Navigating Menopause: A Comprehensive Guide to Hormonal Balance through Functional Medicine
| The Functional Medicine Team at The Facility |
Menopause is a transformative part of life that brings physical and emotional shifts. It is often viewed negatively, but with an understanding of the hormonal changes and the right strategies from functional medicine, this time can be managed positively and gracefully.
In this guide, we will break down the hormonal changes that happen during menopause, present nutritional strategies to tackle symptoms, and suggest lifestyle adjustments that foster overall hormonal balance.
Understanding the Hormonal Changes during Menopause
Wait.. What is Menopause? The medical definition of menopause is twelve consecutive months without a menstrual cycle. There may be years leading up to this of varying cycle lengths: shorter OR longer; as well as skipped periods. This transition is perimenopause, which can last anywhere from 2 to 6 years.
Menopause onset usually occurs between the ages of 45 and 55, signaling the end of a woman's reproductive years. This transition is marked by a significant decrease in hormone production from the ovaries, mainly estrogen and progesterone. While these hormone levels are often measured (we encourage that!); there is no laboratory test that confirms menopause: it is purely diagnosed with cycle cessation.
Progesterone levels decrease (alongside more frequent anovulatory cycles) on a fairly steady downward trend. However, estrogen levels tend to go on a bit of a "rollercoaster" with periods of high to low before eventually bottoming out. The relative changes between these hormones tend to cause most of the unpleasant symptoms associated with perimenopause and menopause.
After menopause, the adrenal glands (small organs located just above the kidneys) become the primary source for circulating hormones. They continue to produce testosterone, which can be converted to estrogen largely in fat tissue. [Spoiler alert: Adrenal health is CRUCIAL for supporting menopausal hormone regulation and postmenopausal health !!]
Common Symptoms of Menopause
Due to the changing levels of progesterone and estrogen, most women experience some symptoms during perimenopause and menopause. The severity can vary greatly; and steps can be taken to manage the experience. The most common symptoms reported are:
Hot Flashes (up to 75% of women!)
Moods Swings / Depression / Irritability
Insomnia
Weight Gain
Low libido
Brain Fog
These symptoms can last up to four years after menopause. However, taking care of your baseline health with nutrition and lifestyle habits can minimize the severity and length of disruption. It is notable that other chronic health conditions like osteoporosis, cardiovascular disease, and dementia are associated with the low estrogen levels of post-menopause.
Recognizing these changes highlights the importance of maintaining hormonal balance for overall well-being before, during, and after menopause.
The Importance of Hormonal Balance
Hormonal balance is crucial before, during, and after menopause. Fluctuating estrogen levels can lead to uncomfortable symptoms and health challenges. Functional medicine takes a deeper look at the root causes of these symptoms, aiming not just to treat them but to restore balance through personalized care and lifestyle changes.
The functional medicine approach includes nutritional strategies, supplementation and/or hormonal interventions (bioidentical HRT), and quality of life habits like stress management and good sleep hygiene. Although there are broad recommendations we can make, the best course is to work with a provider one-on-one for individualized care.
Nutritional Strategies to Alleviate Symptoms
The right nutrition can significantly ease menopausal symptoms. By choosing a balanced diet, women can find relief and support their hormonal health. A big focus is on blood sugar management; as better metabolic health can influence severity of hot flashes, sleep disturbances, and weight gain (the top three symptoms reported!).
There are a number of things to increase using a nutrition inclusion lens:
Incorporating Phytoestrogens
Phytoestrogens are natural compounds found in plants that can mimic estrogen. Consuming foods high in phytoestrogens can help alleviate symptoms of low estrogen. For example, adding two servings of organic soy products, such as tempeh or edamame, to your weekly meals may ease hot flashes. Additionally, flaxseeds, known for their high phytoestrogen content, can be easily sprinkled over yogurt or smoothies.
Increasing Omega-3 Fatty Acids
Omega-3 fatty acids are beneficial for reducing inflammation and improving mood. Eating fatty fish, such as salmon or sardines, just twice a week can lower the severity of mood swings and improve heart health. Other sources include walnuts and chia seeds, which can be incorporated into salads or breakfast bowls.
Consuming A High-Protein Diet
During menopause, the natural decline in estrogen levels causes a loss of muscle mass and strength. Getting enough daily protein will help prevent muscle loss, balance your blood sugar, and maintain a healthy weight. For most women, protein consumption should be 20-30% of the total daily calorie intake. This is possible on a plant-based diet with effort; although animal sources of amino acids are more tolerable and easily bioavailable. Supplementing with collagen peptides or a high-quality protein powder can help to acheive these daily goals.
Focus on Whole Foods
Prioritizing whole, unprocessed foods can greatly enhance overall health. Incorporating a colorful variety of fruits and vegetables daily, like spinach, berries, and carrots, provides essential nutrients. A high-fiber, plant-rich Mediterranean Diet is a great framework to not only nourish the body, but can also help lessen menopausal symptoms.
BONUS: Subscribe to our email list to get the Menopause Support Program curated by Functional Nutritionist, Kate Daugherty, MS, CNS. This program includes a sample meal plan, shopping list, and recipes for a full week of eating using nutritional principles to manage the symptoms of menopause.
Lifestyle Modifications for Hormonal Balance
Beyond nutrition, various lifestyle changes can play a significant role in achieving hormonal balance during menopause. Here are some strategies to consider:
Regular Physical Activity
Exercise is a powerful tool against weight gain and mood swings. Aim for at least 150 minutes of moderate exercise each week, combining aerobic activities like brisk walking or swimming with strength training at least twice a week. This approach can enhance hormonal health and elevate mood while decreasing muscle loss and decreasing insulin resistance.
Stress Management Techniques
Stress can greatly disrupt hormone levels, worsening symptoms. Regularly practicing stress-reduction techniques like yoga or mindfulness can help keep hormonal fluctuations in check. For instance, dedicating just 10 minutes a day to deep breathing exercises can significantly improve emotional well-being. Taking care of your adrenal glands (your stress hormone powerhouse!) matters for long-term hormonal balance and prevention of chronic disease.
Quality Sleep
Good sleep is essential for maintaining hormonal stability. Establishing a calming bedtime routine and ensuring a dark, quiet environment can boost sleep quality. Limiting screen time an hour before bed (and/or utilizing blue light blocking lenses) can also help in achieving a restful night's sleep.
Support Networks
Connecting with others can provide emotional relief and a sense of community. Joining support groups, whether in person or online, allows sharing experiences and advice, making the journey through menopause feel less isolating.
...Need a crew? Check out our friends at Hot Flash Health:
Integrating Functional Medicine into Menopause Care
Functional medicine provides a personalized path for managing menopause. By examining individual health history, current symptoms, diet and lifestyle choices we can recommend tailored approaches.
Testing Hormone Levels and Other Biomarkers
A conventional doctor may look at only your serum hormone levels. However, we want to understand your hormone metabolism. This gives us information about your detoxification pathways and a more targeted approach to estrogen:progesterone balance. It is also essential for women who are considering Hormone Replacement Therapy (HRT) to limit risk factors associated with exogenous hormones (re: breast cancer and uterine cancer risks). Looking at androgen levels (testosterone) is helpful since these are the primary source of estrogen post-menopause (through aromatization); and optimal levels support libido, mood, and bone health. || Pssst... our favorite test is the DUTCH Plus read more about it here!
Testing adrenal hormones and their salivary metabolites (cortisol, cortisone, DHEA-s) give clues about the function of the HPA Axis. It's an inside look at 'How well are you actually managing your stress levels?' While daily symptoms can give some clues, having the data on paper is a sobering reality check. Further, seeing a rhythm can provide a more targeted intervention.
Beyond hormones, a comprehensive metabolic assessement to include glucose, insulin, a1c, liver enzymes, lipids, and electrolytes is important to assess related drivers of weight gain. A full thyroid panel, inflammatory markers, Vitamin D, and immune markers are other key insights to best support both short-term "feeling your best" and long-term "optimal healthspan". [We order a Comprehensive Bioscreen from LabCorp for most patients which covers all of this + more!]
--- See this extended discussion in podcast/video format with Hot Flash Health || Revolutionizing Menopause: Functional Medicine, Hormone Health, and Aging Gracefully - with Dr. Mitchell Rasmussen, DC, CFMP and Kate Daugherty, MS, CNS.
Natural Supplements
There are a number of natural supplements that can provide relief for menopausal symptoms. This includes herbs like black cohosh or vitex, antioxidants like Vitamin E or sulfurophane, adaptogens like ashwaghanda or holy basil, and fatty acids like Evening Primrose Oil or Fish Oil. Shwew! Here's what we don't recommend after reading that list: taking it all. The best approach to supplementation is working with a provider (and ideally collecting some data) to develop a supplement plan specific to you.
Don't fall into the marketing trap of "hormone balance" supplements. You must understand YOUR specific picture to restore balance .. it is not one size fits all when it comes to perimenopause and menopause.
Holistic Health Assessment
As part of comprehensive care, we will ask questions about your diet, exercise habits, mental health, and environmental factors that could be affecting hormonal well-being. From this baseline, we can recommend changes and coach you through optimal habits with the most 'bang for your buck'. Often, a complete lifestyle overhaul feels overwhelming in the midst of this major life transition. Focus on small changes that are realistic over the long-term.
Embracing the Journey Ahead
Knowledge is a powerful asset, and learning about menopause can empower women to take control of their health. Being well-informed facilitates better communication with healthcare providers and encourages decisions that prioritize individual health needs.
Approaching this life stage with optimism and practical strategies can lead to a vibrant future. Remember, each woman's experience with menopause is unique, so tailoring your approach is essential for successful navigation. As you embark on this journey, know that support is available. Embracing these changes can lead to a more balanced and fulfilling life during and beyond menopause.
More Resources on Perimenopause + Menopause-
Podcast: Hot Flash Health
Interview: DUTCH "Finding Comfort in the "Menopause Metamorphosis" featuring Esher Blum, MS, RD, CDN, CNS
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Want to work with a functional medicine doctor to run labs and assess nutrient status? Struggling with hormone imbalance, IBS, weight gain, mood changes? Let's look at BIOCHEMISTRY. Read more about Functional Medicine at The Facility here.
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