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ABCs of Menopause


The following is by no means the complete and magic “cure” for menopause.  Take from it what works for you, or make this a springboard to do more research on your own.  There’s lots of good advice (and some bad) out there.  However, one of the most important things to understand is that there is no cure.  In fact, the mere suggestion of a “cure” implies that some disease state exists.  What we need to realize is that menopause is a completely natural part of life.  We are in too much of a hurry to find a magic pill or miracle drug that will make us feel better.  Rather, we should turn our focus inward and do the work that is required to heal ourselves from within.  I’m not suggesting that all the symptoms of menopause can be eliminated through mere force of will, but it is possible to make this time one of challenge and self-empowerment.  Also remember that nobody has to “go it alone”.  We at True Harmony would be happy to discuss any of this information in more detail with you.  In fact, you should always check with your healthcare provider before initiating any new treatment, supplement, or lifestyle change.


A   Acupuncture

Studies have suggested that acupuncture can reduce symptoms of hot flashes, insomnia, anxiety and vaginal dryness.  Your acupuncturist can create a customized treatment to address your particular physical and emotional symptoms.  This is done by stimulating specific points (with tiny needles) on or near the surface of the skin to direct your body’s life energy flow (Qi – pronounced chee).  According to Chinese medical theory, illness arises when the flow of Qi through its channels (meridians) becomes unbalanced.  Acupuncture can alter various biochemical and physiological conditions in order to regain the body’s balance.  Menopause is a great time to get balanced – try it!


B   Bioidentical Hormones

For women who have a desire to replace the diminishing level of hormones that come with menopause, bioidentical hormones are a good option.  These are hormones that are created in a lab to be identical to the ones our bodies naturally make.  They can be compounded (mixed) by a specialty pharmacy to specifically match an individual’s needs.  This is different from the synthetic, mass-produced treatments that are made by the drug companies.  Bioidenticals can be taken in various forms such as lozenges, creams or vaginal suppositories.  Some studies suggest that side effects (such as breast tenderness, breakthrough bleeding and insomnia) are lower with bioidenticals.  They do require a prescription – so ask your provider about them!


C    Calcium

 To help prevent bone loss, menopausal women should get 1,500 mgs per day.  This can be a combination of food and supplements – food is the best way.  If you are getting all or most of your calcium from supplements, remember to divide the doses.  Your body will only absorb a few hundred mgs at a time.  Some good sources for calcium are low fat dairy products, salmon, tofu, green leafy veggies and fortified cereals and juices (watch out for the sugar).  Vitamin D is required in order to properly absorb calcium – 400 ius per day.  We also get Vitamin D from sunlight, so it is abundant here in Arizona!.


D    Diet

Reshape your attitude about “diet”.  You don’t have to be “on a diet”.  Your diet is what you eat every day.  The trick is making the right diet choices.  Fad diets like the “cabbage soup diet” or the “Southbeach diet” or the “grapefruit diet” may help you lose weight in the short term.  But, let’s face it -- you are not going to (and should not) eat like that for the rest of your life.  Make your diet work for you and try thinking about “diet” in a positive way.  Don’t obsess on what you are denying yourself.  Instead, concentrate on all the good foods you add to your diet and the benefits those good choices will have on your life.  Also think about portion size.  You should never eat an entire meal in a restaurant.  The serving sizes are too big!  Instead, split it with a friend or save half for lunch the next day.  Cut out sodas (yes, even diet soda), processed and fast food – too many fats, sugars, carbs and empty calories!  Eat lean meat, fish, whole grain bread and pastas, and lots of fruits and veggies.  The seven “magic foods” your diet should include are:  olive oil, yogurt, blueberries, fish, nuts, chocolate and wine (the last two in moderation, please).



E    Exercise

 Decreasing levels of estrogen can lead to bone loss.  Exercising and keeping active is important to keep your bones going strong.  Even if you have not been good about exercising in the past, you should think twice about it now, because it is more important than ever.  Exercise does not have to be boring or monotonous, and you don’t have to join a gym, so there is no excuse to not do it!  Some good examples are working with light weights, hiking or brisk walking for 20-30 minutes, practicing Yoga, or taking dance lessons.  Not only will exercise help with bone loss, it will also help you to feel energized and happy, improve your mood and enable you to sleep better.  Just do it!


F    Fish Oil/Flax Seed Oil

According to a 2002 statement released by the American Heart Association, research has shown that omega-3 fatty acids:

Omega-3 fatty acids are essential to human health but cannot be manufactured by the body.  Therefore, omegas must be obtained from food. Omega-3 fatty acids can be found in fish, such as salmon, tuna, and halibut, and other marine life.  Walnuts, soybeans, and flaxseed are also good sources.  There are three major types of omega 3 fatty acids that are ingested in foods and used by the body: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Once eaten, the body converts ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used by the body.  If you don’t eat much of these foods, you can use supplements in the form of capsules or oil.  Research indicates that omega-3 fatty acids reduce inflammation and help prevent risk factors associated with chronic diseases such as heart disease, cancer, and arthritis.  The University of Maryland claims that Omega-3s can also help with the following conditions (some of which are also associated with menopause).


High cholesterol                     Depression                              Bipolar disorder

High blood pressure               Schizophrenia                         ADHD

Heart disease                          Eating disorders                     Burns

Diabetes                                  Irritable bowel disease           Asthma

Weight loss                             Macular degneration              Menstrual pain

Arthritis                                  Colon cancer                           Breast cancer

Osteoporosis                           Prostate cancer



G    Goals

This is a time to reassess your goals.  Your activities and attention may now be shifting from being the caretaker to taking care of yourself.  Many women experience a renewal of creativity during this time.  Others will change careers or make huge lifestyle changes.  If you don’t have goals – set some.  Start out with short term goals.  What are your goals for menopause – controlling symptoms, becoming more informed, becoming more healthy?  What is it you always wanted to do or learn, but never had the time?  Where would you like to be in 6 months?  What do you want to be doing a year from now?  Don’t hold back and don’t make excuses.  Seize the moment and make some change.  You are now free to move about the world!


H    Herbal Supplements

Black Cohosh can help with hot flashes, night sweats, and emotional swings.

Chaste Berry can help with PMS symptoms, irregular periods, and depression by balancing perimenopausal hormones.

Dong Quai can enhance energy and a sense of well-being with its analgesic and anti-allergy effect.  It also helps to relax smooth muscle.

Ginkgo biloba may increase blood flow to the brain thus helping with memory and general brain function.

Gotu Kola also increases circulation to the brain, but it is a stimulant, so don’t use before bed.

Inositol can be used as an alternative for depression.

Kava Kava can induce relaxation and sleep.

Licorice Root has anti-inflammatory, antibacterial and anti-cancer properties than can help with many symptoms of menopause including fatigue.

Melatonin (and its precursor 5-HTP) can produce drowsiness and help with sleep disorders.

St. John’s Wort can be used to treat mild to moderate depression.

Valerian can be used to treat the anxiety component of depression.


I    Identity 

Use this time for self-exploration.  Who are you?  Who do you want to be?  What things have you accomplished and what things are still on your “to do list”?  What is it that makes you a unique and wonderful individual in this universe?  In the past you may have been nurturing a relationship and a family and all your attention was focused on others.  Many women find that an “empty nest” is a catalyst for change when focus changes from taking care of others to taking care of yourself.  This may be a time to reconnect with old friends you haven’t seen in decades, or a reason to go out and form new relationships.  Think about what it takes to live your life to its absolute fullest, happiest and healthiest.  Who are you deep, deep down?  If you can’t figure it out yourself, perhaps some help is in order.  Childhood issues, issues of emotional or physical abuse can resurface at this time and need to be explored and resolved.  Each person finds her own way of doing this.  Some will throw themselves into charitable activities, others may seek counseling, life coaching, or spiritual healing.   Whatever road leads to self-awareness is the one that is right for you.


J    Joints

As we age, our joints require more attention.  Joints are places where our bones come together but don’t quite meet.  They are separated by a cushion of cartilage, membranes and fluid.  As we get older, tendons and membranes contain less fluid, cartilage can start to rub together, and mineral deposits can form in joints.  As a result, our joints become less flexible, and we can experience pain, inflammation and stiffness.  Fortunately, there are some things we can do to help prevent this situation.  First, exercise has been shown to prevent joint degeneration, and regular stretching can help retain flexibility (yoga is great for this).  Diet also plays a role (and we have already discussed that).  Proper hydration is also very important.  Your health care provider may also recommend supplements such as glucosamine and condroitin, or anti-inflammatories.   When it comes to joint flexibility, live by the following rule: “use it or lose it”.


K    Kegels and K-Y

Our pelvic floor muscles loose elasticity and strength as we age just like all other muscles.  You may begin to notice urine leakage when you cough or sneeze or you may notice more frequent urges to urinate.  In some cases, patients report feeling as though “everything has dropped”.  This is definitely worth a trip to see your physician.  There are options ranging from exercises to surgery.  Remember the Kegel exercises you practiced when you were pregnant?  Well, bring them back!  They will help tone pelvic floor muscles and reduce or sometimes reverse some of the symptoms. has a great article on how to perform Kegels.  Another pelvic issue that arises during this time is vaginal dryness, irritation or pain with intercourse.  Using a lubricant such as K-Y or other prescription strength treatments can help reduce irritation and restore elasticity and strength.  And, that leads very nicely into our next subject!


L     Libido

Hormone levels naturally decrease with menopause.  Hormone imbalance can cause changes in vaginal tissue, decreased lubrication and decreased or lack of interest in sex.  Low levels of estrogen can cause vaginal tissue to become thin and easily irritated, leading to avoidance of intercourse.  There are treatments available that may help revitalize vaginal tissue, making intercourse less painful, and therefore more enjoyable. 


M   Massage

 Exploring a variety of massage techniques, massage for menopause sessions can include:


N    Night sweats

Hot flashes are one of the most common signs of perimenopause, the years leading up to menopause. Menopause, when your period stops for good, typically happens between age 45 and 55.

Intense heat starts in your chest and rises to your neck and head. Beads of sweat grow until perspiration run down your face. It’s a hot flash due to menopause and can occur 20 or 30 times a day.  When it happens at night we refer to it a night sweats.

Doctors theorize that hot flashes and night sweats happen as a result of changing estrogen levels. Fortunately, there are plenty of ways to beat the heat and excessive sweating of menopause.  You can try non-hormonal options as well as hormonal treatments for these symptoms. 


O   Olive Oil

Olive oil benefits for a healthy heart are well-known.  That's probably why olive oil has been a mainstay of the Mediterranean diet for millennia. One French study suggests that those people over 65 years old who regularly used olive oil for both cooking and as a dressing had a 41% lower risk of stroke compared to those who never used olive oil in their diet. (A 1.5% risk in six years compared to a 2.6% risk.)  Olive oil can also be sued as a vaginal lubricant.


P   Phytoestrogens

Phytoestrogens are weak plant-derived estrogens that are structurally similar to estrogen hormones produced by the body.  Consuming phytoestrogen rich foods is a gentler approach than hormone replacement therapy for relief of menopausal symptoms.   Another alternative is to take phytoestrogens supplements. Phytoestrogens include nuts and seeds, soy products and herbal teas.


Q Quit

This is a great time to drop bad habits and develop good ones.  If you are a smoker, develop a plan to quit.  If you drink soda, quit.  If you eat fast food, quit.  Quit making excuses for not doing the things you want to do.  Quit blaming yourself for things you cannot control. 


R    Reflexology

At menopause reflexology works by regulating the hormones and glandular functions of the body. It can help to alleviate and balance both the physical and emotional systems. By working with the hypothalamus and pituitary, reflexology can help to restore balance to the endocrine system.


S     Soluble Fiber   

Benefits Of Soluble Fiber

  1. Healthy digestion.
  2. Reduces appetite.
  3. Lowers cholesterol levels.
  4. Treats digestive disorders.
  5. Lower blood sugar.

Weight loss: Soluble fiber can also help you get to -- or stay at -- a healthy weight by keeping you feeling full without adding many calories to your diet. Healthy bowel movements: Soluble fiber soaks up water as it passes through your system, which helps bulk up your stool and guard against constipation and diarrhea.


T    Tumeric

Here Are Some Of The Most Coolest And Beneficial Ways To Incorporate Turmeric In Your Menopause And Post Menopause Period!



U    UV screen

Sunscreen, also known as sunblock, is a lotion, spray, gel, foam, stick or other topical product that absorbs or reflects some of the sun's ultraviolet radiation and thus helps protect against sunburn. Diligent use of sunscreen can also slow or temporarily prevent the development of wrinkles, dark spots and sagging skin.


V    Vitamins


MaryAnn Shostek PA-C MaryAnn works with Dr. Brass at True Harmony since 2008. She is an integral part of the care that we provide for our patients and community. She specializes in OB care, PCOS, fertility and general women's health.

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