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Changing our approach to the menopause

29 Jul 2022

What do you know about the menopause and how to support those going through this period of great change? In this 10-minute read, we dive into recognising signs of the menopause, the menopause in the workplace, preparing for the menopause and an integrative toolkit to relieve symptoms using herbal remedies, nutrition, exercise, mental wellness and conventional treatments. These are the main takeaways from my chat with Dr Anne Henderson on the Doctor’s Kitchen Podcast.

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Signs and symptoms of the menopause

Symptoms are messages from the body to tell you what’s going on – inform you about the biological changes in hormone levels and body function. They are key to understanding what is happening in the body to smooth the menopausal transition.

Although we usually associate the menopause with hot flushes, women may experience a wide range of signs. These can be physical, psychological and emotional such as headaches, sleep disturbances, anxiety, brain fog, and forgetting words. Some people have elements in all 3, others only experience a few symptoms. Understanding menopausal symptoms and why they happen promotes better support to thrive during this transitional period.

Support through the menopause

As explained by Dr Anne Henderson, the menopause is a time of great biological, physical and emotional change. Those going through the menopause may experience symptoms of varying intensity. Support through the different stages is essential to make the transition smooth and reduce the impact on personal and professional life.

On the personal level, the menopause can be a time to focus on yourself, connecting to your body and its needs. Adapting to the changes happening in your body may drive you to make some changes in your lifestyle and how you look after your health. We will dive into some tools to support your physiology through hormonal changes, including herbal remedies, nutrition, exercise, mental wellness practices and conventional treatments.

Family and friends of those going through the menopause also play a key role in helping smooth the transition. Recent campaigns such as the Make Menopause Matter campaign have been advocating for better menopause education to increase awareness and provide better support.

Key things to understand about the menopause

1/ The menopause can start before the age of 45

Some people go through premature or early menopause before the age of 45.

2/ The menopause impacts physical, psychological and emotional health

Menopausal symptoms can vary considerably between people and may impact quality of life, performance at work, social relationships and overall wellbeing. Those going through the menopause may struggle physically because of poor sleep, digestive problems and vasomotor symptoms like hot flushes and night sweats. Psychologically, they can experience brain fog and cognitive changes, struggling to do things they have done for years which can cause embarrassment, fear and worries.

3/ Those going through the menopause are not under-performing

Menopausal symptoms can obstruct your ability to perform your job. Appropriate support, understanding and openness can make a huge difference.

The menopause in the workplace

In the workplace, there are important steps that businesses, organisations and employers need to talk about to better support their team. These include:

1/ Education about the menopause

Workplaces need to educate their leaders and team member about the menopause, including premature and early menopause that can affect women in their 30s and early 40s, and how the menopause impacts physical, psychological and emotional health.

2/ Understanding that menopausal symptoms can obstruct your ability to perform your job

3/ Implementing measures to support those going through the menopause

Increasing menopausal awareness can support the introduction of measures that make a huge difference, such as work flexibility, working from home, fans in the office, education in the workforce, etc.

Adapting to your body changes – an integrative approach to the menopause

The menopause is a normal transition from fertility to post-fertility that requires adapting to varying body needs. Once you are aware of the changes happening in your body as you transition through the menopause, you can start finding tools that will support your body and relieve symptoms. This is an ideal time to make positive changes to how you look after your health and wellbeing with the help of health professionals and those around you. Dr Henderson talked about the importance of taking a fully integrated and personalised approach to menopausal care, blending herbal medicine, nutrition, physical activity, mental wellbeing and conventional medicine.

Why an integrative approach is important

  • Relying solely on conventional treatment options may not address the wide range of symptoms of varying intensity experienced during the menopausal transition
  • Hormone replacement therapy (HRT) is not a treatment of choice for all, being contraindicated for some people (ref)
  • Although great importance is placed on reduced oestrogen levels associated with the menopause, oestrogen is not the only hormone affected. The approach of the medical herbalist and other complementary tools may provide support to a variety of tissue or organ sites other than solely replacing estrogen.
  • The treatment of menopausal symptoms requires a variety of therapeutic tools that are adapted to the individual rather than one size fits all

Integrative tools to relieve symptoms of the menopause

The first step when personalising your menopause journey is to work out the 5 key symptoms that are affecting your personal and professional life. The goal is to find tools to manage those using an integrative approach, ie. the pillars of herbal medicine, nutrition, physical activity, mental wellbeing and HRT. Recognising and understanding your symptoms allows you to know what you’re trying to deal with rather than a scattered approach to trying everything and focusing on different approaches for your specific symptoms.

Herbal remedies for the menopause

Various herbal remedies have been studied for their effects on menopausal symptoms including hot flushes, night sweats, mood swings, anxiety and skin changes. Herbs like black cohosh, red clover and sage were associated with reduced hot flushes and night sweats. For more examples of herbal remedies, read Natural Menopause written by Dr Anne Henderson and contributing experts.

Guidance for choosing herbal remedies

1/ Do your background research

There are over-the-counter preparations but doing background research is really important to choose the right remedy for you. All herbs are not completely safe all the time. It’s important to research contraindications, especially if you have a high risk of certain diseases. For more guidance on safely taking herbal remedies, read this NHS article.

2/ Buy remedies covered under the umbrella of THR (Traditional Herbal Registration) granted by the MHRA which regulates prescribed drugs

Capsules come in a huge range of qualities. Remedies that are THR certified reach a much higher standard and are fully regulated.

3/ Start with a herbal infusion in small amounts throughout the day

A tisane or herbal infusion is the weakest form of herbal therapy. It works well as an introduction to see how you feel while still getting some of the properties.

4/ If you can, see an experienced herbalist and get a personalised blend

Nutrition during the menopause

Diet is thought to play a role in the severity and frequency of symptoms experienced during the menopause. Studies evaluating dietary patterns showed an association between lower intensity of psychological symptoms, sleep disorders, and vasomotor, urogenital, and somatic symptoms and higher consumption of vegetables, whole grains, and unprocessed foods. (ref)

For more details, read Eating and the menopause, written by our contributor Dr Harriet Holme.

Foods that can help support hormone regulation and help with managing menopause symptoms:

  • Sources of magnesium – green leafy vegetables like spinach, wholegrains, pumpkin seeds, almonds and beans
  • Sources of omega-3 fatty acids – Oily fish, flaxseeds
  • Sources of B vitamins – Eggs, poultry, leafy greens
  • Plants that contain phytoestrogens – soybeans, flaxseeds, sesame seeds, chickpeas.

Exercise and mental wellness

Some examples of integrative approaches that treat specific symptom categories

Brain fog and energy

Part of the reason women experience brain fog and low energy is sleep deprivation, which needs to be addressed. Calming herbs can be helpful in the evenings such as valerian and camomile. In the morning, ashwagandha can be used to create energy for the day ahead.

Cognitive symptoms

To treat cognitive symptoms, it’s important to look at nutrition and whether there are any deficiencies in vitamin D, folate, B12 and ferritin. Many women are deficient in these nutrients even if they are taking supplements. Low levels of these are involved in many issues. For example, low vitamin D is linked to depression.

Weight gain

Middle-age weight gain can be a consequence of loss and muscle tone and mass. It’s important to look at the diet and ensure the intake of quality protein.

The next stage – how long the menopause lasts

Going through the menopause can be scary and overwhelming. The body goes through complex physiological changes over many years that mark the beginning of a new stage of life. But the body will settle to the ‘new normal’ and symptoms will change with time. This is why developing a therapeutic toolkit that works for you is essential to thriving through the change.

Find out more

For more, listen to #157 Natural Menopause Remedies with Dr Anne Henderson and check out her brilliant book Natural Menopause, full of illustrations, tips and practical advice from a trusted professional.

Some resources to dive deeper

Natural Menopause book

https://gynae-expert.co.uk/videos-media/

Research papers

Herbal medicine

A prospective audit of pragmatic herbal treatment of women experiencing menopausal symptoms using measure yourself medical outcome profile (MYMOP2) questionnaires - Journal of Herbal Medicine - 2019

Green J, Denham A, Ingram J, Hawkey S, Greenwood R. Treatment of menopausal symptoms by qualified herbal practitioners: a prospective, randomized controlled trial. Family Practice. 2007

​​Investigation of the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms: An evidence-based systematic review study

Nutrition

Guidelines for dietary management of menopausal women with simple obesity. Przegla̜d Menopauzalny= Menopause Review. 2015

Healthy eating and the menopause - British Nutrition Foundation

A Natural Approach to Menopause - Physician committee for responsible medicine

Exercise

The effects of differing resistance training modes on the preservation of bone mineral density in postmenopausal women: a meta-analysis. Osteoporosis international. 2015

Is exercise an effective therapy for menopause and hot flashes?. Menopause. 2016

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