The Silent Cost of Hormonal Changes
Many women often stay silent about menopause symptoms because they coincide with a phase in life where they are juggling multiple responsibilities. At the peak of their careers, they face intense professional demands while often also caring for aging parents and/or navigating the challenges of raising teenage children. This combination of pressures can make it difficult for women to prioritize their own health or seek support, leading them to endure symptoms quietly while focusing on the needs of others.
We believe the menopause transition should not prevent women from living their fullest lives. With the right approach, women can maintain their optimal physiological, cognitive and emotional balance before, during, and after the menopause.
What is Menopause and the Menopausal Transition?
Menopause is defined as 1 year after the final menstrual period of a woman.
The “Menopausal Transition” includes the stages of perimenopause, menopause, and early post-menopause; it varies in length depending on how early/late symptoms start/finish, but could be 20 years or more in total.
When does it start?
Menopause is a highly individual experience, with no single “common” reality that applies to all women.
Perimenopause is the time-period preceding the menopause, and most often starts in women ages 40 – 44. It is marked by hormonal fluctuation, changes in menstrual flow and in the length of the cycle and is accompanied by numerous physical, emotional and vasomotor symptoms triggered by hormonal shifts.
Awareness and education is essential.
By 2025, there will be 1.1 billion postmenopausal women¹, which is roughly 1/8th of the global population. While this is a staggering number, it does not account for the additional number of perimenopausal women.
MENOPAUSE IS PERSONAL
There is no one common menopause reality.
Menopause is a highly individual experience, with no single “common” reality that applies to all women.
Each woman goes through it differently, experiencing a unique combination of symptoms, timing, and emotional responses. Factors like genetics, lifestyle, and overall health can influence the severity and nature of menopause symptoms, meaning that what one woman experiences may be entirely different from another. This variability underscores the importance of personalized care and support during the menopause transition.
Connecting the Dots: Common (Peri)Menopause Symptoms
Hover your mouse over the dots in the following image to learn more about common perimenopause and menopause symptoms women experience.
Low Energy Levels
Women can experience significant changes in their energy levels during the menopausal transition, which can contribute to fatigue, unusual tiredness, mood swings, difficulty concentrating, and sleep problems. The drop in estrogen and progesterone hormone levels is the main cause for low energy levels for women during perimenopause and menopause.
Sleep Disturbances
The most common sleep disturbance is nighttime awakenings². Hormonal changes during the menopausal transition and menopause symptoms can cause sleep disruption. Some women can even develop sleeplessness or insomnia.
Weight Changes
Metabolic changes can occur during the menopausal transition, and this can lead to sudden weight gain. It’s common for women to experience more weight around their abdomen and hip areas during this mid-life phase. Weight gain, if not managed, can lead to other health issues⁶, which can worsen menopause symptoms.
Anxiety During Menopause
Approximately 25% of women experience increased anxiety during menopause³, and it can affect women at any stage of menopause, including perimenopause⁴. Menopause-related anxiety can increase the feelings and experiences of stress, panic, terrors, uneasiness, irritability, feeling “on edge”, restlessness, difficulty focusing, muscle tension, and inability to manage persistent anxious thoughts or worries.
Menstrual Cycle Changes
During both the perimenopause and menopause stages, women will experience a change in the menstrual cycles and affect ovulation. In perimenopause, women can have irregular cycles and experience lighter or heavier periods and/or shorter or longer cycles; periods can be more painful. A woman is officially in menopause when she has not had a menstrual cycle in 12 months.
Mood Changes and Mental Health
When your body enters the menopausal transition and your estrogen levels drop, this can drastically affect your mood. Irritability, anger, increased stress, anxiety, and generally low moods (including low self-esteem, feeling unloved, unsupported), are common symptoms during the menopause period.
Hot Flashes and Night Sweats
Sudden, intense rises of body temperature, sweating, dizziness, rapid heartbeat, chills, and redness are signs of hot flashes or night sweats (also known as vasomotor symptoms). Night sweats are specific to sleep/nighttime, as they can interrupt your rest. This symptom can range from mild to severe.
Depression During Menopause
Studies show that an increased risk of anxiety and depression can occur during menopause⁵, which can be due to lower estrogen levels affecting how the body releases the serotonin hormone. Women are more vulnerable to depression during the menopausal transition, including feelings of loss of interest or pleasure in activities or day-to-day life, unexplained sadness, tearfulness or crying, and numbness.
Hair and Skin Changes
Both hair and skin conditions can change during the menopausal transition due to the impact on your hormones and collagen levels. Some symptoms include hair thinning, hair loss, dry and/or itchy skin, acne, thinner skin, and increased facial hair.
Urinary System
The loss of elasticity in the muscles can affect the bladder muscles, leading to urinary incontinence (or urine leakage during coughing, sneezing, etc.). Urinary tract infections (UTIs) can also be more frequent during the menopausal transition; uncomfortable intercourse due to vaginal dryness can increase the risk of UTIs as well.
Body Aches & Muscle/Bone Loss
Women can experience joint and body aches (e.g., breasts, back, hips) and muscle pains. Muscle mass and bone density loss are symptoms of the menopause transition, potentially leading to more serious conditions such as osteoporosis and sarcopenia.
Libido Changes
Vaginal dryness, uncomfortable or even painful intercourse, and the overall decline of hormone levels can affect the libido and, in turn, a woman’s intimate life. The other symptoms listed previously can affect a woman’s mental and emotional health, which can also contribute to a lower libido.
Brain Fog and Head-Related Symptoms
“Brain fog” is often used to describe a multitude of symptoms that affect your concentration, memory, and even your mental health. Women can experience difficulty focusing on tasks, feeling sluggish and slower in their actions, and unable to retain or remember information. Headaches/migraines, lightheadedness, and dizziness are also common head-related symptoms.
Skin-Crawling Sensation (Formication)
One of the rarer menopause transition symptoms that women can experience is an itching sensation or skin-crawling sensation known as “formication,” which is a type of paresthesia (abnormal skin sensations like tingling, crawling, or pins). One of the possible causes is the nerve functions, blood flow/circulation, and/or skin moisture/collagen levels being affected during menopause.
Existing Treatments for Managing Perimenopause Symptoms & Menopause Symptoms
1. Menopausal Hormone Therapy (MHT)
2. Antidepressants (SSRIs/SNRIs)
3. Chemical Non-Hormonal Prescription Drugs
4. Herbal Dietary Supplements
5. Cognitive Behavioral Therapy (CBT)
6. Holistic Lifestyle Changes
Menopausal Hormone Therapy (MHT)
During perimenopause and menopause, women often experience fluctuations and a decline in hormone levels. Menopausal Hormone Therapy (MHT), previously known as Hormone Replacement Therapy (HRT), is the primary evidence-based and most extensively studied treatment for menopausal symptoms. This therapy helps restore hormone levels that decrease during the menopausal transition.
Different forms of hormonal therapy are available, including pills, patches, creams, implants, and gels. Options include estrogen-only therapy for women who no longer have a uterus, and combined estrogen-and-progesterone therapy for women who still have a uterus.
Hormonal therapy is primarily used to alleviate common menopause symptoms such as hot flashes, night sweats, vaginal dryness, sleep disturbances, fatigue and mood swings.
Although hormonal therapy is effective, it does carry some risks, including an increased likelihood of blood clots and certain cancers. These potential risks should be thoroughly evaluated and discussed with healthcare providers.
Women may experience side effects from hormonal therapy, including headaches, nausea, breast tenderness, bloating, and irregular bleeding, as well as withdrawal symptoms if the therapy is stopped abruptly. These withdrawal symptoms include the most common menopause symptoms listed above. It may take up to three months to fully experience the benefits of hormonal therapy, especially for symptoms like sleep disturbances and fatigue, and to establish the appropriate treatment protocol. Additionally, the cost of hormonal therapy can pose a barrier for some women, making it a less accessible treatment option.
Antidepressants (SSRIs/SNRIs)
Antidepressants are an option for managing emotional and psychological symptoms experienced during the menopausal transition, as hormonal fluctuations can often affect mood, energy levels, and mental well-being.
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed to help stabilize mood and alleviate depressive symptoms, as well as other menopause symptoms such as hot flashes and night sweats experienced during the menopausal transition. However, the efficacy of these medications for treating menopause symptoms is currently being debated.
Antidepressants can lead to withdrawal symptoms, and individuals may react differently to these medications. They can also cause side effects such as weight gain, sexual dysfunction, insomnia, and gastrointestinal issues, which may affect adherence to treatment. It is essential for women to thoroughly understand the various antidepressant options available and consult with their healthcare providers before starting treatment. Additionally, the time it takes for antidepressants to become effective can lead to frustration, and the pharmaceutical cost can be a significant consideration. There may also be a stigma associated with taking antidepressants, which can discourage some individuals from seeking necessary treatment.
Chemical Non-Hormonal Prescription Drugs
If a woman has a medical history or genetic factors that may contraindicate MHT, such as a history of breast cancer, alternative medications such as chemical non-hormonal prescription drugs are available to help relieve some physical menopausal symptoms.
Examples of chemical non-hormonal prescription medications include clonidine (a blood pressure medication), venlafaxine (an antidepressant), gabapentin (an anticonvulsant), and newer drugs like fezolinetant and elinzanetant, all of which can help relieve vasomotor symptoms such as hot flashes and night sweats.
The use of chemical non-hormonal prescription medications for menopause symptoms, while effective for some, can come with potential negatives side effects including: sedation, dry mouth, low blood pressure, nausea, weight gain, sexual dysfunction, dizziness, fatigue and cognitive effects. These treatments come with a pharmaceutical cost that can range from $20 to $300 a month.
Herbal Dietary Supplements
Herbal and more “natural” options for women have historically been used to help relieve menopause symptoms. Well-known herbal remedies, such as soy, black cohosh, red clover, ginseng, and evening primrose oil, are often advertised and marketed as menopausal aids.
Unfortunately, due to the lack of solid scientific evidence to support the efficacy and safety of these herbal dietary supplements, there are significant challenges and potential risks for women to take these supplements, which can lead women to rely on these herbal remedies, yet have them not provide the expected relief.
The other major risk to note about herbal dietary supplements is that regulation is often insufficient, and this can result in inconsistencies in potency, purity, and safety that can affect women’s health; for example, the suggested dosage for the supplement can be too overwhelming for some women while others may not even receive any relief from the supplement.
Moreover, some supplements can have side effects that have not been fully evaluated, studied or understood, which can make women susceptible to adverse reactions to the supplement.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a modality of psychotherapy to help individuals understand and modify negative thought patterns and/or behaviours for conditions such as anxiety, depression, insomnia, and stress. Women can experience heightened symptoms/conditions during the menopause transition.
This type of therapy offers significant benefits by providing a structured, goal-oriented approach that equips women with mindful strategies, coping mechanisms, and practical skills to manage emotional symptoms related to perimenopause and menopause, while also supporting their overall mental and emotional well-being.
It is important to note that while CBT can be a potentially costly option, it is typically a time-limited investment for women managing menopausal symptoms.
Holistic Lifestyle Changes
This no-cost, side-effect-free option is often recommended as a first-line approach for women, as well as a complement to other treatments for managing symptoms experienced during the menopausal transition. During this period, existing habits and lifestyle choices may become less effective or even exacerbate symptoms—for example, alcohol consumption can trigger more frequent hot flashes.
Recommended lifestyle changes include maintaining a balanced diet, engaging in regular exercise (though certain types, such as HIIT, may not be suitable for women with fluctuating hormones), managing weight, and practicing mindfulness and relaxation techniques. Even small adjustments, such as wearing lighter clothing, can help alleviate hot flashes and night sweats. Cultivating awareness is crucial when making holistic lifestyle changes to more effectively manage menopausal symptoms.
The Balance Wheel
There's no better feeling than feeling truly great.…
Isn't it more powerful to change the world from a place of empowerment rather than from a state of diminished capacity?
Menopause presents women with an opportunity for self-reflection and rediscovery, but its symptoms can often feel overwhelming and all-consuming.
By deepening our understanding of these hormonal changes and managing symptoms effectively, we can shift our focus toward what truly fulfils us in both our personal and professional lives.
Our phytomedicine is thoughtfully crafted to restore balance to your physical, emotional, and mental well-being, helping you feel more centered and in control.
