A Holistic Guide to Thriving Through the Post-Menopausal Years

Menopause marks the end of your menstrual cycles and a new beginning with more stable hormones and new priorities. Your children may have grown up, moved out, and started lives of their own, or your career may look different, you may have retired, down-sized, and have more freedom with your time. You may also find yourself asking new questions:

What do I want this next chapter of my life to look like? What gives me energy? What brings me purpose? And how can I preserve my health so that I can enjoy what I love most?

A holistic approach to post-menopausal health looks at the whole person - not just hormones or individual symptoms. Nutrition, movement, sleep, cognitive health, emotional wellbeing, relationships, purpose, and preventative healthcare all play important roles in healthy aging.

At Women’s Natural Health Niagara (WNHN), we believe post-menopausal care should be personalized, evidence-informed and focused on helping women feel strong, energized, and engaged in their own wellness for the years ahead!

Top Health Concerns for Women During Their Post-Menopausal Years

1. Purpose & Fulfillment

2. Preventative Nutrition

3. Cardiovascular Health

4. Sleep & Energy

5. Genitourinary Syndrome of Menopause (GSM) - formerly known as vaginal atrophy

6. Bone Health, Joint Health & Mobility

7. Hair Thinning

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Purpose & Fulfillment - First and Foremost

One of the most overlooked aspects of post-menopause health is overall quality of life.

With fewer daily responsibilities, you may suddenly have more time for yourself. This can be incredibly liberating-but it can also leave you wondering what comes next OR you may have increased responsibilities ranging from caregiving to unexpected life circumstances- which needs a different kind of approach compared to the former.

Building a fulfilling life involves developing new routines that work for you and make life less complicated. Strengthening old social connections, rediscovering old interests, or exploring something completely new are great ways to support your mental-emotional health at any time in your life, especially now.

Activities that help enhance several dimensions of health at once include:
- Regular walking and resistance training
- Learning a new skill - knitting, sewing, music, art techniques, singing, gardening, a language, designing
- Volunteering or mentoring, or even reciprocal learning which is listening to the life experiences of those who are younger than you, and likewise sharing your own.
- Spending time with family and friends - in particular, intergenerational engagement, which is just a fancy way of saying creating meaningful experiences with people of all ages from children to young adults.
- Creative pursuits
- Spiritual practices
- Getting outdoors and connecting with nature and sunshine
- Travelling and exploring new environments and cultures
- Creating meaningful goals for the next chapter of your life (daydreaming is good for you!)

Physical activity is particularly valuable as it maintains your long-term independence by supporting muscle mass, bone density, cardiovascular health, metabolic health, mood, cognition, and overall resilience. Even 15 minutes a day can make a difference to your physical and mental-emotional wellbeing. It’s about consistency over quantity - rather than hitting the gym once a week for one long session, try shorter sessions each day. And start small if you’ve been inactive for a while. Increase the pace/intensity of your walks every three days or so, and add a few extra minutes, until you are getting 30 minutes of exercise most days of the week.

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Preventative Nutrition

A Mediterranean-style diet provides an excellent foundation for post-menopausal health for most people, as it is associated with a lower risk of mortality by all causes, especially cardiovascular mortality, and it improves vasomotor symptoms (hot flashes), blood pressure, lipids, glucose, and mood. Choosing a Mediterranean diet over a typical Western diet is also associated with a significantly lower risk for breast cancer, ranging between 15-35% lower depending on the study [1–7].

If you are ready to follow the Mediterranean diet you will want to stock up on these foods at your next trip to the grocery store:
- vegetables with ample variety for each day of the week
- fruit, especially berries and cherries for their antioxidant power
- legumes, and if you don’t tolerate them too well start with smaller portions at first to build your tolerance
- whole grains, like quinoa, buckwheat, farro, barley, brown rice, and oats
- nuts and seeds, especially unsalted, unroasted walnuts, almonds, cashews, pecans, sesame seeds and pumpkin seeds, to maximize your nutrient intake and minimize sodium
- extra-virgin olive oil, and
- high quality lean protein such as eggs, turkey, chicken, low-fat dairy, and fish
- spices and herbs, such as ginger, garlic, thyme, rosemary, oregano, dill, basil, cumin, and parsley

This diet is as close to nature as it gets, emphasizing local and seasonal food with a goal to minimize ultra-processed foods, refined grains, added sugars, added sodium (salt), and saturated fat.

A women’s diet needs to be individualized and so we take into consideration digestive sensitivities, religious and taste preferences, health conditions, and potentially genetics when making dietary recommendations.

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Cardiovascular Health - A More in Depth Look

Your heart health deserves our full attention - as women age, cardiovascular risk can be influenced by changes in blood pressure, cholesterol, insulin sensitivity, body composition, physical activity, and other metabolic factors.

Build a foundation with a combination Mediterranean-style and DASH diet (general rule of thumb is to keep sodium intake from all sources to less than 1500 mg to 2000 mg per day depending on the patient, with an emphasis on high potassium and magnesium foods, and increase your intake of soluble and prebiotic fiber.

Also consider discussing some of the following evidence-informed supplements with your Naturopathic Doctor at your next visit. Working with your ND helps keep your treatment plan simple, targeted, effective, and safe (avoiding any interactions with current medications or conditions):

• Coenzyme Q10 - many women need to take statin medication to lower their cholesterol, which may cause CoQ10 insufficiency. CoQ10 is needed as fuel for myocardial mitochondria (the powerhouse of the cell) to generate ATP (our body’s energy currency that fuels all activities, much like gasoline for a car’s engine) in high-energy tissues like the heart.

• Soy isoflavones - benefits lipid profile, however should be avoided in breast-cancer survivors.

• Omega-3 Fatty Acids - include foods such as salmon, sardines, trout, mackerel, or a high quality fish oil or algae oil to get enough of the anti-inflammatory omega-3s, EPA and DHA (postmenopausal women may convert ALA to EPA/DHA less efficiently).

• Oat beta-glucan, psyllium, flaxseeds, and legumes - all great sources of fiber that helps bind bild acids in the gut to reduce circulating LDL cholesterol.

• Foods rich in inorganic nitrates - beetroots, arugula, leafy greens - which promote nitric oxide production to help relax/expand blood vessels and reduce arterial stiffness.

• Hawthorn (Crataegus) - strengthens cardiac muscle contractions (helps the heart pump more effectively), improves coronary artery blood flow, and mild reductions in blood pressure (for those with pre-hypertension or mild stage 1 hypertension).

• Magnesium - regulates blood vessel tone (relaxes smooth muscle) and helps regulate cardiac rhythm.

• Vitamin K2 (MK-7) - helps direct blood calcium towards the bone and away from the blood vessels to reduce cardiovascular calcification associated with high calcium supplementation.

• Aged Garlic Extract - to reduce high blood pressure, improve endothelial function, and slow down soft tissue arterial calcification.

• Hibiscus Tea - 2-3 cups of daily tea reduces blood pressure comparable to some low dose prescription antihypertensives in mild cases.

• Mind-Body Practices - Meditation, acupressure or acupuncture, yoga, massage/deep pressure, and breathing exercises are all effective at decreasing blood pressure and improving parasympathetic tone - this is especially important for those of us feeling wired and/or a dysregulated nervous system.

Advanced Diagnostic Testing may include one or more of the following: Lipid panel, hs-CRP, Apolipoprotein B (ApoB) and Lp(a), Oxidized LDL, Homocysteine

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Sleep & Energy - What is contributing to low energy in the first place?

Many times poor sleep quality or quantity and low daytime energy seem to be the only presenting symptoms, but if we dig a little deeper we may find multiple factors at play - and opportunities to make a real difference. For example, low energy and poor sleep can be caused by an underlying thyroid condition, issues with blood sugar regulation, iron deficiency (with or without anemia), Vitamin D and B12 deficiency, chronic disease, undiagnosed sleep apnea, mental stress, medications, alcohol and caffeine intake, and environmental exposures just to name a few. All of these areas of concern will be explored and ruled in/out during your visits with your Naturopathic Doctor.

Potential remedies to improve sleep range from magnesium and melatonin to herbal relaxants for the nervous system like Valerian, Hops, Passionflower, Chamomile, and Catnip. For those experiencing hot flashes at night adding in Red clover and Black Cohosh may be recommended.

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Genitourinary Health After Menopause

One of the most common areas of concern after menopause is genitourinary syndrome of menopause (GSM). Declining estrogen can affect the tissues of the vagina, vulva, and urinary tract leading to symptoms such as:

- vaginal dryness
- burning or irritation
- vaginal discomfort
- pain with intercourse and changes in sexual comfort leading to a lack of desire
- urinary urgency or frequency
- recurrent urinary tract infections

While these symptoms are common, they are not something you simply have to live with.

‍Natural and Conventional Treatments for Vaginal Dryness

For mild symptoms, vaginal moisturizers and lubricants provide significant relief. Women with moderate or severe GSM may benefit from discussing low-dose vaginal estrogen or vaginal DHEA with their Gynaecologist, Family Physician, or other qualified prescribing practitioner.

For women who prefer non-hormonal approaches, or when certain therapies are not appropriate, other Naturopathic options can be considered - Topical formulas may be ordered by your Naturopathic Doctor through a compounding pharmacy where individualized combinations of hyaluronic acid, Vitamin E, Vitamin D, fenugreek, licorice, red clover, and soy isoflavones may be used. Local probiotic suppositories with specific probiotic strains to support a health vaginal flora are often helpful for preventing UTIs, bacterial vaginosis and yeast overgrowth, and vaginal discomfort too.

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Bone & Joint Health, and Mobility

Bone health is one of the most important long-term considerations for post-menopausal women, since bone loss can accelerate during and after menopause as estrogen levels decline.

An effective bone-health strategy includes a combination of nutrition and movement:

- Resistance and weight-bearing exercises
- How to get enough protein each day
- Sufficient calcium from food, and supplementing when necessary (avoiding over-supplementation)
- Maintaining healthy Vitamin D levels with regular blood testing
- Supplementing magnesium (with dose and format specific for you) and other bone-supportive nutrients and foods
- Limiting smoking and alcohol

Targeting joint inflammation is also key, so that you can move your body more freely and comfortably to maintain your mobility long-term. Treatments may include one or more of the following, when appropriate and not contraindicated with current medications or other health conditions/risks:

• Glucosamine sulfate may reduce joint-space narrowing in osteoarthritis

• Collagen hydrolysate may joint discomfort in osteoarthritis

• Boswellia serrata (Indian frankincense) and curcumin/turmeric may reduce pain and inflammation

• Omega-3s (EPA and DHA) may have anti-inflammatory effect

• Ensuring optimal Vitamin D levels may reduce fall risk
  
  

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Hair Thinning

Losing hair can be quite distressing for women as our appearance is closely connected with our identity and self-confidence. It can also be a sign of an underlying condition, which should be addressed.

The hair goes through different stages of growth (6 stages) which can last several years, followed by a transitional stage (lasting a few weeks), and then a resting phase (or Telogen phase) where the hair falls out (and can last up to 8 months). Hair loss after menopause may be associated with the drop in estrogen and progesterone that occurs and the relative excess of male hormones (such as DHT).

The Treatment of Hair Loss from an Integrative perspective includes:

1. Ordering lab tests appropriate for you, may include one or more of the following: Iron panel with CBC, enhanced thyroid panel, an enhanced hormone panel, 17 OH progesterone, androstenedione, DHT, SHBG, prolactin, fasting glucose and insulin, Hemoglobin A1c, Liver and Kidney function, Autoimmune panel, fungal culture, heavy metals.

2. Obtaining a diagnosis and determining the root cause(s) such as Alopecia areata, Alopecia totalis, Telogen effluvium, Androgenic alopecia, PCOS, Congenital Adrenal Hyperplasia, Prolactinoma, hair damage from styling tools or chemicals, Tinea capitis, Hypothyroidism, or Iron Deficiency.

3. Oral Treatments may include topical melatonin, oral inositol, Spearmint, Saw palmetto, Ashwagandha, zinc, B vitamins, Panax ginseng, Vitex agnus-castus, Black cohosh, and/or formulas to target Gut Health if relevant

4. Nutrition: ensuring enough protein, calories, iron and other micronutrients are eaten each day in sufficient amounts to avoid a deficiency (and correct reversible deficiencies). Address blood sugar regulation (highs and lows) with regularly timed meals, and low glycemic food choices.

5. Mental-emotional and lifestyle health: stress reduction and exercise programming to manage stress hormones and blood sugar, and metabolic health.

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If this all seems like a lot, it’s because it is. When working with an ND we strategize to reduce the overwhelm. What does a tailored treatment plan look like for you? Great question!

The goal isn’t to target all of these areas with every possible remedy or solution. Your treatment plan is refined in a few different ways:

1. A Minimalistic Treatment Plan - We mindfully select evidence-based and tailored to you treatments to to be as effective as we can be without overwhelming your body or your routine.

2. Identifying and eliminating anything that is ineffective, minimally impactful, causing side effects, and adding more burden than benefit.

3. Defining what is a priority right now (items to get started on right away) versus a next step for long-term gains.

Working with a Naturopathic Doctor helps you prioritize your health without the guesswork. We take the time to proactively investigate your health concerns to determine the best approach to optimize your health. We put together a plan that is easy to follow so that you have the information and tools you need to move forward.

If you have any questions before getting started on your journey, book a Free Discovery Call with one of our Naturopathic Doctors today - Click Here to Book Now!

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