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Menopause: A Rite of Passage

Menopause is a time of connecting to the spiritual legacy that your inner being has been carefully incubating for you to discover. Your body, in its innate intelligence, planned for your ovaries to go to sleep so that your life force could be directed towards its personal, spiritual evolution; this evolutionary journey you are meant to take is the discovery of your deepest Being. And so begins the voyage of wisdom…

Biology of The Midlife Shift

Perimenopause is the time leading up to the end of menses. Some women notice a shift in their cycle and accompanying symptoms as early as their 30’s. When a woman has not had a naturally occurring menstrual period for one year she is menopausal. She can also become menopausal overnight by the surgical removal of her ovaries and uterus. If her uterus is removed and the ovaries remain intact, she may experience symptoms of menopause later, due to the cycling of hormones that persists for about five years after the official end of menses.

It is common to see a change in the quality, duration, and length of menstrual cycle as early as 35. Pre-menstrual symptoms such as increased breast tenderness; mood fluctuation, water retention, and headache are often related to an increase in the Estrogen/Progesterone ratio. The skin, breasts, brain and ovaries all contain cell receptors for these two hormones. Estrogen in a general sense promotes “holding,” i.e. storage of fat and water (think thighs, abdomen, and butt,) while Progesterone promotes “releasing” (think social butterfly; creative juices at high tide, pregnancy.) Symptoms of approaching menopause are due to a complex relationship between the thyroid gland, adrenal glands, and ovarian function. Decreased synthesis of ovarian progesterone (Pg) and estrogen (E) are the first shifts occurring with perimenopause. The hypothalamus in the brain responds by increasing the amount of follicle-stimulating hormone (FSH) and leutinizing hormone (LH) delivered to the ovaries (knocking louder at the door, as it were.) Your doctor checks for elevated blood levels of FSH and LH to confirm your menopausal status.

Adrenal Glands: Power and Serenity

The adrenals are small glands that sit atop each kidney which secrete cortisol and epinephrine, commonly referred to as the “stress hormones.” Cell receptors for cortisol and epinephrine will increase or decrease in the body depending on how much stimulation they receive by the nervous system. When increased stresses are met with the long-term use of alcohol, coffee, sugar and refined carbohydrates, as well as the lack of exercise, and emotional “stuffing,” these glands become overburdened. This can result in weakened adrenal and thyroid function, as well as nervous system and immune dysfunction (leading to sleep disorders, mood fluctuations, chronic infections, and increased vulnerability to autoimmune disorders.) Healthy adrenal function promotes restful, restorative and reparative sleep, and a “natural high” in the body and mind.

Exercise, yoga, tai chi, and meditation help us to “reset” our adrenal glands by discharging stress and cleansing the body through sweat, breath, and movement.

Thyroid Gland: the Gatekeeper

The thyroid gland affects all hormone activities and regulates basic functions such as rate of brain activity, circulation and blood pressure; calcium balance, maintenance of normal tissues, and temperature. Lowered thyroid function is quite common in the general population, more common at menopause, and often overlooked due to over-reliance on thyroid-stimulating hormone (TSH) as the sole measurement for adquate function. Some of the most common symptoms of hypothyroidism include weight gain, fatigue, depression, cold hands and feet, constipation; premenstrual syndrome, severe and frequent hot flashes and night sweats; mood swings; reduced libido, and sleep disorders.

With a known or suspected hypothyroid condition, consider reducing: raw broccoli, cabbage, cauliflower; sweet potato, soy products. Consider increasing: iodine-containing foods such as seaweed, seafood

Sexy Mature Women

Many women experience a new level of confidence, creativity, and power at menopause, bringing new meaning to the idea of “fertility.” As we age, our reliance on the adrenal glands for testosterone is increased; this hormone plays an important role in libido and maintenance of tissue elasticity for women (while estrogen keeps the tissues lubricated.) Tired adrenal glands can make us “too tired to play.” Poor thyroid health is also often to blame for a lack of lust, and even for depression that can accompany it. Taking good care of our bodies and spirits at this time can bring an abundance of new surprises to discover.

Insulin Resistance: What’s this around my middle?

You may have noticed extra padding around the waist lately or perhaps it seems to have become more noticeable. There may be more than the occasional ice-cream or cheesecake to blame, however. “Insulin resistance,” (a pre-diabetic condition) is sometimes associated with perimenopause and classically appears with excess fat on the torso.

Normally, the pancreas secretes insulin when sugars are consumed. Insulin is then “accepted” like a key into a lock, allowing cells to be fed with glucose. But if constantly stimulated by insulin, cells can develop a deaf ear the same way a mother learns selective listening with her 4-year-old. You may experience ongoing sweet and carbohydrate cravings while the glucose already in your bloodstream is seeking a landing dock. Cortisol can then become “activated” inside fat cells, promoting elevated blood sugar (glucose) levels along with insulin, leading to increased deposition of abdominal fat in a vicious cycle.

Bad Habits Magnified

Many women tend less to their own well-being than that of others during the reproductive years. In a metaphor, we often “take on” more than “let go,” incompletely assimilating substances and experiences. This often translates into having difficulty releasing waste products via the menses, digestive tract, kidneys, skin, and lungs. Toxic compounds are then stored, often in fat tissue due to their fat-soluble nature. Prolonged stress impacts our adrenal glands by making us more susceptible to deposition of those toxic compounds, while use of antibiotics deplete the healthy gut organisms along with pathogenic ones. This begins to explain how imbalances that have existed for many years are exaggerated around perimenopause, creating more severe symptoms.

Treating Perimenopausal Symptoms

Symptoms of imbalance associated with the perimenopausal years may be significantly mediated by some of the following:

• dietary modifications to enhance adrenal and thyroid functioning • acupuncture & Chinese herbs • homeopathic and herbal medicines • vitamin and mineral supplements • Stress management via exercise, yoga, meditation, etc. • Bio-identical hormone replacement therapy*

Where to Start On Your Own

The liver is your largest internal organ, helping to process and eliminate excess hormones, maintain appropriate blood sugar levels, process fats, and make proteins. You can support it along with your adrenals by:

• Avoiding caffeine & alcohol, sugar, trans fatty acids from fried and processed foods, and pollution. • Eating more artichoke, beets and beet greens, and burdock root. • Exercise to sweating for at least 15 minutes daily; replace lost fluid by drinking at least 1/3 of your body weight in ounces of spring/filtered water daily.

Psycho-Spiritual Journey

To enhance this transformative time you can learn to honor your body in new ways. Start by paying attention to what it says to you throughout the month. Do you need more time alone? Want to get out and dance? Need more protein? Extra sleep? A good cry or laugh? Explore a new way of dealing with stress via tai chi, art-making, or bicycling. Counseling, keeping a journal, art therapy and other creative activities can introduce you to new parts of yourself, help you identify needs, and bring about a new sense of empowerment beyond being the caretaker of others. Get to know yourself in every way possible, so that when something doesn’t feel right you will notice it. Develop your intuition and trust yourself.

During the 30’s and 40’s, while still having regular menstrual cycles, is the prime time to visit a natural healthcare practitioner to discuss how you would like to “honor the change.” Although waiting until night sweats prevent you from sleeping is not ideal, remember, it’s never too late to learn how to better nurture yourself.

* Should be considered as a last resort or temporary measure due to known, long-term risks associated with synthetic hormone use and incomplete studies on natural hormone use.

Dr. Hanna Albert is a Naturopathic Physician with a family practice in Seattle. She can be reached at 206-650-9197, or


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