How to Manage Menopausal Symptoms Naturally

Menopause can bring about many physical changes, including hot flashes, vaginal dryness, pain during sex, heart palpitations, and sleeping disruptions. These symptoms are the result of fluctuating progesterone and estrogen levels.

While many women dread this point in their lives because they fear the common symptoms associated with menopause, menopause can also be viewed as a time of opportunity.

With the right attitude, it is the ideal time to make changes to your lifestyle and diet to improve the quality of your life.

Because menopause happens for women later in life, typically in their 50s, they’re usually at risk for certain diseases related to aging. And when menopause hits, the risk for specific health conditions further increases because as the ovaries age, they release fewer follicle-stimulating and Luteinizing hormones, so the regulation of estrogen, progesterone, and testosterone decline. These hormonal changes and the natural reduction of estrogen levels during menopause can significantly affect your health for years to come if the right lifestyle changes are not made in time.

Due to the reduction in hormonal levels, one becomes more susceptible to weight gain, incontinence, heart disease, stroke, and osteoporosis. According to a study led by Kaiser Permanente researcher Erin LeBlanc, of more than 124,000 women who participated in the Women’s Health Initiative, women who enter menopause before age 46 or after 55 also have an increased risk of developing type 2 diabetes.

Dr. LeBlanc’s study was published in the journal menopause and concluded, “women who start menopause before or after this window should be aware that they are at higher risk, and should be especially vigilant about achieving optimal weight, eating a healthy, nourishing diet, and exercising regularly. These lifestyle changes will help to reduce the risk of type 2 diabetes.” [1], as well as other conditions.

Dietary Guidelines During and After Menopause

While the average age for menopause is 51, you may begin menopause as early as your mid-40s, and some may even experience symptoms in their 30s, chiefly if one is overweight. It’s never too early to start preparing for menopause by developing healthy dietary habits and improving your iron and calcium levels while controlling your sugar and salt intake.

While there are hormone replacement therapies, more and more women prefer natural remedies.

Here is a short dietary guide to help you during the stages of menopause: 

1. Calcium 

Although calcium is the most abundant mineral in the body, menopause causes a decrease in estrogen production, so your body will be less able to retain calcium. And without sufficient amounts of calcium intake, your bones will become weaker, increasing your risk for osteoporosis because blood calcium levels are strongly regulated and do not fluctuate with changes in dietary intakes. When there is insufficient calcium intake from the diet, the body uses bone tissue as a reservoir to maintain constant calcium concentrations in the blood, muscles, and intercellular fluids.

While there are calcium supplements that you can take to ensure sufficient calcium intake, calcium is prevalent in many plant-based foods such as dark green leafy vegetables, including kale, broccoli, turnip greens, and whole sesame seeds. You also want to avoid foods that cause calcium loss, including foods rich in salt, which increases calcium loss in the urine, and caffeine which also increases the rate at which calcium is lost from the body.

Vitamin D increases calcium absorption, and a recent study shows that the overall prevalence rate of vitamin D deficiency was 41.6% in the US. [2-3]

The National Osteoporosis Foundation (NOF) recommends 800–1000 IU of vitamin D after age 50. If you don’t get sufficient sunlight, especially during the winter months, I suggest taking vitamin D supplements with 2000IU a day. You may take vitamin K alongside this vitamin to ensure that calcium is distributed to bone tissue. However, if you consume enough leafy green vegetables, there is no need to supplement this vitamin. If you do not eat sufficient greens, you may need to supplement with vitamin K2 – x2 times a week with vitamin D.

2. Fiber 

Keeping your weight in check during menopause; therefore, following a fiber-rich diet is best. A high-fiber diet can also help you with menopause-related issues that include bowel irregularity and bloating. Foods rich in fiber include Brussel sprouts, bananas, apples, broccoli, pears, whole grains, lentils, and beans. Check out our personalized menu option to receive step-by-step guidance with a meal plan designed for your specific needs here.

3. Soy

Soy’s physiologic activities are similar to estrogen. Therefore, much research has been conducted on the potential benefits of soy on symptoms of menopause and natural alternative to hormone replacement. In a systematic review on using isoflavone supplements for menopausal women, researchers found that isoflavones positively affected blood pressure and glycemic levels. The women who participated in the trials reported a reduction in hot flashes, making it a promising treatment option for women who refuse hormone replacement therapy. [4]

However, soy also has a very positive effect on lipid profiles, making it crucial during menopause. A meta-analysis of 38 controlled human studies of soy consumption showed that soy products with intact soy isoflavones in soy protein would improve lipid profiles. They reduce low-density lipid (LDL) and triglycerides and increase high-density lipid (HDL) levels. The consumption of 25 g of soy protein a day is very beneficial. [5-7]

 4. Avoid Sugar and Unnatural Fats

When taking charge of menopause with a proper diet, it’s essential to recognize the foods that you should increase in your diet. It’s also crucial for you to avoid unnatural fat-rich foods or too many dairy products, as this is a time when your body will have a more challenging time preventing weight gain.

Also, avoid the damaging effects of excess sugar and salt. Remember that menopause increases your risk for diabetes, so you should avoid unnatural fats that collect in your cells where they should not be, as well as added sugar, particularly sugar-rich drinks. And too much sodium has been linked to high blood pressure and calcium losses, as I mentioned.

5. Black Cohosh

The North American Menopause Society suggests natural remedies for hot flashes, including black cohosh. Black cohosh or Cimicifuga racemosa is also known as bugbane, black snakeroot, baneberry, and bugbane. It’s also been touted as a potential treatment for night sweats, vaginal dryness, and sleep disturbances.[8]

This effect occurs due to black cohosh’s effect on serotonin receptors, relieving hot flashes and improving mood through a serotonergic effect. [9-10]

6. Red ginseng

Red ginseng comes in capsule form or can be consumed as a tea. In a double-blind, randomized controlled trial, researchers observed 72 women randomly selected to take a red ginseng supplement or a placebo for 12 weeks. The results showed that the women who took red ginseng had significant improvements in the menopause rating scale, decreased cholesterol levels, and reduced fatigue, insomnia, and depression. [11-12]

7. Red clover

Red clover is high in isoflavone content; therefore, it has the potential to lower menopause symptoms. In a study on the effects of red clover on hot flashes, researchers concluded that red clover effectively reduced the hot flash intensity and decreased night sweating. Red clover also showed an impact on endometrial thickness and an increase in Luteinizing hormone levels. [13] Red clover comes in supplement form, and it can also be taken as a tea.

8. Physical activity

A team of researchers from the Department of Kinesiotherapy and Special Methods in Poland conducted an extensive study to investigate the association between physical activity and the severity of menopausal symptoms. The studies concluded that women with low physical activity levels were more likely to have severe symptoms. [14] Exercise and physical leisure activities are also beneficial for holistic well-being while menopausal women maintain a healthy weight, decreasing menopausal symptoms.

9. Change of Attitude

Although some women suffer during menopause, most women do not. Of course, menopause clinics do not want you to know this. They tell us that when we lose our hormones, we lose our youth, and only doctors with pills can save us from this destiny, but there are many good things about menopause.

Firstly, the effects of estrogen on behavior are diluted. Aggression, copulation, communication, and learning are all affected by estrogen’s ability to activate different molecular pathways. When estrogen is reduced, we become more assertive and better at caring for our interests.

Also, no more menstruation, which is quite nice. No more fear of getting pregnant, no more iron loss, loss of energy, and all of the pre-menstrual syndrome symptoms.

Also, when you reach menopause, most often, the children are leaving or have left home. So you now have the time to rediscover yourself, your needs, and desires, and go after them after years of caring for the children.

If you do not see things as optimally, the herb St. John’s wort, studied extensively for treatment of depression, is superior to placebo and equivalent to antidepressant medications (61–75% improvement in mild-moderate depression) with minimal side effects as compared to some of the antidepressants. [15]

Another study showed that taking St. John’s wort for 12 weeks significantly improved psychological and psychosomatic symptoms and sexual well-being. [16]

The combination of St. John’s wort with black cohosh to treat menopausal symptoms shows a synergistic effect. [17]

I recommend taking 300 mg a day. However, please note that it should not be taken with antidepressant medications, as this can be hazardous.

Furthermore, St. John’s wort can interact with other medications by decreasing their efficacy, including oral contraceptives, anticoagulants, cyclosporine, digoxin, and protease inhibitors. [18]

You may find it appropriate to take hormone replacement therapy for a period if you desire or need it; however, you should weigh the risks versus benefits and think about alternative options.

Menopause can be difficult for women as the symptoms include hot flashes, mood swings, insomnia, decreased metabolism that leads to weight gain, and the risk of developing bone fractures.

However, when met with the right attitude and a dietary plan that supports your nutritional requirements and avoids problematic foods at this stage, you can bravely face menopause and even thrive while reducing many of the discomforting symptoms.

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Dr. Galit Goldfarb

References: 

1. Erin LeBlanc, MD, MPH. Early and late menopause can increase risk of type 2 diabetes: Length of lifetime reproductive cycle can affect risk. Kaiser Permanente. Menopause. 2016,
2. F. Cosman, S. J. de Beur, M. S. LeBoff, E. M. Lewiecki,B. Tanner, S. Randall, and R. Lindsay. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014; 25(10): 2359–2381
3. Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011 Jan;31(1):48-54. doi: 10.1016/j.nutres.2010.12.001.
4. Chen LR, Ko NY, Chen KH. Isoflavone Supplements for Menopausal Women: A Systematic Review. Nutrients. 2019;11(11):2649. Published 2019 Nov 4. doi:10.3390/nu11112649
5. Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids. N Engl J Med. 1995;333:276–282.
6. Food labeling: Health Claims; Soy Protein and Coronary Heart Disease. Federal Register: October 26, 1999. 1999;64:57699–57733.
7. Knight DC, Howes JB, Eden JA. The effect of Promensil, an isoflavone extract, on menopausal symptoms. Climacteric. 1999;2:79–84.
8. Mohammad-Alizadeh-Charandabi S, Shahnazi M, Nahaee J, Bayatipayan S. Efficacy of black cohosh (Cimicifuga racemosa L.) in treating early symptoms of menopause: a randomized clinical trial. Chin Med. 2013;8(1):20. Published 2013 Nov 1. doi:10.1186/1749-8546-8-20
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10. Burdette JE, Liu J, Chen SN, et al. Black cohosh acts as a mixed competitive ligand and partial agonist of the serotonin receptor. J Agric Food Chem. 2003;51:5661–5670.
11. Tode T, Kikuchi Y, Hirata J, Kita T, Nakata H, Nagata I. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet. 1999;67:169–174.
12. Kim SY, Seo SK, Choi YM, Jeon YE, Lim KJ, Cho S, Choi YS, Lee BS. Effects of red ginseng supplementation on menopausal symptoms and cardiovascular risk factors in postmenopausal women: a double-blind randomized controlled trial. Menopause. 2012 Apr;19(4):461-6. doi: 10.1097/gme.0b013e3182325e4b. PMID: 22027944.
13. Ghazanfarpour M, Sadeghi R, Latifnejad Roudsari R, et al. Effects of red clover on hot flash and circulating hormone concentrations in menopausal women: a systematic review and meta-analysis. Avicenna J Phytomed. 2015;5(6):498-511.
14. D?browska-Galas M, D?browska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina (Kaunas). 2019;55(8):466. Published 2019 Aug 11. doi:10.3390/medicina55080466
15. Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, Melchart D. St John’s wort for depression–an overview and meta-analysis of randomised clinical trials. BMJ. 1996;313:253–258.
16.   Grube B, Walper A, Wheatley D. St. John’s Wort extract: efficacy for menopausal symptoms of psychological origin. Adv Ther. 1999;16:177–186.
17. Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther. 1998;15:45–53. 
18. Zhou S, Chan E, Pan SQ, Huang M, Lee EJ. Pharmacokinetic interactions of drugs with St John’s wort. J Psychopharmacol. 2004;18:262–276.