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This Might Be The Reason Your Menopause Symptoms Won't Let Up

Wendie Trubow, M.D., MBA
Updated on September 3, 2020
Wendie Trubow, M.D., MBA
Functional Medicine Gynecologist
By Wendie Trubow, M.D., MBA
Functional Medicine Gynecologist
Wendie Trubow is a functional medicine gynecologist with almost 10 years of training in the field. She received her M.D. from Tufts University.
September 3, 2020

The majority of women experience hot flashes, night sweats, heart palpitations, interrupted sleep, and irritability in menopause. And for a large portion of women, these symptoms either pass on their own, or they opt for hormone replacement therapy, which can reduce or eliminate their complaints.

But then there are the patients who wind up in my office: the ones whose hormone levels are ideal, who faithfully take their meds, and who still have hot flashes, night sweats, or heart palpitations. These women inevitably come in and ask for higher doses or a change in meds. I'm happy to oblige, but after two or three tries, I want to address the elephant in the room: It's not the hormones they think that are causing the problems. Instead of an issue with their female hormones like estrogen and progesterone, it's a dysfunction in their stress hormones—likely caused by adrenal fatigue.

While it's important to note that adrenal fatigue is not recognized as a legitimate condition by the traditional medical community, it's a diagnosis I do use in my functional medicine practice. The good news is that adrenal fatigue is fixable. The bad news is that it requires you to do less, rest more, and stop pushing yourself so hard. Because the hormones that are likely out of balance are your adrenal hormones, which come from your adrenal glands, what you have is adrenal fatigue or adrenal stress. In my private practice I frequently see individuals who have asked too much of their bodies, slept too little, worked too much, stressed too much, had too much alcohol, or simply crossed the line of what their individual body can handle in a day.

So what's a woman to do? Well, first, I recommend finding yourself a good functional medicine provider to help you find the best course of treatment.The overall goal is supporting your adrenals so that they can properly function and not be stressed. While you are waiting for your appointment, I recommend the following:


Stop drinking alcohol.

It's time to say goodbye to wine, beer, and mixed drinks for a while. Not only do they stress the adrenals, but they raise your blood sugar—which is inflammatory and puts additional pressure on the adrenals.


Get to bed on time.

Depending on your specific schedule, going to bed "on time" is around 10 p.m.—and you should be eliminating screens at least 30 minutes before that. When you stay up much later, you get a "second wind" of cortisol secretion, and this can impair your sleep or make it hard to fall asleep since your body is ready for work!


Start meditating.

We don't all need to be meditation masters, but we do all need to make time to sit in silence with no other inputs (TV, computer, kids, radio, etc.) and breathe. Focus on making your exhale longer than your inhale for at least 20 minutes. This will lower cortisol and improve digestion, blood sugar balance, and the ability of your body to repair itself. What do you have to lose? Meditation is more important now than ever.


Eliminate processed carbs and sugar.

These foods are inflammatory and therefore put stress the body. In particular, they stress the adrenal glands and disrupt your blood sugar levels. Once they're feeling better, most people can go back to eating them in moderation.


Focus on stress-reduction.

This is, by far, the hardest, but it's so important to stop being anxious about the things you cannot control. Anxiety and stress activate the adrenals, and if they're busy pumping out cortisol, you won't be able to heal. Techniques like journaling and cognitive behavioral therapy can help with this.

Overwhelmed? Don't be. Pick one thing, get comfortable with it, and add in another when you're ready. Don't get impatient, either. (It stresses your adrenals!). If you've been out of balance for a while, it's going to take a while to get back into balance!

Wendie Trubow, M.D., MBA author page.
Wendie Trubow, M.D., MBA
Functional Medicine Gynecologist

Wendie Trubow, M.D., MBA is a functional medicine gynecologist. She received her M.D. from Tufts University in 2000 and has been practicing functional medicine since 2009. After all these years, she is still passionate about helping women optimize their health and their lives. There are so many different challenges in a woman’s life: work, home, relationships, spirituality, health, and they all matter! While her credentials allow Trubow a solid medical backdrop to help women achieve vitality, her own health journey has also inspired and supported her methods of care.

Through her struggles with mold and metal toxicity, Celiac disease, and a variety of other health issues, Trubow has developed a deep sense of compassion for what her patients are facing. When she's not helping patients in her practice (5 Journeys) you can find Trubow alongside her husband and their four kids, creating a beautiful ecosystem in our yard that provides nourishment to both our body and soul. She also co-authored the book Dirty Girl: Ditch the Toxins, Look Great, and Feel Freaking Amazing!