Menopause and peri-menopause

Advising women on herbal treatment for menopausal problems forms a significant part of many herbal practices, including mine. As many women will testify there can be a long list of symptoms which often start to get worse from when a woman is in her mid-forties or early fifties. 

There are generally considered to be three stages in the menopausal cycle:                    Peri-menopause can occur up to ten years before full onset of menopause and may be characterised by a more irregular cycle, sometimes being heavier or lighter than previously.  Depending on the hormonal balance of oestrogen and progesterone, different women may experience symptoms ranging from bloating, weight gain, low mood, depression, feeling agigated or more irritable. Vaginal dryness and atrophy can cause discomfort during intercourse. 

Menopause is the complete cessation of the menstrual cycle. Predominant physical symptoms are hot flushes and night sweats, aches and pains or loss of energy.  For many others, a sense of increased anxiety or having a ‘shorter fuse’ than before is what prompts them to seek treatment.   Mood can also be affected with feelings of depression while lowered libido and sex drive may feature. 

Poor sleep is another commonly reported problem during menopause.  A disrupted sleep pattern can impact concentration, memory and mood.

Many symptoms such as fatigue, weight gain, hair loss, reduced libido, sleep disturbance and mood swings are common to both the menopause and an under-active thyroid. I have often found that thyroid problems present at this time, and if having blood tests, it is a good idea to check thyroid levels as well.

The third stage is post-menopause and is considered to occur a few years after menopause has taken place.  At this stage the fluctuations of hormonal levels should have settled somewhat so that mood swings and the vasomotor symptoms such as hot flashes and night sweats have abated.  Oestrogen, progesterone and testesterone levels are of course lower. 

The adrenal glands and fat cells can produce a small amounr of these hormones, but in some women, this happens at an extremely low level or not at all. 

Hormone replacement therapy (HRT)

HRT has been used for many decades now to help with the transition to menopause as ovarian function winds down.  Many women will also have experienced menopause at an earlier stage of their lives if they have undergone removal of their uterus and ovaries, creating a ‘surgical menopause’.

Synthetic HRT, originally made from the urine of pregnant mares (PREMARIN), is associated with adverse side effects, including an increased risk of clotting, stroke, breast and ovarian cancers.  Modifications to HRT have enabled the development of a different, more natural form, based on plant hormones.  Bio-identical hormone replacement therapy (BHRT) is considered to be safer than the older version.  It is usually prescribed in the form of a cream or gel, a trans-dermal patch, or vaginal pessaries for local effect.

Herbal treatment of menopause

Many herbs are highly regarded for the treatment of menopausal symptoms. It is a case of working out the right combinations of herbs to help address these problems. It really makes a difference to your quality of life when you can get the support and treatment you need.  Formulating various combinations of herbs that target the predominant symptoms and support the body yield the best outcomes.  So my prescribing for menopause is always based on what each woman is experiencing.  That said, we know that herbs such as Red Clover, Sage, Black Cohosh, Lemon Balm, Valerian are all valuable herbs in providing relief for hot flashes, night sweats, anxiety and poor sleep, some of the more commonly reported problems.  However if your problems are more complex, with a range of different symptoms, a consultation might serve you best in order to get a tailored herbal prescription for your individual needs.