Menopause can be a really rough transition for many women. It is the time in a woman’s life when she has not gotten a period in 12 months. The time leading up to menopause is called perimenopause. During this time, a woman may begin experiencing irregular periods, changes in mood, hot flashes, lowered libido and more. Once a woman has not gotten a period after one year, she is considered post-menopausal.

Many symptoms can begin to manifest as a woman enters this stage in her life, which begins on average around 45 years old. Symptoms may include dry skin, insomnia, weight gain, changes in mood, brain fog, vaginal dryness, loss of sex drive, insomnia, night sweats and fatigue. How can all of these symptoms happen from just a period stopping? Perimenopause marks the time when the connection between the ovaries and brain begins to break down.

Once a woman enters menopause, the ovaries stop producing estradiol, the dominant estrogen prior to menopause. The adrenal glands and fat cells take over as the dominant producers of estrogen in the body, although not nearly as much estrogen is made as the ovaries once did. This drop in estrogen is one of the main reasons why many American or Westernized women are experiencing a less than ideal transition into menopause.

Why “Westernized” women? Women in many other cultures and countries do not experience these symptoms as they transition into life without a menstrual cycle. Studies have been done to decipher why that is. For example, Asian women have a much easier transition into menopause. The studies concluded the reason for this was due to their largely plant-based, low-fat diet. However, this is not the case for Asian women who have adopted American eating habits. This is because this diet has a much higher consumption of fat, especially from dairy and meat. They actually have higher estrogen in general due to this reason. The studies concluded that Asian women actually have a much less dramatic drop in estrogen after menopause because they had less to begin with. This makes the change much easier for them. Westernized women experience a more drastic drop in estrogen, making symptoms much worse.

Another reason women have a harder time transitioning into menopause has to do with our adrenal glands. The adrenal glands are two small organs, with one sitting above each kidney. These small but powerful glands are responsible for secreting our stress hormone, also known as cortisol. Due to the high demands of life women now experience in Westernized lifestyles, by the time they enter menopause, many of their adrenals are overloaded. Women these days are working, taking care of children, running a household and more. By the time menopause comes around, many women are burnt out. Adrenals also secrete small amounts of sex hormones. However, due to this adrenal burnout or adrenal fatigue, women are secreting even less estrogen than they are supposed to, making transitioning worse.

There are also many biochemical reasons for estrogen. There are three different forms of estrogen, some higher than others at different stages in a woman’s life. This hormone in general though plays a large physiological role in the body. For instance, many women experience dry skin and vaginal dryness after menopause. This is due to the fact that estrogen is very lubricating in the body and actually increases collagen production. Another factor for women is how they feel mentally after this transition. Often reported symptoms include brain fog, anxiety, depression and irritability. Estrogen binds to receptors in the brain and is an important factor when it comes to serotonin and dopamine production, our “feel good” hormones. With the loss of estrogen, a woman may feel completely different.

With the drop in estrogen also comes the redistribution of fat cells from the hips and thighs to a woman’s mid-section. Many women report a significant increase in weight gain around the abdomen after menopause. This is due to the change in hormones systemically. Having more weight around the abdomen actually puts women at higher risk for cardiovascular disease.

The other big hormone drop for women is the hormone progesterone. Besides playing a part in a woman’s menstrual cycle and maintaining a healthy pregnancy, progesterone is vital for many central nervous system functions. Cognitive processes and sleep are two of the biggest areas where progesterone is essential. New issues with memory and insomnia begin to arise for many women once they begin going through this life transition. In addition, the loss of estrogen and progesterone together results in a loss of bone mass for many women.

Now that we know much more about menopause and why we may feel the way we do, it is important to know that there are many natural treatments available so we can once again feel “normal.” These include natural hormonal replacement therapies, nutritional supplements, lifestyle and dietary changes, stress management tools, and more.

The best treatment in general is prevention. It is important to take steps now before menopause to maximize health before the drop in hormones eventually occurs. This may include a high-fiber, low-fat diet for starters. By consulting with an integrative or naturopathic doctor before the transition, we can take better steps now to diminish symptoms during menopause.

Dr. Shannon Homkovics is a naturopathic physician, specializing in endocrinology with a focus on women’s health care. She is the co-owner of Restoration Health PLLC, located at 12 Village St., Ste. 3, North Haven, CT. For more information and to make an appointment, connect at 203-239-3400 and

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