A Naturopathic Doctor’s Approach to Treating Menopausal Symptoms

In previous posts, I’ve written about my decision to forego synthetic hormone replacement therapy and try instead, a natural approach.  Both my general internist and gynecologist told me that for most women, natural, botanical products don’t alleviate menopausal symptoms, but I had heard enough anecdotal evidence from friends and friends of friends to want to try it. 

Feeling daunted by the huge number of products to choose from and well-aware that not all botanicals would be right for me, I consulted Shaila Schwartz, a naturopathic doctor at the Noe Clinic in San Francisco, to develop a customized plan for me. As a result of our work together, I have seen a huge improvement in the way I feel.  So, I asked her to share some of her wisdom in treating the effects of menopause on this blog.  Here is the first part of my interview with her.  I’ll post more of her advice later this week. She welcomes your comments and questions. 

First, define naturopathic medicine.  What is different about how you practice medicine?

Naturopathic Doctors (ND’s) are primary care providers who integrate standard medical diagnosis with a broad range of natural therapies.  We treat by addressing the mental, emotional, and physical aspects of an individual while looking for the “root” cause of illness to obtain optimal health for each person.  Individualized treatment plans are implemented to address the “whole person”, rather than simply suppressing symptoms.
 
How can a Naturopathic Doctor help women who are experiencing menopausal symptoms?

We take a natural approach that first focuses on improving physiology through diet, exercise, nutritional supplementation, botanical medicines, and homeopathy.  Effective assessment and laboratory testing can also provide important information for ND’s and their patients to avoid the negative side effects associated with hormone replacement therapy (HRT).

Comprehensive lab testing can be done through various integrative laboratories. Hormone levels are evaluated through serum (blood) or saliva testing.  Estrogen (estradiol, estrone, and estriol), progesterone, and testosterone levels are all measured.  In some individuals, testing of DHEA, Cortisol, and Melatonin activity provides the most clinically relevant information, especially for women experiencing fatigue, sleep disorders, or depression as part of their clinical presentation.  Ideally, having levels testing in the “normal”, perimenopausal and premenopausal state would be best in order to obtain a baseline to compare previous hormone levels in the body. 

What would a typical natural treatment plan look like?

Based on what is happening with a patient’s hormone levels, I customize a plan that includes diet, exercise, nutritional supplementation and if necessary, something to help promote sleep. Here are some specifics:

Diet: Increasing the amount of plant foods, especially those high in phytoestrogens, consumption of soy foods for some women (note: depending on how the body metabolizes estrogens, soy may NOT want to be increased in large quantities for some women).  

Nutritional supplementation - such as a good quality multi vitamin/mineral formula, Vitamin E, Calcium/Magnesium for the prevention of osteoporosis, hesperidin (flavonoid), and gamma-oryzanol (ferulic acid) assist in the maintenance of adequate nutrients in body, protection of cancer and heart disease, and lowers hot flashes and lowers cholesterol levels. 

Help with Sleep - Depending on the results of the comprehensive lab panel some women may require melatonin for a peaceful nights sleep.  Cortisol and DHEA levels may also require support based on the labs through adrenal tonics and supplementation.  
 
Regular exercise - a minimum of 3-4 hours per week is recommended.  Impaired endorphin activity within the hypothalamus is a major factor provoking hot flashes. Exercise increases the production and secretion of endorphins, reducing the frequency  and severity of hot flashes.