Menopause & Perimenopause

menopause & perimenopause hot flashes night sweats anxiety

Naturopathic Treatment of Menopause & Perimenopause

by Dr. Pamela Frank, BSc(Hons), ND

Menopause is defined as cessation of menstrual periods for at least one year.  Perimenopause precedes actual menopause and can last for 2-10 years.  During the perimenopausal period, women may experience all the symptoms of menopause including hot flashes, night sweats, irregular periods, emotional changes – anxiety, depression, irritability, anger, and poor sleep.   Menopause and perimenopause are a natural transition in a woman’s reproductive life, just like puberty.  As such, they are not a medical condition in and of themselves and do not necessarily need to be medicated.  However, when the symptoms of perimenopause/menopause are sufficiently severe as to negatively impact a woman’s quality of life, easing the symptoms is in order. 

Causes of Menopause & Perimenopause Symptoms

  1. The adrenal or stress glands can help to ease the hormonal transition at menopause.  The adrenals produce the building blocks to make hormones like estrogen if more is needed.   Often women with menopause or peri-menopausal symptoms have overly taxed and fatigued their adrenal glands through excessive coffee consumption, nicotine intake or prolonged/chronic high stress levels.
  2. The liver is responsible for breaking down excess hormones and manufacturing building blocks for new steroid hormones.  Hormone imbalance symptoms like those seen at menopause can be the result of an overburdened liver.
  3. Vitamin and mineral deficiencies can lead to poor production of serotonin – a mood-elevating neurotransmitter, and melatonin – a sleep-inducing neurotransmitter. Dopamine is a calming neurotransmitter.  Neurotransmitter imbalances can lead to many of the symptoms of menopause or peri-menopause such as poor sleep, depression and anxiety.

Naturopathic Treatment for Menopause & Perimenopause

  1. Support and nourish the adrenal glands while reducing stress.  Stress reduction is vital because otherwise you only end up breaking even with the adrenal support, you aren’t able to make progress.
  2. Liver detoxification (not the kind found in the health food store!) can help relieve a congested liver and enable more efficient liver function.
  3. Vitamins like B6 and minerals like magnesium are helpful for production of serotonin and melatonin, as well as facilitating many enzyme reactions throughout the body. Tyrosine helps support dopamine production.  5HTP can also help with serotonin production.
  4. Plant hormone-like substances can help make up for hormone deficiencies and smooth the transition at menopause.  Phytoestrogens and phytoprogesterones have a very weak hormone-like activity that acts to moderate hormone levels.  Current data suggests that there is no cause for concern when consuming these as they are very weak and if anything they appear to have anti-cancer properties.
  5. I do not recommend hormone replacement therapy, even bioidentical hormone replacement therapy.  Supplementing hormones is risky business since under certain conditions the body will shunt hormones into estrogen production which may promote cancer growth.  In my opinion, bioidentical hormones are no safer in this regard.

Natural Medicine for Menopause Research


Avis NE, Coeytaux RR, Isom S, Prevette K, Morgan T. Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial. Menopause. 2016; 23(6):626-37.
● Two groups: (1) individualized treatment for first 6 months then the usual care for second 6 months (acu group), (2) vice versa (control group)
● Acupuncture group significantly reduced vasomotor symptoms by up to 36.7% and improved sleep QOL measures (hot flash interference, sleep quality, physical symptoms, memory symptoms, anxiety); all benefits persisted at least 6 months after end of treatment, with benefits noticed after 3 treatments and max clinical benefit noticed at 8 treatments (avg)

Vitamin D:

Cangussu L, Nahas-Neto J, Orsatti C, Poloni P, Schmitt E, Almeida-Filho B, Nahas E. Effect of isolated vitamin D supplementation on the rate of falls and postural balance in postmenopausal women fallers: a randomized, double-blind, placebo-controlled trial. Menopause. 2016; 23(3):267-74.


Johnson SA, Figueroa A, Navaei N, Wong A, Kalfon R, Ormsbee LT, Feresin RG, Elam ML, Hooshmand S, Payton ME, Arjmandi BH.

Daily blueberry consumption improves blood pressure and arterial
stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial. J Acad Nutr Diet. 2015; 115(3): 369-77.

Schisandra chinensis:

Park JY, Kim KH. A randomized, double-blind, placebo-controlled trial of Schisandra chinensis for menopausal symptoms. Climacteric. 2016; 19(6):574-580.
● Kupperman Index score (menopausal symptoms) were significantly lower in the Schisandra group compared to placebo – effective in hot flushes, sweating and heart palpitations

Fenugreek husk:

Shamshad BS, Jayalakshmi HK, Vidyavathi HG, et al. A novel extract of fenugreek husk alleviates postmenopausal symptoms and helps to establish the hormonal balance: a randomized, double-blind, placebo-controlled study. Phytother Res. 2016; 30(11):1755-1784.
● Fenugreek extract (Trigonella foenum-graecum husk) 250 mg each capsule, 500 mg twice daily after meals for 90 days. After 90 days, menopausal symptom severity (GCS) scores decreased significantly, especially in the subsections of the questionnaire involving anxiety, depression, vasomotor symptoms, mood swings, insomnia, headaches, vaginal dryness. Mean quality of life score (SF-36) improved in 73% participants compared with 32.5% of those in the placebo group. In the placebo group, there was a significant increase in general well being and mental health compared to baseline.


Stojanovska L, Law C, Lai B, Chung T, Nelson K, Day S, Apostolopoulos V, Haines C. Maca reduces blood pressure and depression, in a pilot study in postmenopausal women. Climacteric. 2015; 18(1):69-78.

● Over the 12 week period, maca appeared to significantly reduce diastolic blood pressure and depression in postmenopausal Chinese women.


Abdominal acupuncture is an effective and safe method for menopause depressive disorder, it improves the menopause depressive symptoms with persistent action, less symptoms relapse and adverse reactions.

Source: Zhongguo Zhen Jiu. 2010 Nov;30(11):913-7


Natural S-(-)equol, a product of the bacterial transformation of a soybean compound diadzein, reduces severity hot flashes and other menopausal symptoms.

Source: J Womens Health (Larchmt). 2011 Oct 12.

Red Clover Isoflavone:

Supplementation with red clover isoflavones was found to be associated with a considerable decrease in overall menopausal symptom intensity including hot flashes.

Source: Gynecological Endocrinology, posted online August 26, 2011.

Black Cohosh:

Supplementation with black cohosh in early menopausal women was found to show significantly more improvement than the control group in vasomotor, psychiatric, physical, and sexual symptoms.  Source: Chinese Medicine 2013, 8:20

Red Clover Isoflavone:

Supplementation with red clover isoflavones was found to be associated with a considerable decrease in overall menopausal symptom intensity including hot flashes.  Source: Gynecological Endocrinology, posted online August 26, 2011.

Vitamin E:

A lower vitamin E:lipid ratio was found to be associated with osteoporosis. These findings suggest that vitamin E may increase bone mineral density in healthy postmenopausal women.  Source: J Bone Miner Metab, 2013 March 28

Pycnogenol & Skin:

Daily supplementation with pycnogenol in postmenopausal women improved skin hydration by 8% and skin elasticity by 25%.  Source: Skin Pharmacol Physiol. 2012; 25(2):86-92. Epub 2012 Jan 21.


Supplementation with 1.05 g/d ethyl-eicosapentaenoic acid (E-EPA) plus 0.15 g/d ethyl-docosahexaenoic acid for 8 weeks was found to improve depressive symptoms and psychological distress in menopausal women.

Source: Am J Clin Nutr, 2008 Dec 20; [Epub ahead of print]. 


S-equol supplementation may alleviate certain menopausal symptoms in women who are equol nonproducers (women who do not produce the diadzein-metabolite equol after eating soy).

Source: Menopause, 2009; 16(1): 141-8.

DISCLAIMER: The information provided here may not apply precisely to your individual situation. Diagnostic and therapeutic choices must always be tailored to the individual patient’s circumstances, and consultation with a licensed naturopathic physician should be undertaken before following any of the treatment strategies suggested in this web site.

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