Surviving (Thriving) Through the Menopausal Years

“At night I wake up with them, drenched.” “They are terrible! I’m so hot I can’t stand it…” “I haven’t had a decent night’s sleep in years.” “No energy, little appetite, my pep has gone!”

These are all descriptions of perimenopausal and menopausal symptoms from real women. Hot flashes, night sweats, disrupted sleep, lack of energy. Sounds fun, right? While there is a bright side to menopause (No more periods and painful cramps! No more PMS!) there are a lot of challenging symptoms that may show up. Every woman will go through this “change of life,” but every woman’s experience will be as unique as she is. One thing that is certain is that your overall health as you head into the peri- and menopausal years has a huge impact on how well you weather the big change, hot flashes and all.

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Perimenopause Vs Menopause: What’s the Difference?

They are both parts of the stage of a woman’s life when reproductive hormones naturally decline, and she ceases to have a period. Menopause is technically diagnosed when you’ve gone one year without a menstrual cycle, and according to the Mayo Clinic, 51 is the average age for women in the United States.1 Perimenopause, the period in which a woman begins the transition to menopause, usually starts in a woman’s 40s and comes with many of the same symptoms as menopause.


For most women, the most challenging symptoms of perimenopause and menopause are hot fl ashes and night sweats, sleep disturbances, mood (anxiety, irritability, mood swings, depression), and loss of libido. Most of these are related to decreasing levels of sex hormones, particularly estrogen and progesterone, but symptoms can be worsened by stress, a poor diet, lack of regular physical activity, and poor general health. Kelly Andis, CN, a Nutritional Health Coach at Natural Grocers in Lakewood, Colorado, says cleaning up your diet is key. “For many women, sugar alone can increase unwanted menopausal symptoms.” Andis recommends avoiding sugar and grains and increasing your vegetable intake, along with taking steps to reduce stress as much as possible. She says that she has helped many women curb their menopausal symptoms with supplements, but if stress levels are out of control, or if they are eating a poor diet, symptoms will likely return.


Before you can effectively deal with hormonal imbalances, and the symptoms that come as a result, it is crucial that you take care of your general health first. Build a healthy foundation with key supplements, including a multivitamin that will fill in the nutritional gaps missing in your diet (a multi will cover your bases, including the B-complex vitamins; however, if you opt out of a multi, consider taking a B complex supplement); vitamin D to keep your bones, immunity, and cardiovascular system in tip-top shape; magnesium and vitamin K2 to protect from osteoporosis; pre- and probiotics to improve your gut health; and whey protein and/or L-carnitine for building and maintaining muscle mass.


Once you have a healthy foundation, focus on supporting hormone balance. And remember to give it time to work—many supplements take from four to eight weeks to deliver results—and be consistent! According to Andis, consistency is key. “Hormones require consistency. Do not run out of the product [you are taking] and wait for a couple of weeks to buy more. By then, the body is starting to become unbalanced again.”


Indole-3-carbinol (I3C) 

According to Lorna Vanderhaeghe, a women’s health expert and author of Sexy Hormones, perimenopause is a time in which your hormones can fluctuate wildly, with dramatic spikes and drops in estrogen levels, which lead to heavy and/or long periods, mood swings, fatigue, night sweats, uterine fibroids, weight gain, sleep disturbances, and low libido. So, while estrogen levels generally decline throughout perimenopause, they do so in an irregular manner, which can lead to estrogen imbalances. I3C is a compound found in cruciferous vegetables like broccoli and kale and research has shown that it maintains a healthy balance of estrogen by metabolizing more potent, cancer causing estrogens into non-toxic forms. It also helps eliminate xenoestrogens, estrogen mimickers found in certain plastics, pesticides, conventional cleaning products, cosmetics, etc.


Try: 150 - 200mg Daily2

Most symptoms of perimenopause and menopause are related to decreasing levels of sex hormones, particularly estrogen & progesterone

Black cohosh

The herb black cohosh is one of the most studied—and most widely used—natural treatments for menopausal symptoms and other female hormonal imbalances. It has been shown to be especially eff ective for reducing the severity and frequency of hot fl ashes, in addition to reducing other symptoms such as mild anxiety and depression, vaginal dryness, decreased libido, and sleep disturbances. Most research has found that women begin to see relief of symptoms between four and eight weeks of supplementing.


Try: 40-80 MG, Twice Daily6 7 8 9


Recent research has found that black cohosh is even more effective when paired with the adaptogenic herb rhodiola. Rhodiola supports the body during mental and physical stress and has been studied for its ability to reduce anxiety, mental fatigue, stress, and depression. A study published in 2020 showed that a combination of black cohosh and rhodiola was “significantly superior” to black cohosh alone in reducing a number of menopausal symptoms, including hot flashes and sweating, sleep problems, depressed mood, irritability, anxiety, and both physical and mental exhaustion.


Try: 400 MG Daily10 11


A supplement that Kathy Millington, RD, Nutritional Health Coach at Natural Grocers in Lincoln, Nebraska likes to recommend for healthy sexual function in menopausal women is shatavari. “It's traditionally used in Ayurveda as the main tonic for the female reproductive system. It supports healthy libido and vaginal moisture, and I've had women report back to me that it worked well for them,” she says. Shatavari has hormonal balancing properties, and in Ayurvedic practice, it is said to balance excess pitta, or heat, in the body. Animal research has also found that shatavari has an anti-anxiety effect, similar to a common prescription anti-anxiety medication.12


Try: Doses start at 500 MG Daily13

Folic acid

This B vitamin may not be the first supplement that comes to mind when building your menopausal supplement kit, but research has shown that it is effective at reducing both the frequency and severity of hot flashes in menopausal women. Hot flashes are the number one reason a woman seeks medical treatment during menopause; not only are they extremely unpleasant, but they can lead to insomnia and fatigue, behavioral changes, including depression and anxiety, memory and concentration problems, and decreased libido. They can decrease a woman’s quality of mental, physical, and social life. A placebo controlled study conducted in Iran that included 70 menopausal women found that daily supplementation with 1 gram of folic acid significantly reduced the severity, duration, and frequency of hot fl ashes after four weeks, with no side effects.


Try: 1 MG Daily for atleast four weeks

The Importance of Slashing Stress And Supporting The Adrenals

“Healthy adrenals are the key to an effortless menopause” according to Lorna Vanderhaeghe, author of Sexy Hormones. Natural practitioners agree that low adrenal function is one of the most common underlying causes of menopausal symptoms. This is why: The adrenals are an important part of the endocrine system, and though they are best known for producing the stress hormones cortisol and adrenaline, as the ovaries stop producing sex hormones the adrenals pick up the slack and start producing estrogen’s precursor hormones DHEA and androstenedione, as well as progesterone. But often, by the time a woman reaches the perimenopausal and menopausal years, her adrenal glands are so depleted that they are unable to produce adequate amounts of the sex hormones, and will instead prioritize production of cortisol. This can worsen menopausal symptoms and increase symptoms related to adrenal deficiency like fatigue and insomnia. Chronic stress depletes the adrenals, so it is critical to focus on reducing stress as much as possible. Also consider supporting adrenal health with supplements such as vitamin C, a B complex, and the adaptogenic herbs panax ginseng, shatavari, holy basil (tulsi), and rhodiola. While a B complex and vitamin C are helpful for anyone to support adrenal function, you will likely have to try different adaptogenic herbs to see what works best for you.


A woman’s menopause experience is as unique as she is, but how healthy you are overall as you move into these years plays a huge role in how well your body adapts to the changes. Take care of your general health first, and then focus on lifestyle habits and specific herbs and nutrients to treat symptoms such as hot fl ashes, night sweats, insomnia, and anxiety. If one product or lifestyle change doesn’t work for you, experiment with others until you fi nd the right combination, so you will not just survive, but thrive, through this time of life! Also consider visiting your local Nutritional Health Coach (NHC) to help you navigate these transformative years



2 Vanderhaeghe L, MS and Pettle A, MD. Sexy Hormones: Unlocking the Secrets to Vibrant Sexual Health; Chapter 5. Basic Health Publications, Inc., 2010
3 Catenaccio E, Mu W, and Lipton M. “Estrogen- and progesterone-meidated structural neuroplasticity in women: evidence from neuroimaging.” Brain Struct Funct. 2016 Nov; 221(8): 3845-3867
4 Vanderhaeghe L, MS and Pettle A, MD. Sexy Hormones: Unlocking the Secrets to Vibrant Sexual Health; Chapters 2 and 3. Basic Health Publications, Inc., 2010
5 Prior, JC. “Progesterone for Symptomatic Perimenopause Treatment—Progesterone politics, physiology and potential for perimenopause.” Facts Views Vis Obgyn. 2011;3(2): 109-120.!po=75.0000
6 Mehrpooya M, Rabiee S, Larki-Harchegani A, et al. “A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes.” J Edu and Health Promot 2018; 7:36.
7 Mohammad-Alizadeh-Charandabi S, Shahnazi M, Bayatipayan S. “Efficacy of black cohosh (Cimicifuga racemose L.) in treating early symptoms of menopause: a randomized clinical trial.” Chin Med. 2013;8:20.
8 Jiang K, Jin Y, Huang L, et al. “Black Cohosh Improves Objective Sleep in Postmenopausal Women with Sleep Disturbance.” Climacteric. 2015;18:4
9 Northrup C, MD. Women’s Bodies, Women’s Wisdom; Chapter 14: Menopause. Bantam Dell, 2006.
10 Pkhaladze L, Davidova N, Khomasuridze A, et al. “Actaea racemose L. Is More Effective in Combination with Rhodiola rosea L. for Relief of Menopausal Symptoms: A Randomized, Double-Blind, Placebo-Controlled Study.” Pharmaceuticals. May 2020; 13(5): 102 doi: 10.3390/ph13050102
11 Edwards D, Heufelder A, Zimmerman A. “Therapeutic effects and safety of Rhodiola rosea extract WS 1375 in subjects with life-stress symptoms—results of an open-label study.” Phytother Res. Aug 2012; 26(8): 1220-5 doi: 10.1002/ptr.3712
12 Garabadu D and Krishnamurthy S. “Asparagus racemosus Attenuates Anxiety-Like Behavior in Experimental Animal Models.” Cellular and Molecular Neurobiology. Feb 2014;34, 511-521.
13 Lall A. “This Ayurvedic Supplement Reduces Anxiety and Fights Menopause Symptoms.” First for Women, Nov 2, 2019.…
14 Bani S, Hasanpour S, et al. “The Effect of Folic Acid on Menopausal Hot Flashes: A Randomized Clinical Trial.” J Caring Sci. 2013 Jun;2(2): 131-140.