MENOPAUSE

The most common symptoms associated with menopause include: • Hot flashes - Sudden feelings of intense body heat, flushing, chills and sweating • Vaginal dryness and irritation • Poor sexual drive, discomfort during sexual intercourse • Irregular and lighter/heavier menstrual periods • Headaches • Insomnia • Changes in urinary frequency and urgency • Changes in mood, anxiety, depression, memory problems • Weight gain • Thinning of hair

The primary cause of menopause is the natural decline in ovarian function, which leads to decreased production of the hormones estrogen and progesterone. Other causes may include: • Surgical removal of the ovaries (bilateral oophorectomy) • Damage to the ovaries from chemotherapy or radiation treatment • Primary ovarian insufficiency (premature ovarian failure), a condition in which the ovaries stop working before age 40

Menopause is clinically diagnosed after 12 months of complete cessation of periods with no other medical cause. Certain hormone levels like Follicle stimulating hormone (FSH) and estradiol levels can be measured to confirm menopause. Hormone panels like the DUTCH Complete can be used to get a comprehensive assessment of menopausal transition.

The main goal of menopausal management is to alleviate symptoms and prevent chronic diseases. Medical treatments: • Hormone therapy - Replacement of lost estrogen and progesterone through prescription medications. This helps alleviate the systemic symptoms of menopause. It has associated risks like increased risk of breast cancer, blood clots etc. therefore it should be used for the shortest possible time and at the lowest dosage. • Hormone modulating medications like SSRIs, SNRIs and gabapentin to control hot flashes. • Bioidentical hormone therapy - Use of plant-derived hormones that are structurally identical to human hormones is an option that may have lower risks. These include Estradiol, Estriol, Progesterone. • Non-hormonal medications - Certain antidepressants, anti-seizure drugs, and blood pressure medications are known to help manage specific symptoms like hot flashes and mood changes. • Vaginal estrogen therapy - Used to treat vaginal dryness and urogenital atrophy. These may come us vaginal creams, tablets or rings. Menopause and its symptoms can be managed through root cause analysis, focusing on identifying underlying imbalances in the body. A holistic approach that integrates nutrition, lifestyle changes, and complementary treatments can help restore balance where it's most needed, supporting a smoother transition. Diet: A nutrient-dense diet which is anti-inflammatory and rich in fruits, vegetables, whole grains and lean proteins along with your micronutrients, can also support a smooth transition. Lifestyle changes: Stress management through exercise, yoga, meditation. Strength and resistance training is very important to maintain muscle mass and prevent fractures. A strong pelvic floor can help manage menopausal symptoms such as urinary incontinence and improve sexual health. Therefore, practising pelvic floor exercises are very beneficial. Establishing a consistent 7-8 hours of sleep schedule and routine is crucial for reducing stress, boosting mood, and maintaining a healthy weight. Another key focus should be on minimizing inflammation, addressing any chronic infections, and managing potential toxicity within the body.

Soy products - High in isoflavones which mimic estrogen. Isoflavones and lignans are types of plant-derived estrogens that help in hormone receptor modulation. Black cohosh - May help with hot flashes and other menopausal symptoms. Maca root - Adaptogenic herb that can help balance hormones. Red clover - Rich in isoflavones and may help with hot flashes and night sweats. Evening Primrose oil - May provide relief from hot flashes. Vitamin D and Calcium - Important for bone health. Omega 3 fatty acids - May have benefits for cardiovascular and cognitive function. (Ciappolino et al., 2018) (2016) Glutathione, Epitalon - Powerful antioxidants that combat oxidative stress.