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The topic of periods and fertility is extremely present in today’s culture. As the stigma of menstruation is fading away, the lack of open discussion around menopause has become starkly apparent. In fact, as parents teach their teenagers about periods, they are learning and confronting what life is like when periods end.
Menopause happens between the ages of 45 to 52. Before women undergo menopause, they enter a state of perimenopause. Perimenopause is characterized by having an increase in luteinizing and epinephrine hormones, and also a decrease in norepinephrine. Epinephrine is involved in regulating attention, metabolism, excitation, etc. Luteinizing hormones control the release of eggs during a person with the uterus’ cycle. During perimenopause, the body is trying to rid the ovaries of all the eggs to prepare for menopause. Norephedrine is involved in regulating the heartbeat and blood pressure.
Perimenopause can begin anytime between 40 and 44 years old. Perimenopause usually lasts around 4 years, but some women can be in perimenopause for 10 years. Perimenopause ends when a period has not been present for 12 months. This means they are in a state of menopause. In menopause, luteinizing hormone and follicle-stimulating hormones decrease significantly, where both hormones are involved in producing estrogen and testosterone. This imbalance in hormones can cause great discomfort in perimenopausal and menopausal people, and because of this, a lot of research has been done on hormone replacement therapy options and holistic treatment options. (1,2,8).
A majority of people who experience menopause have to endure multiple symptoms. These can include hot flashes, night sweats, memory loss, bone density, sleep issues, psychological difficulties, lower sex drive, vaginal dryness, body aches, mood disorders, weight disturbances, and cognitive decline. Of 73% Americans experiencing menopausal symptoms, hot flashes are at least one of their afflictions. Hot flashes and night sweats, also collectively known as vasomotor, are the most common perimenopausal and menopausal symptoms. Hot flashes and night sweats, on average, afflict menopausal people for 5 to 7 years, yet there have been some cases of people experiencing these symptoms for up to 15 years. These symptoms are huge issues within the menopausal community, which is a large community of people. Many studies are dedicated to the potential alleviation of these bothersome symptoms (3,5).
A lot of menopausal people do not want to ingest hormones to alleviate unwanted symptoms. Some turn to more holistic approaches, also known as CAM interventions, for menopause discomforts. Hypnosis has shown promising efforts against undesirable menopausal symptoms. In a study done that compared hypnosis and hormone pills, hypnosis significantly decreased the number of hot flashes and their intensity. The North American Menopausal Society even recommends seeking out hypnotic therapy for those experiencing bothersome symptomology as a result of their menopause. The only negative of hypnotic therapy is that hypnosis can be
expensive and not as readily available (1,3,4,7).
Cognitive Behavioral Therapy (CBT) and mindfulness-based stress reduction (MBR) are effective at treating the discomfort of hot flashes, but they are not actually effective at decreasing the amount or severity of the hot flashes. CBT and MBR merely help menopausal people develop mental toughness against the uncomfortableness of hot flashes. CBT also temporarily helps with mild depression caused by menopause, although it does not show any positive long-term effects. Some studies have found that the placebo effect can eliminate up to 25% of the discomfort of hot flashes alone, meaning that the uncomfortable symptoms most likely have a large psychological component. More research is needed on CBT and MBR’s effectiveness (3,5,7).
Yoga, practiced relaxation, stretching, and meditation all somewhat help with menopausal symptoms, but there is inconsistent data and it is currently inconclusive. People, especially in perimenopause, may benefit from slowed, controlled breathing due to the anxiety that may come from having naturally raised epinephrine and norepinephrine hormones. Lavender aromatherapy also produces some results in reducing hot flashes. Reflexology (which is a type of special foot message) and acupuncture have shown some significant results in reducing menopausal symptomology, but only a few studies have been conducted. A Mediterranean diet has also shown some improvement in the discomfort of menopausal symptoms. Some menopausal people that are experiencing poor sleep may benefit from passive body warming, which is when you put the body in a really cold environment before going to sleep. For example, this could mean taking a cold shower, which manually lowers the body’s core temperature (which needs to be lowered before sleep can happen) (2,6,8).
Asian people also experience fewer menopausal symptoms. Compared to the 73% of Americans that experience hot flashes, only 10% of Asian people report hot flashes. The theory is that Asian people’s diets contain more phytoestrogens. Phytoestrogens are compounds found in plants that mimic estrogen in the body. A lot of herbs in herbal therapy are high in phytoestrogens, like black cohosh, chamomile, kava, anise, red clover, etc. Akbarzadeh found that herbal therapy was effective at improving libido, blood pressure, bone density, sleep, vaginal health, weight control, psychological health, and reduced hot flashes and night sweats. These herbal menopausal remedies might sound too good to be true and you’d be right. Each herb has some level of side effects. Black cohosh can cause vomiting and headaches, whereas Kava may negatively interact with different medications (1,3,7).
An herb that is not classified as a phytoestrogen, but has shown amazing results in reducing unwanted menopausal symptomology, is Dong Quai. Fifty-five women in one study had 90% to 96% reduction in hot flashes. In another study of 50 menopausal participants, there was a 73% decrease in hot flashes and a 69% reduction in night sweats. More research has to be done on the interaction of Dong Quai with other medications commonly taken by people at the age of menopause (4,6).
If people with menopause do not care for holistic treatment for their symptoms, there are medicinal treatment options. People can use hormone replacement therapy short term. This is the most well-known and effective treatment of hot flashes. Incorporating low doses of estrogen, and possibly progesterone, not only alleviates hot flashes and night sweats, but it also relieves vaginal dryness and prevents bone loss. Vaginal estrogen, which is inserted directly into the vagina, is also an option to alleviate vaginal dryness. People with menopause that cannot have estrogen could take antidepressants in order to alleviate hot flashes and help with mood-related problems. People who struggle with hot flashes and night sweats, but cannot take estrogen, can also take Gabapentin. Clonidine, used to treat high blood pressure, also helps with hot flashes (2,4,8).
27 million people in America, are currently undergoing menopause. Additionally, 1.2 billion people across the world are predicted to be experiencing menopause in the year 2030. These startling numbers do not even include the women experiencing perimenopause. This is a lot of people whose quality of life may be affected by symptoms commonly associated with menopause. Every study discussing the positive effects of CAM Interventions makes the point that more research is needed, specifically in the medical community. Almost all research on holistic approaches to menopausal discomfort has included small population studies over a short amount of time, which contain a lot of confounding variables. Clinical trials are needed to make more definitive assessments on what is more universally useful for women undergoing menopausal difficulties (1,3).
Menopause is just as prevalent as menstruation, but because of ageism menopause is culturally talked about less. This social “faux pas” needs to be rectified so that as a culture, we can demand more research to be done on perimenopause and menopause symptoms. Hopefully, this article is part of the movement that brings menopause into the social stratosphere.
Akbarzadeh, M., Ebrahimi, A., Tayebi, N., & Fatemeh, A. (2020). Investigation of the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms: An evidence-based systematic review study. Journal of Family Medicine and Primary Care, 9(6), 2638. https://doi.org/10.4103/jfmpc.jfmpc_1094_19
Innes, K. E., Selfe, T. K., & Vishnu, A. (2010). Mind-body therapies for menopausal symptoms: A systematic review. Maturitas, 66(2), 135–149. https://doi.org/10.1016/j.maturitas.2010.01.016
Carmody, J. F., Crawford, S., Salmoirago-Blotcher, E., Leung, K., Churchill, L., & Olendzki, N. (2011). Mindfulness training for coping with hot flashes. Menopause, 18(6), 611–620. https://doi.org/10.1097/gme.0b013e318204a05c
Cramer, H., Lauche, R., Langhorst, J., & Dobos, G. (2012). Effectiveness of Yoga for Menopausal Symptoms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine, 2012, https://doi.org/10.1155/2012/863905
Johnson, A., Roberts, L., & Elkins, G. (2019). Complementary and Alternative Medicine for Menopause. Journal of Evidence-Based Integrative Medicine, 24, 2515690X1982938. https://doi.org/10.1177/2515690x19829380
Ozcan, H., Çolak, P., Oturgan, B., & Gülsever, E. (2019). Complementary and alternative treatment methods for menopausal hot flashes used in Turkey. African Health Sciences, 19(4), 3001–3008. https://doi.org/10.4314/ahs.v19i4.21
Pinar, G. (2020). Use of Complementary and Alternative Medicine for Menopause Symptoms and Its Effect on Quality of Life Among Turkish Women. Online Journal of Complementary & Alternative Medicine, 5(3). https://doi.org/10.33552/ojcam.2020.05.000613
Menopause. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401
Contributors
Author: Katrina Peavy
Editor: Kayjah Taylor
Health scientist: Dora Sow
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