Written by Dr. Jordan Robertson, ND
Transitioning through menopause happens for most people between the ages of 49 and 52 and marks the end of the production of hormones such as estrogen and progesterone. 1 This time for many people brings both positive and negative experiences and symptoms that can affect her life in many ways. People spend a third of their lives in the menopausal phase 1 and benefit from learning resiliency and self-compassion for this hormonal life transition.2–4
For some people, the menopause transition creates hormone stability and a relief from symptoms associated with the monthly cyclical hormone release. Symptoms such as breast tenderness and menstrual migraines may improve as the menopause transition begin and ovulation becomes less frequent. Without ovulation, the hormone changes that contribute to PMS are not produced and people may feel better than they do when they are cycling every 28 or so days. For others, the loss of hormone production brings new symptoms, and people may experience hot flashes, night sweats, insomnia, mood changes, changes to mood, lower sexual function and vaginal dryness. Symptoms of menopause can last upwards of 8-10 years, and in some cases, such as vaginal atrophy, they never resolve.5
People transitioning through menopause are often seeking solutions to their symptoms including natural and botanical options to help their body feel supported during this time. Menopause can be considered a time to celebrate the end of hormonal changes and a new awareness of the body if symptoms are not clouding how wonderful this time can truly be for people. Support for menopause symptoms can be safe and effective, helping people get back to enjoying this important life stage.
Vaginal tissues are sensitive to estrogen and the loss of estrogen at menopause impacts the health of vaginal tissue and disrupts the type of bacterial flora in the vagina.6 Symptoms of vaginal atrophy may feel like a new discomfort during intercourse or during exercise. Lubricants can support the maintenance of healthy sexual function in people after menopause by reducing pain during intercourse or providing vaginal moisturizing throughout the day.
The exact cause of hot flashes has been difficult to understand, even with decades of research. Low levels of estrogen during menopause influence the temperature regulation areas of the brain and cause flushing even with minor changes to body temperature.7 Sage (Salvia) is the best studied non-hormonal option for hot flashes. Using sage for 4 weeks reduces the frequency, severity and how long hot flashes last (duration) in people both in the daytime and overnight.8–10 Hot flashes are a frustrating experience during menopause and often people are hoping for a quick solution to get back to feeling like themselves. Like most treatments for hot flashes, Sage can take 4 weeks of consistent use to see a reduction in hot flashes.
Changes to sleep during menopause are not solely caused by hot flashes – which is a common myth. The changes to both sleep and mood are independent of hot flashes, although certainly frequent night sweats and hot flashes worsen the already-difficult sleep in people in menopause.11 Sleep depth and stages are reliant on estrogen and progesterone, and the loss of these hormones once ovulation finishes can create difficulty falling or staying asleep.12 Melatonin is a natural hormone produced by the pineal gland in the brain. It regulates sleep-wake cycles and has been studied in people during menopause to support sleep quality and daytime energy.13 People in menopause may need to focus on their sleep routine, caffeine or alcohol use more than during other phases of their lives given the hormone changes they are experiencing.
Sexual health is not only impacted by vaginal dryness with many people reporting a loss of interest and pleasurably of sex during menopause. Herbal medicine such as Tribulus has been studied during menopause and has shown an increase in reported sexual function and libido14–16. Tribulus increases testosterone levels and supports a healthy libido, improved sexual desire and improves orgasm in people transitioning through menopause14–16.
Menopause can be a time of celebration in people as they reach their potential in many areas of their career, family, and personal life. The personal wisdom and confidence that comes at this time can often be overshadowed by symptoms that leave people feeling like a visitor in their own body. The symptoms of menopause can be safely and effectively supported with botanical medicine and nutritional supplements that have been studied during this hormone transition to improve symptoms and quality of life to help people enjoy the celebration that menopause and aging truly are.
Smart Solutions Product Partners:
- Koothirezhi, R. & Ranganathan, S. Postmenopausal Syndrome. in StatPearls (StatPearls Publishing, 2021).
- Brown, L., Bryant, C., Brown, V., Bei, B. & Judd, F. Investigating how menopausal factors and self-compassion shape well-being: An exploratory path analysis. Maturitas 81, 293–299 (2015).
- Hoga, L., Rodolpho, J., Gonçalves, B. & Quirino, B. Women’s experience of menopause: a systematic review of qualitative evidence. JBI Database Syst. Rev. Implement. Rep. 13, 250–337 (2015).
- Włodarczyk, M. & Dolińska-Zygmunt, G. Searching for predictors of sense of quality of health: A study using neural networks on a sample of perimenopausal women. PloS One 14, e0200129 (2019).
- Peacock, K. & Ketvertis, K. M. Menopause. in StatPearls (StatPearls Publishing, 2021).
- Angelou, K., Grigoriadis, T., Diakosavvas, M., Zacharakis, D. & Athanasiou, S. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data. Cureus 12, e7586 (2020).
- Bansal, R. & Aggarwal, N. Menopausal Hot Flashes: A Concise Review. J. -Life Health 10, 6–13 (2019).
- Bommer, S., Klein, P. & Suter, A. First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Adv. Ther. 28, 490–500 (2011).
- Dadfar, F. & Bamdad, K. The effect of Saliva officinalis extract on the menopausal symptoms in postmenopausal women: An RCT. Int. J. Reprod. Biomed. Yazd Iran 17, (2019).
- Zeidabadi, A. et al. The effect of Salvia officinalis extract on symptoms of flushing, night sweat, sleep disorders, and score of forgetfulness in postmenopausal women. J. Fam. Med. Prim. Care 9, 1086–1092 (2020).
- Proserpio, P. et al. Insomnia and menopause: a narrative review on mechanisms and treatments. Climacteric J. Int. Menopause Soc. 23, 539–549 (2020).
- Lee, J., Han, Y., Cho, H. H. & Kim, M.-R. Sleep Disorders and Menopause. J. Menopausal Med. 25, 83–87 (2019).
- Treister-Goltzman, Y. & Peleg, R. Melatonin and the health of menopausal women: A systematic review. J. Pineal Res. e12743 (2021) doi:10.1111/jpi.12743.
- de Souza, K. Z. D., Vale, F. B. C. & Geber, S. Efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: a randomized, double-blinded, placebo-controlled trial. Menopause N. Y. N 23, 1252–1256 (2016).
- Tadayon, M., Shojaee, M., Afshari, P., Moghimipour, E. & Haghighizadeh, M. H. The effect of hydro-alcohol extract of Tribulus terrestris on sexual satisfaction in postmenopause women: A double-blind randomized placebo-controlled trial. J. Fam. Med. Prim. Care 7, 888–892 (2018).
- Vale, F. B. C., Zanolla Dias de Souza, K., Rezende, C. R. & Geber, S. Efficacy of Tribulus Terrestris for the treatment of premenopausal women with hypoactive sexual desire disorder: a randomized double-blinded, placebo-controlled trial. Gynecol. Endocrinol. Off. J. Int. Soc. Gynecol. Endocrinol. 34, 442–445 (2018).