A Proactive Approach to Menopause

Menopause is the complete absence of menstrual periods caused by changes in hormonal rhythms. The good news is that there are no more periods. The less-than-good news is that periods are replaced with symptoms that can be bothersome, including hot flashes and temperature changes, mood changes (anxiety and depression) and sleep problems. There can be vaginal dryness and some irritation with urination. There can also be a decline in short-term memory.

Menopause also brings an increased risk of fracture of the bones of the wrist, back and hips. There is an increased risk of heart attack, stroke and dementia. There are, however, several things you can do to decrease your risk; follow the suggestions below for a healthy journey through menopause.

Be proactive
There are several stages of menopause; ask your doctor which stage you are in and to do a risk assessment. With your healthcare practitioner, create a management strategy that includes the following goals:

Minimize bone loss and maintain optimal bone density: Consider a baseline DEXA bone density scan to determine your present bone density. You may wish to take a few bone density supplements including:

1,500 mg of calcium per day in the form of calcium citrate;
A minimum of 400 IU of vitamin D per day (consider 1,000 IU of vitamin D, especially if you live in northern latitudes including the northern US and Canada)You may ask to have your blood level of vitamin D checked to determine your dose of daily vitamin D;
Use a multivitamin that contains bone mineral support nutrients such as magnesium and boron.
Exercise daily. Weight-bearing exercises, such as walking, help improve bone strength. Strengthen the bones in your arms with biceps curls three times per week.
Minimize your risk of heart attack and stroke: Your healthcare provider can provide a risk assessment for coronary artery disease and conduct blood work to test you for risk factors. I recommend the following tests:

A complete lipid panel,
Homocysteine , and
Highly sensitive CRP.
If you can, get tested for lipoprotein(a), fibrinogen and sub fractions of your LDL and HDL. You can control all of these risk factors with diet, exercise and supplements, or with medication if these are not effective enough. Click here to read more about heart health.


Minimize your risk of dementia: In general, preventing and minimizing dementia, memory loss and decline in mental functioning should include the following:

Decrease the toxins you expose your brain to by eating organic foods whenever possible.
Minimize exposure to mercury by limiting intake of large fish like swordfish and tuna and by not having amalgam fillings.
Eat blueberries—studies show they help decrease the harmful effects of free radicals and can help improve mental function.

What about hot flashes?
Hot flashes are rapid changes in body temperature. They can be uncomfortable, but are not dangerous. There are a number of different strategies for managing hot flashes—here are a few suggestions:

Make soy protein about one-quarter to one-half of your daily protein intake. You can increase soy intake by eating tempeh, tofu, soymilk, miso soup and by using soy protein powder and protein bars. For more information on soy, click here.
If soy is not effective, you can add black cohosh at 40 – 80 mg two times per day.
Anxiety and depression
For symptoms of anxiety, a comprehensive approach that includes regular exercise, a positive attitude, adequate rest, eating regularly and supplements is best. The best supplements to try if you are experiencing anxiety are GABA and L theanine.

GABA can be taken as 100 mg lozenges at times of anxiety or as capsules of 500 mg two to three times per day. You can also empty a capsule of 500 mg into some water and sip it.
L theanine, an amino acid, is extracted from green tea (but there is no caffeine in it) and is taken as a capsule. It is usually in doses of 200 mg per capsule. You could try one capsule two to four times per day.
Using hormones
In general, it is best to avoid using supplemental estrogen and progesterone if you can manage your symptoms and risk factors without them. There are slightly increased risks of heart attack, stroke, breast cancer and clots when using them. You doctor can prescribe local applications of estrogen for vaginal symptoms.