Menopause
Gary Null
Menopause marks a natural transition and the end of a woman’s reproductive cycle that typically begins between the ages of 45 and 55. Nationally, the average age of menopausal onset is around 51 years old. The conventional parameter for a final diagnose is the end of one full year without a menstrual period; however, the lead-up phase known as perimenopause can last anywhere from a few months to over a decade, and can start as soon as the early 40s. Due to rising life expectancies, hence women living longer, this means many women will be spending almost half of their lives being postmenopausal. Although the average age of natural menopause has risen slightly across generations -- from roughly 48 years in the 1950s to 50 years today – more women are nevertheless struggling with early or premature menopause than during past generations. This has been a disturbing shift that is affecting the lives and long-term health of many women. Early menopause, which can begin even in the late 30s, now impacts 5 to 12 percent of women worldwide. Premature menopause before age 40 strikes about 1 to 4 percent. There can be many causes for this modern trend. Genetics, autoimmune disorders, smoking, chemotherapy and radiation, psychiatric drugs, obesity, unhealthy junk diets, etc., can each play a role. Most alarming, however, has been the ever-increasing exposure to endocrine disrupting chemicals across the American environment. Plastics, pesticides, cosmetics, everyday household products, flame-retardants, and contaminated food chains are accelerating the breakdown of ovarian health. In some women who are most heavily exposed to toxic chemical overloads, natural menopause can begin up to three years earlier. Unlike previous generations, which had lower chemical exposure, today, women’s bodies are being flooded with hormone disruptors. The risks of premature menopause are further amplified when other stressors such as poor nutrition or chronic illness are added into the equation.
It is absolutely crucial for women to accept the fact that menopause is not a disorder but a natural biomolecular process and a normal stage of life. When this is understood, then menopause can be an opportunity for personal renewal rather than a sentence of decline. In our hyperactive society, there is a lingering cultural belief that after menopause, women face inevitable risks of breast cancer, heart disease, high blood pressure, arthritis, diabetes and other chronic health conditions. There are no certainties to these common myths. With the right knowledge and making healthy decisions, menopause can be a vibrant period for women to flourish physically, psychologically and spiritually. In fact, the menopausal years can be a time for women to feel healthier, happier and more empowered than ever before. “The perimenopause is a crossroads,” says Dr. Christiane Northrup, a board-certified obstetrician-gynecologist and a pioneer in women’s health and wellness movement. “One road says, ‘Grow.’ The other says, ‘Die.’ It is completely a choice. Are you going to continue doing the same old things that led you to where you are now? Or are you going to wake up and use your own power to truly flourish and move into what are the best years of your life?” As Dr. Sherrill Sellman, naturopath, psychotherapist, and author of the best-selling book Hormone Heresy, points out, many doctors and women alike still harbor misconceptions about the nature and effects of menopause. Yet in cultures like Japan and other nations in the East, where menopause is fully embraced rather than dreaded, women report far less disruptive symptoms and use hormone therapy at rates of only one-tenth as in the West. Dr. Sellman notes, “The Japanese, for example, don’t have a word for menopause or hot flashes. They look at it as just a transition period, but not one with a significant effect on a woman’s life.” In these cultures, menopause is celebrated as a rite of passage into greater wisdom and strength rather than being a threshold entering decline.
Symptoms
Every woman’s journey through menopause is unique. Her genetics, overall health, living situation and relationships, and her environment at large can shape how she experiences the transition of changes through menopause. Nevertheless, there are certain common patterns all women go through during perimenopause and beyond. One of the earliest shifts involves the menstrual cycle. Periods usually become shorter or longer, lighter or heavier, or many women might skip months altogether. Sometimes women will observe irregular spotting and these occurrences will be unpredictable. These are signals that the ovaries are winding down their egg production. Vasomotor symptoms, such as hot flashes and night sweats, affect up to 80 percent of women worldwide. These symptoms can strike like sudden waves of heat, which can last for a decade or more. For about 25 percent of women, vasomotor symptoms are severe enough for women to seek medical help. In addition, around 65 percent of women gain weight, typically 1.5 pounds per year, as fat is redistributed toward the abdomen and muscle mass drops. For this reason, regular movement and exercise, is important to decrease the odds of heart and metabolic problems.
Over half of perimenopausal women experience sleep disturbances, such as problems falling asleep or frequently waking up in the middle of the night. Night sweats worsen the quality of sleep. Up to 68 percent of women experience mood shifts like irritability, anxiety, depression, and emotional fatigue. Bouts of sadness, even without any apparent cause, can emerge due to the body’s hormonal fluctuations. Brain fog and difficulties concentrating, which is due to temporary brain changes and its energy use, are reported by over half of menopausal women; fortunately, these neurological changes usually stabilize during the post-menopausal period.
Vaginal dryness and discomfort is part of what’s called genitourinary syndrome of menopause. These symptoms affect between 50-65 percent of women during the first year after the last period and up to 84 percent within six years. Genitourinary symptoms can include itching, burning, painful sex, urinary infections or leakage. Joint aches, muscle fatigue, heart flutters, physical and mental exhaustion, and hair thinning add to panoply of symptoms. Although this scenario may at first appear depressing, there are causal factors that are largely under women’s control. “Many changes appear in perimenopausal women, but the negative ones usually arise from stress, bad diet, pharmaceutical drugs, exhausted adrenal glands, and other things, not from lowered estrogen levels,” says Dr. Sellman. “I believe, based on my own experience, that the symptoms of menopause, and also those of PMS, which are produced by the same imbalances, are really the result of poor health. When we can correct these imbalances, our hormones automatically go back into balance and we receive all the benefits. Women need to understand that a healthy liver, a healthy digestive system, a healthy adrenal system, and getting the colon working are the factors that contribute to healthy hormone production.”
Although genetics and lifestyle have a fundamental impact on menopause unfolds for women, environmental factors like endocrine disrupting chemicals are increasingly implicated in tipping the scales toward earlier or more intense symptoms. Recent studies show that higher exposure to these chemicals disrupts ovarian function and hormone signaling. What was once called estrogen dominance, where estrogen is the primary causal factor, is now regarded as being a relative imbalance because progesterone levels also decline during perimenopause. In fact, progesterone falls more sharply thereby leaving estrogen’s effects more pronounced. This might be due to hormone residues in nonorganic dairy, meat, food produce or pesticides that mimic estrogen’s effects. Or it might be caused by a sluggish liver struggling to clear excess hormones due to toxic overload or stress. The consequence that women experience abdominal weight gain, bloating, breast tenderness, mood swings, headaches, low libido, fibroids or foggy thinking. “The symptoms of too much estrogen out of balance with progesterone includes the gaining of weight, particularly on the abdomen, hips and thighs, because the nature of estrogen is to turn food into fat,” Dr. Sellman explains. “This happens to the animals in the feedlots. It also happens to us. As long as we have this imbalanced relationship we will continue to put weight on no matter how much we try to diet or exercise. Lumpy fibrocystic breasts are stimulated by high estrogen levels. Depression, mood swings, rage, anger are all caused by estrogen excess, as is food retention, bloating, fatigue, and headaches. Those migraine headaches that happen before your period or when your hormone levels are out of balance are all related to high estrogen levels. High estrogen also decreases sex drive, which is a major problem for women. It’s not about menopause. It’s really about these imbalances.”
When the liver is overburdened, it can recycle estrogen in a more harmful form. This can increase the risks for hormone-sensitive illnesses like breast cancer. Dr. Sellman says. “When we have compromised liver function, we cannot properly metabolize estrogen safely out of the body. So what happens with high levels of toxicity that overwhelm the liver is that the liver then metabolizes estrogen down a pathway that turns it into a more toxic form of estrogen. It then gets reabsorbed back into the body, putting women at risk of hormone dependent cancers like breast cancer.”
Misconceptions About Menopause
Misconceptions about menopause can run deep. One of the most deceptive myths is that menopause is the start of decline instead of a potential gateway to vitality. Dr. Linda Ojeda, author of Menopause Without Medicine, observes that many women dread menopause as “the beginning of the end,” fearing they’ll lose their youth, sexuality, purpose or sanity. “They believe that life is going to be downhill from this point on… They fear that their behavior will become erratic, hysterical, and out of control. This is not true. When we reach fifty, we do not turn into raging maniacs, and we are not more susceptible to clinical depression. In some women, however, lowered levels of estrogen, endorphins, and serotonin, substances that affect mood, can create mood swings. Levels can be raised naturally in these women. We know that beliefs and attitudes affect the transition… If you are approaching menopause with fear and trepidation, you need to examine your attitude.” Recent clinical evidence echoes this: while hormone dips can shift moods, they’re not destiny. In China for example, where elder women gain status, menopausal symptoms plummet when cultural stigmas fade.
Popular views of post-menopausal sexuality are another myth. According to clinical psychologist Dr. Janice Stefanacci Steward, “Many women fear that they are going to lose their passion and sexuality. Really, only a small portion of women who go through menopause have their sex drive adversely affected. For those women who lose their sexual desire or have difficulty becoming and staying aroused, help is available. But most women do not experience sexual arousal problems, and many report feeling more sexual because the risk of pregnancy is gone.” In fact, Dr. Northrup notes that women in their 50s and 60s often enjoy their peak intimacy when they have freed themselves of old narratives. “You don’t hear that because the mainstream culture would lead you to believe that after the age of forty you’re pretty much washed up as a woman, and you’re no longer desirable and that’s the end for you.” It is these types of messages that must be turned off and pushed aside. This detrimental view was birthed in the 1960s when cheap synthetic hormones hit the market and the popularity of Dr. Robert Wilson’s 1966 book Feminine Forever. Wilson based his theory on a single short study that concluded menopausal women were withered “eunuchs” needing estrogen to stay forever young. This sparked the panic behind hormone replacement boom, though. By the way, Wilson was later discredited for undisclosed ties to the pharmaceutical industry and his entire view has been dismissed as hysterical propaganda to support the hormone replacement boom.
Contrary to Wilson’s misinformed tale, ovaries don’t shrivel and quit at menopause. They adapt. Dr. Sellman explains, “We do not cease producing estrogen. At menopause we are going through a transition from our fertility years to our what I call wise women years. The body in its wisdom to conserve energy is reducing the amount of estrogen made by the ovaries by 40 to 60 percent. It’s reduced because we don’t need mature eggs in our menopausal years.” The World’s Health Organization, for example, has actually found that an overweight postmenopausal woman has more estrogen running through her body than a skinny premenopausal woman. Furthermore, during menopause, the ovaries’ inner layer for the first time activates protective compounds for heart health, blood vessels, skin glow, libido, and overall physical vitality. When healthy life-style choices are optimized, women can sustain their well-being for decades ahead. Far from an estrogen shortage, it’s often the progesterone-estrogen ratio – too little progesterone against estrogen -- that is tilting and contributing to hot flashes, sweats, weight shifts, sleepless nights, headaches, tiredness and emotional blues.
Hormone Replacement Therapy (HRT)
The natural medical community has long warned about the dangers of synthetic hormone replacement therapy (HRT) but it wasn’t until 2002 that mainstream conventional medicine began to catch up. At that time, the U.S. Women’s Health Initiative abruptly halted its large-scale trial due to the clinical evidence that linked combined estrogen-progestin therapy to higher risks of breast cancer, heart disease, stroke and blood clots in many women. However, even in late 2025, these concerns persist. Recent reviews continue to confirm that newer synthetic progestins, similar to their older formulations, still increase breast cancer risk by up to 26 percent after five years of use. This is particularly worrisome for women over 60 or those who started HRT after a decade of being postmenopausal.
While newer guidelines from the North American Menopause Society and others note that for younger women within 10 years of menopause the benefits to relieve hot flashes, night sweats, insomnia and vaginal dryness often outweigh risks of using lower dose HRT for shorter durations, there remains the need to avoid synthetics because of their unnatural molecular structure, which can disrupt natural hormone pathways and lead to chronic illnesses. Dr. Sherrill Sellman provides the context on how this developed,
“In the 1970s, women turned their backs on supplementation with estrogen alone because it had been found to cause endometrial cancer. So the drug companies came up with hormone replacement therapy, which used a combination of estrogen and a synthetic progestin such as Provera. They used a synthetic because natural progesterone, which has no toxic side effects, cannot be patented. To sell HRT to women, who were scared of hormones after the revelations of the 1970s, the companies claimed that HRT reduced the risk of a condition most women were unaware of osteoporosis. In the early 1990s, a new reason for healthy women to take this powerful carcinogenic steroid was introduced. HRT was said to be a way to protect the heart. So doctors began using HRT, originally supposed to be only a short-term treatment for relief of menopausal symptoms, as a long-term treatment to prevent other conditions, conditions that only might occur.”
However, the evidence reveals that instead of being beneficial, HRT actually increased the risk of serious complications and even death. The fact remains these are synthetic drugs that are n listed by the National Institutes of Health as known human carcinogens. According to Dr. Christiane Northrup, for the millions of women still on synthetic HRT, the progestin component is the major red flag. “For the life of me, I cannot understand why the medical profession still does not understand the difference between the progesterone that your body produces and progestin, which is a completely artificial hormone that your body has never seen before.” Dr. Kent Hermsmeyer, at the Oregon Primate Center, has shown that monkeys deprived of estrogen so they become perimenopausal, when given Provera developed coronary disease leading to heart attacks. Synthetic progestin can cause the coronary arteries to become hyperreactive; this is why many perimenopausal women experience chest pains indicative of angina. On the other hand, natural progesterone or bioidentical hormones match a woman’s own molecules exactly, even if its lab-made from plant sources like soy. Consequently, natural hormones offer a gentler path for menopausal relief without the risks of blood clotting and cancer.
Compounded Bioidentical HRT versus FDA-Approved Bioidentical HRT
No doubt, menopausal women trying to navigate hormone options can feel overwhelmed. One challenge is to intelligently weigh the differences between custom-compounded bioidentical HRT against FDA-approved versions in order to discuss the options with a medical practitioner. Bioidentical hormones are chemically identical to what a woman’s ovaries once produced. In 2025, FDA-approved bioidenticals include estradiol patches or gels for estrogen and micronized progesterone capsules, which have been proven to reduce hot flashes by up to 80 percent without the risks of synthetics. Compounded hormones are made in pharmacies to meet a woman’s personaized needs. However, according to the American College of Obstetricians and Gynecologists they are not inherently safer or more effective than the standardized bioidentical hormones. Transdermal estrogen, eitehr compounded or FDA-approved, seems safer than pills because it skips the liver and further lowers clotting risks.
Bioidentical progesterone is hands down safer than synthetic progestins. It also protects the uterus without aggravating breast cell growth. FDA options rely solely on estradiol; compounding may include a mix of estriol or estrone for a broader mix. For women who prefer to seek compounded hormone support, be certain the pharmacy is 503B federally overseen pharmacies and follows good manufacturing practices. Of course, compounded hormones are more costly.
Natural Hormone Replacement
Natural Progesterone
Progesterone is a powerhouse hormone that helps keep the uterine lining in check. It contributes to curbing the growth of excessive breast tissue and helps to keep a woman’s libido alive. For both women and men, progesterone works in cooperation with estrogen to manage reproductive cycles while also normalizing blood sugar, supporting bone integrity, easing sleep, and dialing down anxiety and depressive moods. Once a woman enters menopause, progesterone levels crash and can leave them feeling off-balance. As a bioidentical match counters “estrogen dominance” symptoms and can reduce risks risks for fibroids and cysts associated with hormone overload. Women may also experience a reinvigorated glow due to improved cortisol balance. Unlike progestin in Prempro, which increases cancer risks, micronized progesterone like Prometrium is FDA-approved and bioidentical. One study showed Prometrium decreased night sweats and flashes by 60 percent after three months. Natural progesterone is also highly effective for heavy perimenopausal bleeding without the mood swings and clotting risks.
Pregenolone
Pregnenolone functions as the factory boss, or precursor, for the synthesis of other hormones including DHEA, testosterone, progesterone, estrogen, and cortisol. On its own, it appears to sharpen cognitive function and manage anxiety and moods. However, pregenolone levels gradually fade with age and takes a harder hit during menopause. Some small scale trials and research indicates it might support memory and learning in midlife women. Unlike other hormones, it has been less studied, especially to analyze long-term and high dose use.
DHEA
DHEA (Dehydroepiandrosterone) is produced by adrenal glands and ovaries. Properly, it is a pseudo-hormone or hormone precursor involved with metabolism, immunity, brain protection, and supporting testosterone and estrogen levels. DHEA levels can begin to decline as early as mid-30s and accelerates as women enter perimenopause. As a supplement its touted for its anti-aging benefits: sharper memory, mental clarity, emotional calmness, and better muscle tone. A 2024 meta-analysis of postmenopausal trials concluded oral DHEA (50 mg daily) can hike bone density by 2 percent when paired with calcium and vitamin D alone. Italian research found DHEA improves women’s sex life. In fact, the FDA has green-lighted low-dose DHEA vaginal inserts for painful intercourse, normalize pH, and easing dryness. In general, women will benefit from DHEA at low doses but should refrain from higher doses because of the lack of clinical studies to determine its safety threshold.
Estriol
Estriol is the weakest of the three main estrogens that can serve as an kind of adjunct in bioidentical HRT formulas to help lessen the risks of cardiovascular problems, osteoporosis, and reduce hot flashes. It can also nourish the skin’s vitality. Estriol carries no breast or uterine cancer risks.
Tripe Estrogen
The classic triple estrogen blend in bioidentical HRT is 80 percent estriol and 10 percent each of estradiol and estrone. Compared to Premarin, this formula mirrors pregnancy’s gentle mix and provides more punch to silence hot flashes, night sweats, forgetfulness and brain fog. One trial observed it improved sleep quality and mood fluctuations in 70 percent of women after six months.
Advantages of Bioidentical HRT
Women who follow compounded bioidentical HRT regimens report on how their bodies slip more easily into their natural rhythms. Some forms of bioidentical hormones, however, are more potent than synthetics. Since estrogen is a growth-stimulating hormone, it is associated with cancer and tumor formation, particularly in the breast and endometrial areas. The worry is that excess excessive levels late in life may have consequences. Barbara Seaman and Laura Eldridge note in The No-Nonsense Guide to Menopause that because bioidenticls are natural and derived from soy and yams, they do not carry the risks of horse urine-derived hormones synthesized in a laboratory or warehouse. Also, unlike synthetic HRT, they relieve the liver and there are no red flags associated with cancer and strokes. Bioidentical topical creams also absorb more easily via the skin fats. One caution concerning compounded HRT is the chance of women receiving uneven doses unless it is purchased from a fully-certified FDA-regulated pharmacy. For that reason, women are advised to avoid purchasing compounded bioidentical HRT formulas from overseas.
Testosterone
Testosterone might seem like a men’s thing, but women produce it too but in smaller doses from their ovaries and adrenal glands. It plays a role in heart and bone health, helps tone muscles, and keeps sexual desire and arousal alive. to keep reproductive bits strong, hearts pumping, bones dense, muscles toned, nerves firing, and yes, desire and arousal alive with good lubrication. Since the ovaries supply about a quarter of a woman’s testosterone, levels inevitably decline during menopause. This can result in hypoactive sexual desire disorder (HSDD), which is a lack of sexual spark that frequently causes distress in about 10 to 15 percent of midlife women. A series of seven trials with over 3,000 women found transdermal testosterone could boost women’s sexual drive. However, the FDA continues to hold off its approval for postmenopausal HSDD. Alternative testosterone sources are skin patches or creams at one-tenth a male dose to reach premenopausal norms. The downsides of testosterone replacement could include skin pimples, voice change and sometimes slight weight gain.
Natural Therapies
Natural therapies are the best means to ease menopause without relying on hormone replacement. For many women, simply shifting their daily habits can make a world of difference. Adopting healthier diets, herbs or supplements, remaining physical active, reducing stress and better sleep can bring extraordinary relief on their own. Although bioidentical hormones have a place for many women, they are not necessarily the first line of relief. The beauty in a natural approach to manage menopause and postmenopause is that women are learning to tune into their body’s wisdom with nature’s own resources and therapies.
Diet
A nutrient-packed diet rich in plants, fiber and wholesome foods can be a game-changer to tame menopause’s ups and downs, including hot flashes, insomnia, weight gain and emotional swings. Intelligently adopting a vegetarian or vegan diet will help regulate hormones and flush out toxins that limit the energy available to women. This is supported by the latest gynecological research.
One cross-sectional study of over 150 postmenopausal women found that those who followed a modified Mediterranean diet, with its emphasis on olive oil, nuts, legumes and green vegetables, reduced the odds of moderate-to-severe hot flashes and sexual discomfort by up to 80 percent; it was observed that the Mediterranean diet’s anti-inflammatory strengths hindered inflammation and thereby better supported a rebalancing of hormones. Another study with postmenopausal women showed a low-fat vegan diet high in soybean-based foods dropped severe hot flashes by 88 percent in under 12 weeks; moreover, the women also managed to lose 8 pounds on average without any pharmaceutical aids.
Soy is rich with plant estrogens called isoflavones that influence the body’s estrogen receptors. Consuming or supplementing isoflavones can block toxic chemical estrogen imitations, called xenoestrogens that are now ubiquitous in our environment: plastics, bisphenol A, phthalates, parabens, forever chemicals, pesticides and herbicides. Scientists at Beth Israel Medical Center observed that a dominant compound in soy cuts hot flash frequency and intensity by up to 50 percent in menopausal women. As one researcher, Dr. Hope Ricciotti, put it, “the chemical structure of this compound is very similar to that of our estrogen, allowing it to act as a regulatory mechanism if the body’s natural levels decrease.” A large recent meta-analysis of 12 clinical trials confirmed soy isoflavones ease overall menopausal symptoms like headaches, mood swings, heart palpitations, and even depression and anxiety by up to 72 percent. Dr. Jane Guiltinan, a naturopathic physician from Washington, encourages women to consume phytoestrogen foods, “Soybeans, tofu, tempeh, anything made with soy, will contain plant estrogens. Oats, cashews, almonds, alfalfa, apples, and flaxseeds contain smaller amounts of estrogen. A woman emphasizing those foods in the diet can experience significant decreases in her hot flashes.”
Flaxseed is a very effective fiber that can harness harmful estrogens in the gut so they are sufficiently expelled from the body. A Mayo Clinic study confirmed taking a teaspoon of flax oil three times a day is superior to black cohosh and vitamin E for reducing hot flashes across all the menopausal stages. A more recent found 10 grams daily for three months slashed the severity of hot flushes, sleep disturbances, anxiety and joint aches by as much as 155 percent compared to a placebo. Ground flax seed can also be sprinkled on salads or added to smoothies for additional benefits.
Women will also benefit immensely by keeping their blood sugar steady and weight in check. Extra pounds and belly fat will fan the severity of hot flashes. Replacing higher glycemic carb foods, like potatoes and wheat, with lower glycemic substitutes such as yams and whole fiber-rich whole grains will help clear unwanted estrogen residues. Ann Louise Gittelman, author of Before the Change: Take Charge of Your Perimenopause, explains, “Low-glycemic, or slow-acting, carbohydrates will supply lots of energy for their calories. . . . I choose unprocessed carbohydrates that are moderate to low on the index, which also provide high-quality fiber to help eliminate excess estrogen from the system by lowering blood levels of this hormone.” Fruits like apples, grapefruits, lemons, pears and peaches, plus fiber-loaded veggies, deliver a sufficient supply of healthy phytohormones. Gittelman adds. “A level blood sugar helps to prevent perimenopausal symptoms such as depression, mood swings, and hot flashes, and it leads to weight loss without any effort… We need to add essential and beneficial fats, not take them away. These come in the form of the high-lignan flaxseed oil, olive oil, toasted nut seeds, and avocado. These fats stabilize blood sugar levels.”
On the flip side, dodge sugar, coffee, alcohol, processed junk, saturated fats, and meats—they spike insulin, cortisol, and symptoms like flashes or blues. Dr. Christiane Northrup warns, “excess sugar in the diet will cause increased insulin, increased cortisol, and that raises havoc with your own hormones. . . . Decreasing sugar in the diet or eliminating refined sugar all together will actually balance hormones in many women.” Ultra-processed eats, like sodas, fast food and packaged snacks, aggravate fiercer hot flashes. Meat-heavy meals also will worsen them.
Nutrients and Herbs
There are many nutrients and herbs on the market that claim to relieve perimenopausal and menopausal symptoms by restoring the progesterone-estrogen balance. Based on a review of systematic meta-analyses and clinical studies from sources like the North American Menopause Society and peer-reviewed journals, some standout as crucial for women to consume either through foods or supplements as they navigate the transitions during menopause. These nutrients address the key concerns about hot flashes and night sweats, bone density loss, emotional instability, sleep disturbances, heart health, fatigue and inflammation that are so often exacerbated by a decline in estrogen and other hormones. Despite these recommended nutrients and herbs, it is always wise to consult with your healthcare doctor or medical practitioner for personalized dosing and to be assured they best fit your individual health needs.
Calcium is crucial for postmenopausal women in order to counteract the acceleration of bone loss due to estrogen declines. It is necessary for preserving skeletal integrity and reducing the risks of fractures that affect one in three women after age 50. About 1,200 mg daily is required from food and supplements in order to optimize absorption, especially when taken with vitamins D and K. Evidence from some of the more updated meta-analyses shows that consistent supplementation can lower hip fracture risk by 20 percent over five years thereby making it a foundational nutrient for long-term bone health.
Magnesium plays a key role in over 300 bodily processes, including calming the nervous system and alleviating anxiety or depression in perimenopausal women. Magnesium deficiencies impact about half of midlife women due to stress and poor diets. By helping to regulate blood pressure and muscle relaxation, it can aid in easing night sweats and cramps. A daily dose of 300 to 400 mg, preferably as magnesium glycinate, has also been linked to 25 percent better sleep in perimenopausal women.
Omega-3 Fatty Acids (DHA/EPA) support heart health and cognitive clarity during menopause. Since estrogen loss intensifies inflammation, DHA and EPA also help modulate women’s moods by reducing inflammatory cytokines that can worsen hot flashes and joint pain. Systematic reviews indicate that 1,000 to 2,000 mg daily can decrease hot flash frequency by 30 percent and enhance cognitive function in postmenopausal women.
Vitamin B6, B9 (Folate) and B12 are vital for postmenopausal women’s energy production and neurotransmitter synthesis to combat fatigue, brain fog, and elevated homocysteine levels that heighten heart disease risks. Deficiencies, common in 30 to 50 percent due to age-related absorption issues, can intensify mood swings and cognitive relapses. Supplementation with a B-complex providing 25 to 50 mg B6, 400 mcg folate, and 500 to 1,000 mcg B12 daily has been shown to reduce depression and increase overall well-being.
Vitamin D is arguably the top nutrient for women in perimenopause, menopause, and postmenopause because it supports calcium absorption to maintain bone density and regulates mood shifts by influencing serotonin pathways. Vitamin D deficiency is widespread and affects up to 70 percent of mid-life women due to the lack of sunlight and poor dietary habits. Low levels have been associated with great intensity of hot flashes and more frequent fatigue in menopausal women. In addition, low vitamin D increases osteoporosis risks and the intensity of bouts of depression. Research shows that keeping vitamin D blood levels above 30 ng/mL can alone improve women’s overall quality of life by 30 percent.
Vitamin E is a powerful antioxidant that protects cells from oxidative stress associated with hot flashes, vaginal dryness, fatigue and adverse skin changes in menopause. It also strengthens the immune system and heart function. For better absorption, take vitamin E in its tocopherol form because it will not interfered with hormonal balance. Clinical trials have demonstrated that 400 IU daily can cut hot flash occurrences in half and alleviate episodes of nausea and vomiting in postmenopausal women.
Black Cohosh is one of the most popular herbs for managing hot flashes, sweating, mood swings, irritability, and sleep disturbances during menopause. It appears to work via serotonergic and dopaminergic pathways rather than direct estrogenic activity. Standardized extracts have been found to safely reduce vasomotor symptoms that are comparable to low-dose estrogen therapy. The herb’s serotonin-modulating and antioxidant properties can also benefit bone health. A 2023 randomized trial confirmed black cohosh extract significantly reduced hot flash frequency without altering women’s hormone levels or endometrial thickness. Short term use is preferable, less than 6 months, to avoid overtaxing the liver.
Dong Quai, or the “feminine ginseng”, is a standard herb in traditional Chinese herbal formulas to relieve menopausal symptoms and increase circulation. Newer formulations standardized for ferulic acid and ligustilide have demonstrated it improves hot flashes and fatigue when combined with other herbs. It seems to be more effective when combined with chamomile or astragalus. While generally safe, dong quai should be used cautiously by women taking anticoagulants due to its mild blood-thinning effects.
Equol is a potent metabolite found in the the soy isoflavone daidzein, which is produced by certain gut bacteria. Because equol is more bioavailable, it has stronger estrogenic activity to relieve hot flashes and various mood symptoms. Some research suggests that good wholesome dietary habits to maintain a healthy gut microbiome composition enhances the body’s equol production Unsurprisingly, women who support their gut microbiota with a healthy plant-based diet that is rich in probiotics are capable of producing equol with far greater benefits than women who are not equol producers.
Evening Primrose Oil is rich in gamma-linolenic acid (GLA) that supports hormone balance and reduces inflammation that is associated with breast tenderness. It also helps to relieve emotional ups and down, night sweats and mild hot flashes. There is some evidence it may also improve skin hydration and elasticity in postmenopausal women. While results are mixed, several studies show improvements in psychological and vasomotor symptoms.
Fenugreek Seed contain natural steroidal saponins that help balance hormones, glucose levels, digestion and reduces menopausal symptoms such as hot flashes, night sweats, mood changes and loss of libido. Its active compound diosgenin possesses estrogen-like and metabolic benefits. A 2022 randomized, placebo-controlled study found that fenugreek extract improved hot flashes, mood, and sexual function in naturally menopausal women. It also showed favorable effects on lipid and glucose metabolism, supporting its broader metabolic benefits. Fenugreek in vaginal creams has also been shown to relieve risks of menopausal vaginal atrophy.
Hops contain the potent phytoestrogen 8-prenylnaringenin that can reduce hot flashes and benefit sleep in menopausal women. Hops also possess antioxidants and anti-inflammatory agents that protect the health of breast and uterine tissues. Some studies suggest combining hops with soy can enhance symptom relief. Because of its mild sedative effects, hops are more useful at night and when symptoms are accompanied by insomnia or anxiety. However, due to rare reports of endometrial thickening, women with hormone-sensitive conditions should use hops cautiously.
Licorice Root contains glycyrrhizin and the phytoestrogen liquiritigenin that help relieve hot flashes and vaginal dryness. Licorice extracts can improve vasomotor symptoms similarly to hormone therapy. Modern studies confirm reductions in hot flash frequency comparable to hormonal therapy, though effects tend to wane after discontinuation. Postmenopausal women should be cautious of long-term use of glycyrrhizin-containing licorice because it can cause fluid retention and high blood pressure. Deglycyrrhizinated (DGL) forms of licorice are safer for long-term use.
Maca is a Peruvian root traditional used to increase physical energy and libido while reducing hot flashes and sleep problems in menopausal women. It appears to act through hormone regulation rather than direct estrogenic activity. Recent clinical research confirms that maca can help reduce anxiety and improve sexual function in postmenopausal women without affecting their estrogen levels, which suggests it has adaptogenic properties.
Pycnogenol is rich in free radical antioxidant flavonoids called proanthocyanidins that are linked to better mircocirculation and lower oxidative stress, which can alleviate menopausal discomforts such as hot flashes and poor sleep. It has also been shown to improve skin elasticity and vascular flow to the skin tissue. A clinical trial found that women taking Pycnogenol for 12 weeks had significantly improved menopausal symptom scores and healthier vascular function.
Red Clover contains two isoflavones -- biochanin A and formononetin -- that help reduce hot flashes and improve cardiovascular health. A recent meta-analysis found that red clover extract (80 mg/day) significantly lowers hot flash frequency in women with more severe symptoms. It can also support healthy lipid levels and vascular function. Notably, red clover can also be consumed as a soothing tea combined with other herbs to support menopausal health.
Siberian Rhubarb Extract has been widely used in traditional medical systems and studied for its ability to relieve hot flashes, emotional swings, anxiety, vasomotor imbalances and other menopausal symptoms. It acts on an estrogen receptor that protects breast and uterine tissues. Results from several placebo-controlled trials confirm its effectiveness on the Menopause Rating Scale. A recent meta-analysis reinforced this extracts ability to improve overall menopausal symptom.
Soy Isoflavones such as genistein and daidzein act as mild phytoestrogens that preferentially bind to ER-beta receptors to support bone, cardiovascular and urogenital health. Regular consumption of soy-based foods or isoflavone supplements can reduce hot flashes and even normalize cholesterol levels. Recent randomized controlled trials show that daily soy isoflavone supplementation can lead to a 50 percent reduction in vasomotor symptoms.
St. John’s Wort is best known for its mood-lifting and anti-depressive properties; however, it can also reduce the intensity of hot flashes intensity and improve sleep quality in menopausal women. Combining St. John’s Wort with black cohosh or isoflavones may enhance benefits for both mood and vasomotor symptoms. However, it can interact with prescription medications, notably antidepressants and anticoagulants, even other hormone therapies, therefore seek consultation with a healthcare provider.
Vitex, also known as chaste tree or chasteberry, is known for normalizing the luteinizing hormone progesterone to balance hormonal cycles and reduce hot flashes, anxiety, and sleep problems in menopause. Its effectiveness is believed to due its ability help modulate dopamine and melatonin pathways. It appears to act through dopaminergic modulation, reducing prolactin and indirectly supporting progesterone activity. Although it is more commonly recommended for premenstrual symptoms, clinical studies show that combining vitex with other herbs like black cohosh and soy further advances menopausal symptom relief.
Exercise
Physical movement and exercise is a natural remedy for menopause and will calm down the frequency of hot flashes while improving mood. It is crucial to begin becoming more active before undesirable symptoms peak. Aerobic activities like dancing, brisk walks, runs, swims or bike rides will also help to maintain bone strength. In addition, resistance training can alone cut postmenopausal vasomotor symptoms by 131 percent.
“Exercise is absolutely crucial, especially after the age of forty,” says nationally renown gynecologist Dr. Northrup. “Your body is not as forgiving.” Research out of Tufts University recommends two 40-minute weight sessions per week in order to better boost bone density than estrogen medications like Premarin. The ideal is combine aerobic exercise with resistance training to best benefit the lumbar spine and hips. Dr. Northrup also shares Dr. Joan Vernikos’s insights at NASA: Standing and moving against gravity rebuilds the pelvic floor muscles and keeps the urinary tract fine tuned. Vernikos writes, “When you just start to stand up and sit down, or really increase your G force by moving your body up and down through space, this dramatically decreases urinary stress incontinence because moving through that vector of gravity strengthens the core stabilizer muscles. Even if you exercise and you sit six hours a day, which is most people, those bits of exercise that you do will not counteract the adverse effects of sitting. You need to just stand up and sit down. It’s so easy to do.” In addition, water workouts, such as swimming, match land exercises for strength, flexibility and cardio vascular health.
Finally, incorporate yoga into your daily regimen will smooth menopausal symptoms, Even doing 60 minute sessions for just twice week can improve a variety of menopausal symptoms by two-thirds in over a 10 week period. One large meta-analysis of 10 human trials concluded yoga eases overall menopausal symptoms, including sleep, anxiety, depression, body mass and blood pressure. Women may want to take note that long-term yoginis frequently out due other exercisers in heart health and a zest for life.
Stress Management
Stress doesn’t just fray nerves during menopause but also aggravates hot flashes, night sweats, sufficient sound sleep, and emotional storms by spiking cortisol, which disrupts women’s natural progesterone balance. Fortunately, mindful stress management practices will restore the resilience to handle stress. Adapting your life to a stress managing routine can boost quality sleep, overall mood, self-esteem and confidence to take greater ownership of your life.
Beyond its physical advantages, yoga can reduce anxiety and depressive blues by rewiring stress responses. Research confirms yoga improves symptoms associated to menopausal and postmenopausal stress across the board and increases women’s sense of genuine well-being and happiness.
Meditation, especially those in the mindfulness category, calms down the inner mental chatter that women so often entertain when their hormones are creating havoc. By lowering cortisol, positive moods emerge. A meta-analysis of randomized trials found mindfulness-based meditations eased menopausal symptoms by over 200 percent and increased women’s quality of life; on an average of 8 weeks, anxiety, depression and stress are remarkably reduced. Another analysis of 1,005 peri- and postmenopausal women observed a decline in sleep disturbances by nearly a half.
Qigong is an ancient Chinese gentle flow exercise that coordinates breath and movement to cultivate inner energy to soothe menopause symptoms. Tina Chunna Zhang, founder of the Qi Gong Center for Women in New York City and author of several books on the martial arts, shares, “You do this in the morning and in the evening, at least twice a day. It’s very simple. You stand up with feet parallel to the ground and keep both feet apart about shoulder width, and then you relax your body. You relax your mind as well. Your hands come up in front of you like you’re holding a beach ball. Your palms face yourself in front of your chest. Then you start to take a deep inhale all the way through your nose while your arms rise upwards. Keep them moving upwards when you’re inhaling. Then when you exhale, your arms go downwards from the side. You also exhale all the way through your nose. Repeat this about eight to sixteen times.” A review of 35 trials investigating qigong, in particular the Baduanjin form, concluded it eased perimenopausal depression and anxiety, and improved sleep, by 64 percent.
Homeopathy
Homeopathy remains a popular natural therapy among women seeking a more gentle approach to their transition through menopausal. The choice of remedy depends upon the woman’s unique physical, emotional and mental profile. According to the late Dr. Ken Korins, a classically trained homeopathic physician in New York City, only one remedy should be used at a time for best results. “Sometimes it’s a matter of trial and error,” Dr. Korins explained. “If one does not work, another can be tried.”
While clinical evidence for homeopathy has historically been mixed, several modern studies suggest that individualized or complex homeopathic remedies can help relieve menopausal vasomotor and mood symptoms. A 2022 systematic review found that women receiving individualized homeopathic treatment reported measurable reductions in hot flashes and sleep disturbances compared to placebo. In a 2023 randomized controlled trial, a complex homeopathic formula containing Lachesis mutus, Sepia officinalis, and Sanguinaria canadensis significantly improved the peri- and postmenopausal women’s quality of life scores after eight weeks.
For hot flashes, Lachesis suits women who feel intense internal heat, which is often worse during the day. Belladonna is recommended when hot flashes cause facial flushing, throbbing headaches, and sensitivity to light. Glonoine (nitroglycerin) helps when the hot flashes are accompanied by pulsating head pressure and anxiety. Manganum may be suggested to relieve hot flashes accompanied by fatigue and melancholy.
For vaginal dryness and thinning, Sepia is the primary remedy when there is pelvic heaviness and emotional withdrawal. On the other hand, Natrum muriaticum is preferred when dryness is accompanied by depression and a desire to be alone. Bryonia may be taken when motion aggravates pain.
Homeopathic medicines are most effective when a proper evaluation is conducted by a professional homeopath.
Aromatherapy
“Aromatherapy is truly holistic because it is a mind-body treatment,” says Ann Berwick, author of Holistic Aromatherapy and Women’s Health. “I think this is part of the secret of its power.” Berwick uses essential oils to help alleviate hormonal imbalance and emotional upheaval in women going through menopause. For example, cypress, fennel, and clary sage are believed to have estrogen-like effects.
Modern research supports aromatherapy’s benefits. A 2021 randomized controlled trial found that postmenopausal women who received daily inhalation of clary sage and lavender essential oils for four weeks had significantly fewer hot flashes and better sleep quality compared with a placebo. Essential oils such as fennel and clary sage have also been found in laboratory studies to mildly bind to estrogen receptors; this likely explains these oil’s balancing effects on emotional swings and thermoregulation.
Beyond hormonal support, aromatherapy appears to influence the autonomic nervous system. Inhaling lavender and bergamot oils can lower heart rate and reduce cortisol levels to support stress management. As Dr. Berwick notes, “When women take a few moments each day to breathe in a scent that calms their nervous system, they reconnect with themselves—and that may be one of the most healing aspects of menopause.”
Aromatherapy is best used as a supportive therapy. Essential oils can be diffused in the air, added to baths, or diluted with carrier oils for massage. Oils should always be used in low concentrations, and women with allergies or hormone-sensitive cancers should consult a medical practitioner before use.
Reflexology
Laura Norman, a certified reflexologist from New York City, explains: “For menopause, in addition to working the reproductive organs, I would also encourage you to work your thyroid gland, as this will help take over when the ovaries produce less estrogen. This is how to find this point: the base of the toes reflects the neck area where the thyroid is located. Press your thumbs into the base of your toes and thumb-walk across that ridge, particularly in the base of the big toe. Another area to massage is the adrenal gland reflex point. You are on the big toe side of the foot. Go about a third of the way down your foot. You are under the ball of the foot, in line with the big toe. If you press your thumb into that area, it will provide energy when you feel fatigued. Also, the pituitary gland, which helps all the other glands to work, is located in the center of the big toe. Pressure applied there helps stimulate that area. Both feet should be massaged equally.”
Contemporary medical evidence supports reflexology as a relaxing, noninvasive therapy that can help relieve common menopausal complaints. A meta-analysis of controlled trials found that foot reflexology in particular reduced hot flash frequency, night sweats, fatigue and anxiety in menopausal women compared with sham or control treatments. Another randomized controlled study showed that 12 reflexology sessions over a six week period improved sleep quality and reduced depressive symptoms in postmenopausal women.
Research suggests that reflexology works by stimulating nerve endings in the feet that correspond to internal organs and endocrine glands thereby promoting better circulation and autonomic balance. There is also some evidence it can reduce cortisol and blood pressure while enhancing relaxation responses. For this reason reflexology can be a valuable adjunct therapy for managing both the physical and emotional transitions women go through during menopause.
Reflexology can be practiced by a trained therapist or through simple self-massage at home. Regular practice can complement other natural approaches such as exercise, yoga, diet and aromatherapy to enhance a smoother menopausal transition.
Gary Null’s Natural Menopause Solution
In my eighteen-month study using a strict program of an organic plant-based diet, cleansing and detoxifying, women who had been postmenopausal returned to a premenopausal state of health or improved their premenopausal symptoms. The women were eating no animal proteins, sugar, caffeine, or processed food; exercising six days a week for an hour; drinking lots of fresh organic juices; and taking certain herbs. Skin wrinkles were diminished, energy restored, human growth hormone was back, hormones were balanced and status was improved. The gray, thinning hair of one seventy-one-year-old woman grew back brown and thick. Another woman had had a low libido, and her mucous membranes had been dry, as was her skin. Her skin and mucous membranes regained moisture, and she enjoyed a level of health and energy that she hadn’t experienced for years. Her toenails and fingernails, which had been brittle, yellow, and cracked, became pink and fresh. This was all without medication or any hormone replacement therapy. We just gave her body a chance to rebalance itself; we honored it by not giving it anything that would have led to an imbalance.
First and foremost, my program involved eliminating all dairy from the diet in every form. Women were told to read labels and make sure there was no casein in products because casein and whey are dairy. Women also eliminated wheat in any form. Then I had them eliminate all meat, sugar, fried foods, carbonated beverages, chicken, artificial sweeteners, and caffeine. They couldn’t use the hydrogenated fats any longer.
Over the next six months, I introduced certain supplements. But the program was more than about supplements. It was about cleansing the system: taking the body burden of all these highly denatured foods and getting them out of the system. Once you stop something that is negative, it doesn’t mean that the negative consequence is automatically gone. If you stop drinking fluoridated water and you’ve been drinking it your whole life, you still have all that fluoride built up in your body and with it a lot of lead as well. So first was elimination. Get rid of what’s causing an assault on the body. Why? Many of these things are hormone disruptors. They can disrupt how the body creates hormones and utilizes them. Menopause is really about hormonal changes. So anything that could limit the radical shift in hormones could at the same time help the body.
Within three weeks, people talked about having more energy. Within two months, they were losing weight. They were sleeping better and having more energy. By four months people were talking about how their moods changed. They were feeling better. They no longer had the highs and the lows. They no longer had the anxiety and mania. They no longer had depression. By half a year, they were seeing changes in their skin. Aging spots were diminishing. Vision was improving. Body functions were working better. Localized joint inflammation was gone. They were breathing better. Their digestion was improved. We had people talking about their hair. There was one woman who showed everyone her hair. She had gray hair on the outside, but near the roots for about a quarter of an inch was natural black hair. She hadn’t seen any black hair coming out of her head in twenty years. Here it was all over her head. So in effect the body was rejuvenating. It was de-aging. She was not the only one. One woman who was fifty-four said that she would be afraid to shampoo her hair because of how much hair would come out of her head. She had been going bald but it was filling back in again.
People started realizing that there was a rejuvenation process involved here. It was really doing something terrific. The weight across the room was just pouring off people. Why? I wasn’t starving them. They were having plenty of food to eat, but it was the quality of the food. There were lots of live energy foods: fresh fruits and vegetables, fresh fish, fresh spices, grains, beans, legumes, and tubers. We had a class on making cooking more interesting using different types of oils: toasted sesame, garlic lemon, sweet basil and black pepper oil. They started using more grains and more beans.
I heard about how their varicose veins went down, spider veins went away, and bruising was no longer the case. Receding and bleeding gums stopped. Teeth became firmer. All of this was accomplished without ever using new drugs or medications. It was just lifestyle. They were exercising using both weights power resistance like power walking, jogging, or biking. They were also taking some time to deal with the stress in their lives. Most people don’t realize how destructive stress is. Stress creates cortisol. Cortisol blocks progesterone. That allows estrogen no longer to have something that is blocking it and keeping it in check. That makes you more susceptible to breast cancer, endometriosis, and ovarian cancers.
I even showed them ways to make interesting juices. Get a bunch of your favorite fruit and throw it in a blender. Put in some soy or rice protein powder, and throw in a B complex of 100 milligrams. Throw in some vitamin C. Throw in a banana and blend it all up with some juice, rice, or soymilk and you’ve got an energy shake that’s filled with phytochemicals. The more phytochemicals you put in your body the more natural hormone rebalancing you’re going to do. In effect every glass of fresh fruit juice and every glass of fresh vegetable juice is helping you remain younger longer. It has the phytoestrogens, the natural plant based ones, which protect you against cancer, and keep you more youthful.
Among the supplements I used was beta-1, 3-D glucan, which helps in marrow production and is great for the immune system. I don’t believe there is anything you can put in your body that is as good for your brain and heart as Coenzyme Q10. Then, of course, the mother of all hormones, DHEA, at 25 to 50 milligrams, helps your body protect you against cancer, heart disease, and diabetes. It is crucial on all levels. You’re going to be less susceptible to fluctuations in insulin and cortisol, and all these other bad hormones. You’re going to slow down the aging of the brain. It also helps raise the levels of circulating beta-endorphins known to decline with menopause, so quite simply you feel better.
I would also add in the essential fatty acids like primrose oil, borage seed oil, and flaxseed oil, generally about 1,500 milligrams. Start the day with some rice protein and folic acid at 800 micrograms, Vitamin E with tocotrienols at 400, boron at 3 milligrams, calcium magnesium at 1,000 milligrams, and quercetin generally 2,000 milligrams a day. Most women are deficient in potassium. They need potassium for energy.
You need vitamin C throughout the day. Remember you’re creating free radicals all the time, twenty-four hours a day. Free radicals are what cause your cells to become inflamed and damaged. So the more free radicals you have, the more damage you’re going to have and the more disease you’re going to produce. Also, the quicker you’re going to age, and the more you’re going to be sick. Free radicals can be stopped or limited with antioxidants. Chinese green tea and bilberry extract, n-acetyl cysteine, and glutathione trap the free radicals. Alpha lipoic acid should be at the top of most people’s list of things they should have in their system. Take melatonin at nighttime, generally 1 to 3 milligrams. Aloe vera is quite simply one of the five most important immune boosting, antiviral, antibacterial superstars of nutrition. Take two ounces of aloe vera twice a day. Additionally, the women took black cumin seed oil to assist in decreasing inflammation throughout their bodies as well as curcumin to help protect their DNA.
We also had the women take some things to enhance libido, like black cohosh, cramp bark, dong quai, and Siberian ginseng. Chickweed, dandelion greens, fennel, sage, and squaw vine are terrific at rebalancing naturally the hormones. Gotu kola and dong quai relieve hot flashes, vaginal dryness, and even depression.
The more of the red fruits you consume or the powdered concentrates of red fruits, the more repair to your DNA, and that’s what we want to do. We want to repair the DNA. Now it’s done slowly. It’s done over a period of time, but yes it can be repaired.
These women also exercised every day. They dealt with stress every day. They focused upon positives and the things they could control. The results were amazing.