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Menopause & Perimenopause

picture of a woman at menopause and perimenopause doing yoga
Menopause can be a beautiful stage of life

Naturopathic Treatment of Menopause & Perimenopause

Menopause is defined as the 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 natural transitions 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 treated.  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 happy, motivating neurotransmitter.  Neurotransmitter imbalances can lead to many of the symptoms of menopause or peri-menopause such as poor sleep, low libido, low motivation, depression and anxiety.

Natural Treatment for Menopause & Perimenopause

These are the steps that I would use as a naturopath to help with menopause & perimenopause:

  1. Support and nourish your adrenal glands and HPA axis while reducing your stress.  Stress reduction is vital because otherwise you only end up breaking even with the adrenal/HPA axis 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 the 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 in herbs can help make up for hormone deficiencies and smooth the transition at menopause.  Phytoestrogens and phytoprogesterones have very weak hormone-like activity that acts to modulate hormone levels.  Current data suggests that there is no cause for concern when consuming these as they are very weak and may help to balance estrogen.
  5. Personally, 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.  In my opinion, bioidentical hormones are no safer in this regard.

For help with this or any other health problem, book an appointment here or call the office for more information at 416-481-0222.

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

Picture of Toronto Naturopath Doctor Dr. Pamela Frank, Best Naturopath in Toronto many times over
Dr. Pamela Frank, BSc(Hons), Naturopathic Doctor

Dr. Pamela has practiced as a naturopathic doctor in Toronto since 1999. She has received numerous “Best Naturopath in Toronto” awards. She is registered with the College of Naturopaths of Ontario.

Dr. Pamela Frank uses a natural treatment approach that may include acupuncture, herbal medicine, nutrition, diet, vitamins, supplements, and other natural remedies to restore balance and provide long-term resolution to almost any health problem.

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 the first 6 months then they received the usual care for the second 6 months (acupuncture 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 the end of the treatment, with benefits noticed after 3 treatments and max clinical benefit noticed at 8 treatments (avg)

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

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

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-hypertension 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. The mean quality of life score (SF-36) improved in 73% of 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.


Natural S-(-)equol, a product of the bacterial transformation of the soybean compound daidzein, reduces the severity of hot flashes and other menopausal symptoms. Source: J Womens Health (Larchmt). 2011 Oct 12.

S-equol supplementation may alleviate certain menopausal symptoms in women who are equol nonproducers (women who do not produce the daidzein-metabolite equol after eating soy). Source: Menopause, 2009; 16(1): 141-8.

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.

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

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]. 

Phytoestrogens and Menopause

Plant-based therapies such as phytoestrogen supplementation were shown to significantly reduce some menopausal symptoms including hot flashes.
Source: Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis.JAMA. 2016 Jun 21;315(23):2554-63.


In a blinded, placebo-controlled trial, 90 postmenopausal women (ages 45-60 years) were treated with fennel or a placebo. The fennel group had a significant decrease in a range of menopausal symptoms. It was concluded that fennel is an effective and safe treatment in reducing menopausal symptoms without adverse effects.
Source: Effect of Foeniculum vulgare Mill. (fennel) on menopausal symptoms in postmenopausal women: a randomized, triple-blind, placebo-controlled trial.Menopause. 2017 Sep;24(9):1017-1021.


A systematic review was conducted finding that the use of acupuncture, both as an adjunctive treatment or alone, was effective at improving the health-related quality of life and vasomotor symptoms of menopause with no negative side effects.
Source: Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. The Journal of Alternative and Complementary Medicine. 2018, Jan 3.

Diet and Age of Menopause Onset

A study found a link between the type of food that women regularly ate, and the age they went through menopause. Those who had higher amounts of refined pasta and rice went through the change earlier, while women whose diets focused more on fish, beans, and other legumes started menopause at a later age.
Source: Dietary intake and age at natural menopause: results from the UK Women’s Cohort Study. 2018. J Epidemiol Community Health, jech-2017.

Green Tea to Reduce Cholesterol/Triglycerides

In a randomized control trial, green tea extract was found to significantly reduce triglyceride and cholesterol levels compared to placebo. Therefore, green tea extract may be a more cost-effective way to improve lipid profiles in postmenopausal women without major side effects.
Source: Impact of green tea extract on serum lipid of postmenopausal women: A randomized controlled trial. 2017. Journal of Traditional and Complementary Medicine.

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 on this website.

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