Menopause: Is it hot in here, or is it just me?!

Catch yourself saying this often? There is a logical explanation for it...hormones!

Menopause is a normal physiological change women experience at some point in their life. It is not something we should try to prevent but also not something we have to ignore. Several things can help women adapt to these hormonal changes. The typically age of menopause is 51, but it is normal to experience symptoms 5-6 years on either side. Women can also be jolted into menopause at an earlier age due to such things as a bilateral oophorectomy (removal of both ovaries), chemo/radiation or even a very stressful event. Also, all women experience menopause differently, which is why individualized treatment is important to see the greatest improvement.

Common/classic symptoms:



  • changes in your menstrual cycle
  • hot flashes/night sweats
  • sleep disturbances
  • vaginal dryness
  • low libido

Other symptoms that may be associated with menopause:

  • anxiety/depression
  • memory issues
  • urinary incontinence
  • weight gain
  • skin/hair changes (dry skin; more or less hair)
  • fatigue
  • joint pain
  • headaches
  • dry eyes

What is happening?

A little terminology: Perimenopause is the period immediately before menopause, starting with changes in the menstrual cycle and ending 12 months after the final period. Postmenopause begins after the final period. Menopause encompasses all of this.

During our childbearing years, our bodies secrete estrogen, progesterone and FSH (among other hormones) to regulate our cycle, produce an egg, stimulate ovulation and create a menses every month. As we age, the number of ovarian eggs decrease and these hormones begin to change. FSH levels initially rise during perimenopause, then progesterone levels begin to decline (less produced in your ovaries). This typically initiates a longer, heavier and/or less frequent period. Finally, close to the end of perimenopause, estrogen levels decline, causing those dreaded hot flashes/night sweats and dryness (everywhere!). The variety of different menopausal symptoms occur as these hormones have many effects in our body and there is a strong connection between your sex hormones and stress hormones. 

What can you do to improve your symptoms?

About 75% of menopausal symptoms can be managed with non-hormonal strategies, including diet, herbs and lifestyle changes. 


  • Eating a whole foods colourful diet is always a good start to ensure adequate nutrients. 
  • Adding omega 3s, found in fish/fish oil, nuts and seeds will help decrease inflammation causing more severe menopausal symptoms. Several studies have shown a decrease in hot flashes and depression with omega 3s. 
  • Flax seed is a good source of omega 3 but also acts as a pytoestrogen (mimic or blocks estrogen depending on what is needed). In this case, it mimics estrogen to minimize symptoms. One tablespoon ground per day is an adequate dose.
  • Eating adequate good fats is important for hormone synthesis but will also help with lubrication. Think oils, butter/ghee and avocado. 
  • Finally, noticing symptom triggers and avoiding them as much as possible is key. Common hot flash triggers are alcohol, caffeine and spicy food. 

Herbs: Several botanical herbs have been studied around their effectiveness on menopausal symptoms and may be all that is needed.

  • Black cohosh has been shown to decrease several symptoms including hot flashes/night sweats, joint pain and depression and is safe in breast cancer.  
  • More recently Maca has popped up and has been shown to have the most effect on low libido. 
  • Saint John's Wort is very effective in taking "the edge off" if you are feeling anxious or depressed, as well as improving hot flashes.
  •  Considering the connection to the adrenal (stress) gland, Ginseng or Ashwagandha may be the right herb. It acts on the adrenal glands to improve psychological well-being, fatigue and sleep.
  • Finally, Valarian can be taken in combination with any of these herbs for insomnia due to night sweats.

These herbs are just a few herbs I tend towards for my patients. Consult an ND to find the right herbs and doses for you.

If diet and herbs have not made a significant change in your menopausal symptoms, bio-identical hormonal therapies, or conventional medication may be indicated. Bio-identical hormones mimic our natural hormones to elicit the same physiological response. The dose is dependent on the individual. Hormonal therapy and medication can have both benefits and risks. I recommend starting with the most natural strategies and work from there. 

Remember this is a new phase of life, meaning an opportunity to reassess your health status as well as create new life goals for this next phase. I am solely here to help you along the way.

In health & happiness, 

Dr. Karen