Perimenopause: Conventional vs. Holistic Symptom Management
Perimenopause is a natural transition that typically begins in a woman’s 40s, though it can start earlier. During this stage, the ovaries gradually produce less estrogen, leading to a variety of physical and emotional changes. For some, perimenopause is a smooth transition, but for many, it comes with symptoms that impact quality of life.
Understanding your options—both conventional and holistic—can help you make the best choices for your health.
Common Symptoms of Perimenopause
Irregular periods
Hot flashes and night sweats
Sleep disturbances
Mood changes or irritability
Vaginal dryness
Changes in libido
Weight gain or difficulty losing weight
Conventional Symptom Management
Conventional medicine often focuses on symptom relief through medications and hormone therapy. Common approaches include:
Hormone Replacement Therapy (HRT):
Estrogen therapy can reduce hot flashes, night sweats, and vaginal dryness.
Progesterone alone can support better sleep and regulate mood swings that are linked to hormonal shifts.
Testosterone therapy can increase libido, improve cognitive function, and maintain lean muscle mass.
HRT is generally effective, but may not be appropriate for everyone, depending on personal and family health history.
Non-Hormonal Medications:
Antidepressants (SSRIs, SNRIs, and bupropion) are typically the first-line treatment for perimenopause. It is mainly prescribed to women who report symptoms of hot flashes, night sweats, and mood swings.
Sleep medications are often used to manage insomnia.
Other medications like gabapentin and clonidine can also be used to manage hot flashes and insomnia.
These treatments can be very effective, but they often come with potential side effects and may not address the root causes of imbalance.
Holistic Symptom Management
Holistic approaches aim to support the body through this transition, reducing symptoms while also promoting long-term health.
Lifestyle & Nutrition:
A whole-food, Mediterranean-style diet rich in vegetables, fruits, lean proteins, and healthy fats can balance hormones and reduce inflammation.
A plant-based diet, particularly one rich in soy, can significantly reduce hot flashes and night sweats in postmenopausal women. Studies have shown that adding a daily serving of soybeans to a low-fat vegan diet can decrease hot flashes by over 80%, with nearly 60% of women becoming free of moderate-to-severe hot flashes (1).
Regular exercise supports mood, sleep, bone density, and metabolism.
Limiting alcohol, caffeine, and refined sugar may reduce hot flashes and improve energy.
Botanical Medicine:
Herbs such as black cohosh, chaste tree berry, and ashwagandha are often used to support hormone balance, though individual needs vary.
Other herbs like St. John’s Wort can be used as a gentler alternative to SSRIs for those who want to try a more holistic treatment to manage depression and anxiety.
Acupuncture:
Acupuncture has been shown to reduce hot flashes, improve sleep, and support emotional well-being during perimenopause (2).
Stress Management:
Mind-body practices such as yoga, meditation, and breathing techniques can calm the nervous system and improve resilience.
An Integrative Approach
For many women, the best approach lies somewhere in between. Combining conventional options with holistic support can help reduce symptoms effectively while also addressing underlying imbalances and supporting overall wellness.
Perimenopause is a unique and personal experience. There is no one-size-fits-all approach, but understanding both conventional and holistic options can empower you to choose the path that feels right for your health and lifestyle.
If you’re navigating perimenopause and want individualized support, you can book an appointment with Dr. Kristiana Engelhardt, ND, at Reformed Natural Therapeutics.
References:
Barnard ND, Kahleova H, Holtz DN, et al. The Women's Study for the Alleviation of Vasomotor Symptoms (WAVS): a randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women. Menopause. 2021;28(10):1150-1156. Published 2021 Jul 12. doi:10.1097/GME.0000000000001812
He Q, Ren Y, Wang Y, Zhang F, Zhang S. The efficacy and safety of acupuncture for perimenopause symptom compared with different sham acupuncture control groups: A protocol of systematic review and meta-analysis. Medicine (Baltimore). 2020;99(10):e19366. doi:10.1097/MD.0000000000019366