Menopause: Thriving Through Changes

Reviewed by Manna Ko, PhD

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Up to the mid-twentieth century, menopause was little understood, and commonly referred to as simply "The Change." Today this normal progression of life and its causes and effects are better understood. Hormone replacement therapy has been introduced to relieve certain symptoms. Alternative therapies have become more readily accepted and accessible.

How Menopause Begins

Estrogen and progesterone hormone levels begin to decline in our early 40s. The onset of menopause can begin as early as four years before true menopause sets in (the peri-menopausal phase). In the peri-menopausal phase, ovaries no longer ovulate systematically and estrogen levels begin to fluctuate. Unfortunately, the timeframe for dealing with menopausal symptoms can continue years after menopause has begun, affecting up to one third of a woman's life.

Effects of Menopause

Some women experience only a minor nuisance, while other women find menopause extremely uncomfortable and difficult. "The Change" is really many changes that can happen throughout the menopausal years:

  • Menstrual Cycle in Peri-menopause: Unpredictable periods (until they cease at the end of menopause). Throughout this time, women may experience interchanging periods with heavier flows and longer duration, or lighter flows and less duration.
  • Bladder: Inability to hold urine during activities such as exercise or even sneezing, as well as urgency in having to urinate.
  • Vaginal: Painful intercourse or decreased desire due to vaginal dryness or thinning of the skin.
  • Temperature: Thirty seconds to five minutes of hot flashing, cold shivers, or night sweats, possibly producing a flushed face or red patches on the skin.
  • Sleeping: Breaks in sleeping patterns, sleeping too much or too little.
  • Mood: Reports indicate a link between mood shifts and estrogen.
  • Cognitive: Intermittent breaks in memory, focus, and decision making may occur.
  • Bodily: Increase in weight, decrease in muscle mass, lack of muscle and joint flexibility, skin irritations, thinning skin and tissue, or excessive skin and tissue. Decreased connective tissue and bone density.
  • Behind the Scenes: Decreased estrogen levels may produce other metabolic changes, possibly leading to bone tissue loss (which leads to osteoporosis), high cholesterol (stroke and heart attack risk), changing glucose levels (diabetic risk), among other metabolic changes.

Positive Changes

During and after menopause, women are free from the menstrual cycle and liberated from mothering duties such as child rearing. Doctors have also discovered that women who treat menopause with self-respect and as a natural, beautiful part of life, may experience less severe symptoms.

Common Sense Ways to Improve the Experience

Menopause is a good opportunity to improve your well-being with healthier lifestyle choices. The healthy habits listed here have been passed down over generations — they are common-sense ways to make a positive change in your life. The focus of these tips is to pamper yourself, especially since menopause can last many years:

  • No Smoking: Smoking reduces oxidation levels. Oxidation is critical to cellular function. The quality of cellular function impacts the appearance of our skin, the thinning of skin, hydration, and many other aging qualities.
  • Diet: Use a doctor-recommended diet, high in fiber and well balanced in vitamins and minerals, including calcium. Proper diet assists with every aspect of your body's function. Knowing that weight gain and decreased muscle mass are part of the aging game, proper diet is prudent for the aging population.
  • OTCs: Over-the-counter products such as vaginal lubricants or estrogen cream may help vaginal discomfort.
  • Bladder Training: Most primary care physicians and gynecologists can recommend bladder training exercises for urgency (pelvic muscle and kegel exercise).
  • Exercise: Cardiovascular and muscular strength training, with a proper warm up and cool down, three times per week to maintain proper weight, reduces the risk of decreased muscle mass, inflexibility, osteoporosis, and a host of medical conditions and diseases.
  • Medical Exams: Regular exams with a primary care physician and gynecologist are critical throughout the aging process since hormone levels can affect other mechanisms in the body.
  • Rest: In the form of proper sleep, yoga, massage and meditation.

Pharmaceutical Drugs

Pharmaceutical drugs have risks associated with them. Medication does not work for everyone. Your doctor can help you determine if and which medication is right for you. Here is a list with brief descriptions:

  • Birth Control Pills: At the onset of menopause, the doctor may prescribe birth control pills to balance hormone levels.
  • Clonidine, known as Catapress: Used to manage hot flashes. Side effects may include dizziness, blurred vision, first-dose syncope, and withdrawal hypertension.
  • Selective Estrogen Receptor Modulator (SERm): In the form of the medication Evista, SERm may be prescribed for the prevention and treatment of osteoporosis. Risks include developing health problems such as venous thromboembolism and hot flashes.
  • Hormone Replacement Therapy: The goal of hormone replacement therapy is to add estrogen and progesterone, which are lost through menopause. There are many oral medications on the market that can be prescribed by your doctor for hormone replacement therapy. Premarin (conjugated estrogen) and Provera (medroxyprogesterone) are the two most common medications used during menopause. Progesterone may be prescribed in combination with estrogen medications in order to reduce risks associated with the medication.

Hormone replacement therapy has received controversial reviews due to increased risk for many medical conditions, including breast cancer, uterine cancer, ovarian cancer, endometrial carcinoma, malignant neoplasm, gallbladder disease, thromoembolitic disease, photosensitivity, endometrial cancer, and an increase in cholesterol levels, edema, weight gain, and bleeding.


There are many supplements, vitamins, and natural healing remedies on the market. The following list includes some of the natural supplements that may help menopause symptoms. There are risks associated with almost every supplement.

  • Black Cohosh (Cimicifuga Racemsoa), Vitex (Chaste berry), Lachesis and Aromatherapy: for general menopausal symptoms
  • American Ginseng (Panax quinquefolius): adaptogenic herb to support adrenal function, energy support, nervous system support
  • Rehmania (Rehmania glutinosa): cooling effect, reduces hot flashes, sweating episodes, heart palpitations
  • Resveratrol (Polygonum cuspidatum): general antioxidant, hormonal balancing effect
  • DIM (Diindolylmethane) and Chrysin: conversion of estrogen with the goal to reach a more favorable balance of estrogen fractions
  • Calcium and Magnesium: reduces cramping and promotes healthy bone density
  • Isoflavones (genistein, diadzein are the main ones): phytoestrogens that work to be estrogen modulators, cardio protective and immune enhancing.
  • Indol 3 Carbinol: estrogen modulator, antioxidant
  • B complex: stress support
  • Dong Quai (Angelica sinensis): a natural similarity to "SERM" (Selective Estrogen Receptor Modulator)
  • Milk Thistle (Silybum marianum): liver support
  • Belladonna (Atropa belladonna): a remedy for hot flashes, heart palpitations, restlessness, and headaches
  • Calcarea carbonica: for night sweats, heavy menstrual flow, a sense of being overwhelmed, weight gain
  • Natrum muriaticum: headaches, cravings, and other menopausal symptoms
  • Oophorinum: for women who have had their ovaries removed
  • Pusatilla (pulsatilla pratensis): mood swings
  • Sepia: anxiety, irritability, libido issues
  • Sulphur: for hot flashes and night sweats
  • Geranium and rose oil: helps to modulate hormone levels, irritability, and mood swings

Consult a Qualified Doctor

The information in this article cannot treat, diagnose, or replace the advice of a qualified doctor; however, it may help guide you in your consultation with a qualified doctor. Menopausal symptoms may signify a more serious medical condition. Menopause can occur unnaturally, prompted by eating disorders, intense over-exercise, systematic conditions, ovarian disease, hysterectomy, ovary removal, and adrenal disorders (among other conditions). A comprehensive evaluation of menopausal symptoms by a qualified doctor must be performed in order to identify the right treatment plan.

The right treatment plan may require the integration of services from different types of healthcare providers. Qualified primary care physicians and gynecologists can provide the most suitable treatment plans.

About the Reviewer of This Article

Manna Ko, PhD, is a clinical nutritionist and herbologist, member of the American Academy of Anti-Aging Medicine, and founder of the The Center for Healthy Living. Dr. Ko obtained her doctorate from American Institute of Holistic Theology and is a certified clinical nutritionist and certified clinical herbalist.