the individual woman. The average expected age of menopause today is 51, give or take 5 years. Menopause unfolds in three stages, this transitionary period requires us to support the physiological changes so that we can gracefully adapt to a new way of functioning in the world. 

Stage 1: Perimenopause

Perimenopause is the 3-5 year period before menopause when your oestrogen and other sex hormones begin to drop, which typically occurs in your late 40’s. This is a time where symptoms of menopause begin to be experienced intermittently as egg numbers in the ovaries begin to fall far enough to cause a shorter menstrual cycle. As it progresses, menstrual cycles continue to shorten, whilst also becoming interspersed unpredictably by unusually long cycles. Though fertility is low here, there is still the chance that a woman may conceive. 

A variety of symptoms may be experienced at this time due to the steady decline in hormones, including:

• Hot flashes
• Sleep disturbance- insomnia
• Night sweats
• Elevated heart rate
• Mood Changes- irritability, depression, anxiety
• Vaginal dryness or discomfort during intercourse 
• Urinary issues

Stage 2: Menopause

Menopause is technically defined as the last natural menstrual period. It is a completely natural state a woman is in after the ovaries have stopped ovulating because of egg depletion. After 12 straight months of missing your period, you are considered in menopause. It is important to remember that every woman is unique and will experience menopause differently. Some women experience few, if any symptoms, and those who do, the symptoms can vary widely! 

In addition to the symptoms mentioned during the perimenopause phase, the loss of sex hormones can also cause increased accumulation of visceral fat (fat around your belly), loss of muscle mass and strength, loss of bone density, urinary leakage, severe tiredness, brain fog, joint pain, hair loss and diminished libido.

Stage 3: Post Menopause 

Post menopause starts after one year has passed since your last menstrual cycle. Symptoms that started in perimenopause can continue through menopause and post menopause, however many of these symptoms should begin to ease during this stage. Phew!

It is important to mention that while the conventional medicine approach to ‘treatment’ attempts to alleviate menopausal symptoms through Hormone Replacement Therapy, this is a completely natural process in the female body, and by ‘suppressing’ symptoms we are really prolonging the transitory period and not addressing the root cause, which could likely be poor liver and gut function. From a Naturopathic standpoint the aim is to provide symptomatic support through addressing underlying organ weaknesses with dietary and lifestyle adjustments along with specific supplemental and herbal recommendations unique to the individual. 

Below are some general diet and lifestyle tips to consider during this life stage. 

Dietary:

1. Eat more whole, plant-based foods. Evidence suggests that women who follow a plant-based diet experience significantly less symptoms than those who eat a standard diet. A diet high in animal protein may also contribute to lowered bone density due to calcium being pulled from the bones when the body attempts to neutralise acidity. 
2. Increase calcium rich foods. Bone mineral density decreases at menopause, so it is important to start concentrating on eating more calcium-rich foods and other bone-building nutrients. These include sesame seeds, tahini, chia seeds, celery, dried figs, almonds, dark leafy greens such as spinach and kale, rhubarb, amaranth, sardines, edamame, tofu, beans and lentils
3. Incorporate ground flaxseed meal. Flaxseeds are a rich source of dietary lignans and isoflavones. These two compounds have been shown to help reduce symptoms of menopause, particularly hot flushes. Flaxseeds also help reduce blood cholesterol and protect against cardiovascular disease, the risk of which increases at the onset of menopause.
4. Reduce caffeine intake. Whether it comes from coffee, tea, cacao or colas, caffeine is a diuretic that causes calcium loss via the kidneys. Caffeine intake of more than 300mg per day (around 2 double shot coffees) have been shown to accelerate bone loss in post menopausal women. Also, because your adrenal glands takeover from your ovaries in producing small amounts of sex hormones after menopause, it is highly common to experience adrenal burn out during this time (sleep problems, fatigue, brain fog). Caffeine has a destructive effect on the adrenal glands, so it is a wise idea to reduce it or avoid it altogether.
5. Reduce alcohol intake. Consumption of alcohol during this time may exacerbate menopausal symptoms, including hot flashes, sleepless nights, mood swings and fatigue. If you do drink, enjoy it, but it is recommended to consume alcohol in moderation, no more than 4 standard drinks per week is ideal, or a maximum of 2 drinks in one sitting.

Lifestyle:

1. Daily movement. Exercise will help improve bone mineralisation, decrease cholesterol, whilst improving circulation, cardiovascular health, oxygenation of the tissue, stress levels, blood pressure and relieve hot flushes. Find movement practices that you enjoy, which you will be more likely to show up to daily. This could be simply walking in nature, pilates, yoga, resistance training, HIIT workouts, swimming, cycling or maybe even dancing! Even doing 10 minutes of intentional movement per day will be beneficial. Consistency is key.
2. Manage your stress. Menopausal symptoms can be greatly amplified if a woman is experiencing stress. It is important to find ways to relax during this period. Consider massage, meditation, deep breathing, yoga, exercise or socialising with friends and family. 
3. Get some sunshine. Vitamin D is crucial for skeletal health, immune regulation and has been shown to help boost mood. It is recommended to check your blood serum Vitamin D biannually to monitor levels throughout the year.

References:

• Cheng, et al. (2007). Isoflavone treatment for acute menopausal symptoms. Menopause. 
• Hechtman, L. (2018). Clinical Naturopathic Medicine. Elsevier: Sydney. 
• Rizzoli, R et al. (2014). Nutrition and bone health in women after the menopause. Women’s Health.

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