post menopause hormone balance

Post Menopause Hormone Balance

If you scored high in the ‘Post Menopause Hormone Balance’ section of the Health Score Quiz, please read this article as it contains some useful information and resources to help you.

This page is designed to help you understand why you might be experiencing symptoms relating to post-menopausal hormone imbalances. In this section we look at what the menopause is, the hormones involved, some of their functions and where they are produced.

In addition to that we will look at how you can support healthy hormone balance when you are post-menopausal, testing that you may want to consider and some introductory nutrition and lifestyle interventions that you may find useful.

What is the menopause?

Let’s start off by first considering what the menopause is, and what is occurring at that time, as this creates the basis for the rest of the information on this page.

For most women, the menopause occurs between the ages of 45-55, however some it will be earlier or later than this. Menopause is considered when a female has not menstruated for 12 consecutive months. For some females it is a transition that happens with very few symptoms, but for many others a variety of symptoms can occur, with some females experiencing symptoms to up to or perhaps even longer than a decade.

The perimenopause is a period that occurs before the menopause, and during this time one may experience some of the common menopausal symptoms as well as periods that are becoming more irregular with changes in menstrual flow. The menopause is that point of no period for 1 year and the post menopause is following that.

In some cases, menopause can occur as a result of injury, treatment for certain diseases or surgical intervention on the ovaries and related structures.

Menopause, hormonal changes and their influence on well-being

Menopause occurs when the ovaries have become depleted of follicles and ovarian function is lost. The follicles are the structure within the ovaries that produce and release eggs allowing for menstruation and fertility. Hormones that were produced in the ovaries cease to be produced there, however, hormones continue to be produced in the adrenal glands and to some degree in fat tissue as well.

The result of lowering levels of estrogen and progesterone can be vast, here are some of the symptoms that might be associated to depleted levels of these two hormones.

Symptoms of Estrogen Insufficiency

  • Hot flashes
  • Night sweats
  • Foggy thinking
  • Insomnia
  • Heart palpitations
  • Yeast infections/Urinary tract infections
  • Low mood/depression
  • Bone loss
  • Dry skin
  • Painful intercourse
  • Low libido
  • Vaginal dryness/atrophy
  • Headaches
  • Reduced cognitive function and memory lapses
  • Incontinence
  • Less full breasts

Symptoms of Progesterone Insufficiency

  • Acne
  • Joint Pain
  • Anxiety
  • Headaches
  • Cramping
  • Swollen breasts
  • Foggy thinking
  • Reduced libido
  • Mood swings
  • Depression
  • Hot flashes
  • Water retention
  • Saggy or loose skin
  • Thinning hair

It is also possible that females enter into a low androgen state as the body tries to compensate for the reduced estrogen levels and tries to convert more testosterone into estrogen. However, testosterone is also protective at the right level in females, especially for bone health.

Equally, as estrogen and progesterone reduce this can also cause an androgen dominant state in some females. This can result in symptoms like increased hair growth in other areas of the body such as the face, neck, upper back etc. Testosterone however is likely to also decrease as this is also produced in the ovaries, but again not exclusively to the ovaries.

There is also good evidence the metabolic rate slows, and fat distribution will almost certainly change, as fat now becomes more inclined to store around the mid-section and less in the lower body because of the hormonal changes, and perhaps increased insulin resistance and poorer glucose management as a result.

Osteoporosis or weaker bones with reduced mass and strength, is a real issue when one is post-menopausal, as all of the sex hormones play a role in maintaining healthy bones. As a result, nutrition, exercise, management of stress and other factors that impact bone health are important to manage. In some cases, hormone therapies may be beneficial. However, there are many hormonal interventions, ranging from natural interventions to more standard pharmaceutical based Hormone Replacement Therapies (HRT).

Testing considerations for post-menopausal hormone balance

To confirm menopause some basic blood tests can be run and this in combination with a detailed history and symptoms will usually be adequate.

The blood markers typically assessed include follicle stimulating hormone (FSH) & oestradiol (E2). The pattern you expect to see are significantly elevated FSH levels and low levels of E2.

It is also good practice to also assess the following when ruling in or out the menopause and getting a broader overview of one’s health, and things that may be contributing to similar symptoms mentioned above:

  • Thyroid levels – TSH, Free T4 and Free T3
  • Fasting cholesterol levels and ratio’s, fasting triglycerides, fasting insulin, fasting glucose, HbA1c
  • Liver and kidney function
  • Testosterone, DHEA-S & prolactin

I also like to consider a more detailed hormone panel that includes sex hormones and sex hormone metabolites, DHEA, DHEA-S, cortisol, melatonin via a dried urine hormone assessment.

If you are looking to work with a professional to help you understand more about the levels and interactions between your hormones, then please feel free to get in touch to enquire about working with us on a 1-2-1 basis, using the enquiry form at the end of this page. Following or sometimes before an initial consultation we can guide you with appropriate laboratory tests.

What about hormone replacement therapies (HRT)?

HRT is certainly right for some people and goes a long way to helping one manage symptoms and reducing risk from certain chronic diseases as well. However, this must be assessed on a case-by-case basis, with the support of a qualified practitioner overseeing the prescription and the ongoing retesting while taking HRT. Unfortunately, the later mentioned area of ongoing testing rarely occurs, and this in some cases may lead to unwanted side effects or consequences to one’s health.

It is suggested that those with an elevated risk of cardiovascular disease, blood clots, estrogen sensitive cancers, gallstones or dementia should approach HRT with caution. In fact, I think everyone should approach it with caution and test and review regularly to try and ensure it is a safe as possible. The idea of HRT is that it is for temporary use as the body transitions, but in some cases no use or even longer-term use is perfectly acceptable. It should also be noted that the research is very mixed in this area, especially around the cardiovascular and dementia risk/benefit associated with HRT.

There are different forms of HRT, most females have no idea that the dominant HRT are unnatural forms of estrogen and progesterone. Certain HRT’s are made from estrogen isolated from horse’s urine which contain more than 200 substances mostly foreign to humans. The major problem with these types of forms, is that they are metabolised in the body in a specific way that may increase risk of certain estrogen dominant cancers.

There are also other HRT options, utilising what is known as bio-identical hormone replacement therapy (BHRT). BHRT are manmade hormones derived from plant estrogens and are chemically identical to what the human body produces. These can come in various forms, including creams, patches, gels, pills and injections.

Whilst this is a more natural means of introducing hormones into the body, it too does not come without its risks, albeit perhaps a slightly reduced risk profile. Having said that, the general at-risk group for standard HRT still applies to BHRT as well.

HRT or BHRT may be a good option for some, but it needs to be approached and considered with caution and an understanding of the risk vs reward. HRT or BHRT, for me is not the initial step, as so often we can rebalance hormones and improve the levels and ratios through appropriate nutrition and lifestyle interventions, and avoid all of the risks associated with HRT and BHRT. If significant nutrition and lifestyle intervention has taken place and still symptoms and imbalances persist, then reviewing the potential benefit of HRT or BHRT may be worth doing with someone who specialises in that area, and who will continue to review side effects of the potential treatment. As a general rule of thumb, it is recommended that HRT only be used for treatment of menopausal symptoms at the lowest possible dose for the shortest period of time, and I would recommend exploring BHRT as a preference to standard HRT.

Nutrition & Lifestyle considerations for the post-menopausal female

Movement

Be sure to include weight bearing exercise, strength training, stretching and some aerobic exercise into your routine. These can help to maintain healthy bones, maintain muscle mass and strength as well as be beneficial for stress management, glucose management etc which can in turn help to balance hormones.

Exercise has also been shown to lower the severity and frequency of hot flashes. Overall, exercise helps to mitigate a number of the risks associated with the menopause, and should be a cornerstone of your lifestyle in optimising health and preventing conditions or symptoms associated with the menopause.

Nutrition

There are a variety of areas that I would focus on with a post-menopausal female struggling with hormonal symptoms.

1. Address glucose regulation

This means working towards a diet that helps to manage blood sugar within smaller margins. This helps to reduce demand on the adrenals but as you transition into menopause, this can also mean you lose some of your ability to manage glucose effectively.

2. Consider the consumption of food-based phytoestrogens

Foods such as fermented soybean, flax seeds, apples, carrots, fennel, celery, parsley and other legumes contain small amounts of phytoestrogens. Higher consumption of these foods in certain cultures is thought to be one of the reasons that they experience less menopausal symptoms.

3. Eat plenty of pre and probiotic foods to maintain a diverse gut ecosystem

Higher levels of certain health promoting bacteria’s, like the lactobacillus and Bifidobacterium species are said to help with the appropriate metabolism, conversion, balance and excretion of hormones.

You may find my article – What are the best prebiotic and probiotic foods? useful.

If you suffer with chronic digestive issues, this may be an important area to prioritise.

Stress Management

Put simply, an adrenal gland that is under considerable demand, because of physical or emotional stress ,is less likely to be efficient at the production of sex hormones, resulting in a higher likelihood of menopausal symptoms.

Chronic stress is something that has been shown to lower a hormone known as DHEA. This hormone is involved in the production of estrogen and testosterone. Low levels may result in low levels of sex hormones, especially as the adrenal glands are now the primary gland for sex hormone production. DHEA can be taken as HRT, however, I would prefer first of all to treat the underlying chronic stressors, which may be mental, emotional or physical, such as an immune or inflammatory challenge.

It is always important to evaluate your environment to understand the relationships you have to others, the stress you might be exposed to and to truly prioritise yourself to ensure you feel and function at your best, so perhaps you can achieve your goals and support others. This is probably even more important when transitioning through the menopause or when post-menopausal.

Adding in mindfulness, Thai chi, supportive talking therapies like CBT, hypnosis, psychotherapy etc have been shown to be a great approach for some people to help manage stress and directly the menopausal symptoms. Other tactics include reviewing your schedule, relationships, general goals and ensuring that you aim to prioritise yourself moving forward. So many of the post-menopausal females that I have worked with have spent years putting others before themselves, and in some cases, they feel guilty above putting themselves first and lowering their own stress levels. I have found the inclusion of talking therapies, life coaching, hypnotherapy and mindfulness therapy extremely powerful for those going through these physical and mental transitions.

Nutritional / Herbal Supplements

Supplements can sometimes be useful as a way of managing the symptoms of the menopause and offering some support in rebalancing hormones.

Some that I would consider depending on symptoms include:

  • Vitamin E
  • B Vitamins
  • Evening primrose oil
  • Sage
  • Black cohosh
  • Red clover and other isoflavones
  • Ashwagandha
  • Ginseng
  • Liquorice
  • Dong Quai
  • Wild Yam
  • Chasteberry
  • Maca

I must stress though that potluck consumption of these supplements will more often than not result in disappointment. It is important to understand what your specific imbalances and stressors are and work from there. Evidence of the above supplements is inconsistent because every menopausal cause brings something different to the table as to why their hormones are where they are, hence each natural treatment will have to be unique to get the best possible outcome.

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