How This OB/GYN Manages 4 Common Menopause Symptoms, Naturally
It can be so confusing to find the "right" way to manage menopausal symptoms. Hot flashes, mood swings, unpredictable menstrual cycles, vaginal dryness, reduced libido, sleep interruption, and weight changes plague many of us throughout the transition—and with women spending one-third to one-half of our lives in the postmenopausal phase, we deserve some relief and answers!
A recent study in the venerable journal Menopause looked at the differences in symptom relief, side effects, and safety of women using conventional hormonal therapy (all of which are FDA-approved and by prescription only) versus those using pellet hormone therapy (PHT), in which pellets containing estradiol and testosterone are inserted into and absorbed by the body and last for three to nine months.
The women receiving pellets had more complications, according to the study, such as abnormal bleeding requiring hysterectomies and other bothersome side effects like hair loss, acne, and weight gain. Another worrisome issue is that once pellets are administered, the amount of time it takes for the medication to disperse and be metabolized by the body varies greatly from woman to woman.
Because the side effects are varied, some people may not want to rely on pharmacological methods and instead look for natural ways to manage their menopause symptoms. That said, working with your doctor or OB/GYN to find the safest and most effective plan for you is always recommended.
Natural methods to manage common menopause symptoms.
As a board-certified OB/GYN, integrative women's health doctor, and breast cancer survivor, these are my tried-and-true natural-based methods for managing menopause symptoms. Remember, when using supplements, talk to your doctor, make sure they don't interact with any medications you're already taking, and be patient! Unlike pharmacological solutions, supplements will take longer to work (typically 30 to 90 days), and they require consistent use as directed.
For hot flashes and night sweats:
- My current favorite supplement is French maritime pine bark extract1, which, according to one small study from the brand Pycnogenolmay "reduce signs and symptoms associated with menopausal transitions," including hot flashes and night sweats.
- Soy-derived genistein2, red clover3, and Siberian red rhubarb4 are all considered phytoestrogens5, as they work well for some by increasing plant-derived molecules resembling estrogen (a hormone that naturally decreases during menopause).
For mood changes:
Early in the menopause transition, patients often complain about mood swings. Anxiousness, panic, and darkness descend from seemingly out of nowhere, which can alter relationships and our sense of reality.
- I love vitex (aka chasteberry or chaste tree berry) for the mood changes, as well as some of the physical "PMS" symptoms, like breast tenderness. Though more research is needed, some experts believe chaste tree berry acts to increase the production of our own progesterone stores6, which can counteract a shift toward "estrogen dominance."
- Ashwagandha, passionflower, Rhodiola, and tulsi (or holy basil) are also promising: Some small studies suggest they may help level our moods and decrease stress7.
For sleep disruption:
Sleep disruption is a huge issue, yet patients often don't recognize how it's affecting them: In truth, sleep affects almost every other menopause complaint (the same can be said for PMS symptoms). If we don't get good restorative sleep, we become exhausted and can't think straight, our moods decrease, we become less interested in sex, and our bodies may hold on to unwanted weight, which can increase the risk of other health issues like metabolic disease, insulin resistance, and cardiac issues.
- Some research suggests when you consume passion flower as a tea, it may enhance sleep8.
- I recommend organic, full-spectrum hemp-derived products. The route of administration is also key: If you need help immediately to slow down and fall asleep, under-the-tongue tinctures or sprays absorb and metabolize the fastest. If you need help staying asleep, oral preps, like gels, gummies, or swallowed tinctures will work hours after they've been digested and processed—just as you would normally start waking up in the middle of the night.
Memory and cognition are also impaired when we are sleep-deprived, stressed, depressed, or overwhelmed. Take a good look at your lifestyle practices to support mental health: Boundary setting (aka saying no!), taking time alone, and spending time in nature, as well as mindfulness, meditation, and yoga practices can be restorative.
For low libido:
If only libido were an on-off switch! Everything from our personal relationships with our bodies to how we communicate with lovers can influence sexual interest, sexual response, and pleasure. Creating opportunities for self-exploration is really important, but as tissues under hormonal influence change (i.e., vaginal dryness from decreased estrogen production), penetration could become painful.
For anyone determined to avoid even the safest topical vaginal hormones, consider energy devices to increase blood flow and collagen production: Both of which may restore the ability to self-lubricate and enjoy pleasure. I love the radio frequency devices like Votiva for this (you will need to visit a trusted sexual-health-trained medical professional to get this treatment).
Urinary tract infections (UTIs) and vaginal dryness can increase in frequency over time due to loss of estrogen on the delicate intimate tissue of the reproductive tract: D-mannose and cranberry extract have long been used to decrease UTIs and can safely be used in menopause, but keeping the tissue well-hydrated and protected is just as important. Do not use cleansers here (the vagina is self-cleaning!), make sure to try some pH-balanced personal moisturizers, and consider probiotics with a known impact on the vaginal microbiome. You may also try gently stretching the vaginal canal with a vaginal dilator.
I love making use of the natural world to optimize health. While I've found the suggestions listed above to be helpful for me, always work with your doctor to determine what will work best for you. And remember, without lifestyle alterations, like exercise, sleep, and stress reduction, lasting impacts will be hard to come by.
Suzanne Gilberg-Lenz, M.D. is a nationally renowned doctor, expert, speaker and advocate for integrative women’s health. She is also the Chief Medical Officer of Le Minou, a sexual wellness destination.
As a partner at Women’s Care of Beverly Hills, she’s performed thousands of deliveries and continues to help women transition through important phases of their lives, from adolescence to post menopause. Her expertise covers all aspects of gynecology including sexual health, fertility, pregnancy, childbirth, postpartum, and the science of self care.
Dr. Suzanne received her Bachelor's in Psychology from Wesleyan University and her Doctor of Medicine from the University of Southern California. Her diverse background combining her degrees in conventional medicine, Ayurveda, and holistic medicine are key factors to what make her the integrative women’s healthcare expert that she is. Her mission is to not only explore what it means to be a woman in this culture and age, but to also support growth as individuals and how people show up in their communities.
Since 2006, Dr. Suzanne has reached millions through television, print, and dozens of online platforms. As the landscape of women’s health changes, networks such as CNN, NBC, and Fox look to her for answers on new medicine and technological developments for postpartum depression, fertility, HPV, and sexual wellness.