What is it?

Menopause is the one year anniversary from your last menstrual period. Everything after that point in time is called post-menoause, and the time leading up to it (4-10 years prior) is considered perimenopause.

Perimenopause can start in your early 40s and may last for ten years. This is often a time in a female’s life that is dreaded and has a lot of negative stigma associated with it. Let’s change that. During this time, estrogen and progesterone start to decline, but they often don’t do so in a gentle manner. Instead, they start to decline and then ramp up and then decline and ramp up, until eventually they become depleted and the ovaries stop making the hormones. After this, the adrenal glands take over production, but produce estrogen and progesterone at a much lower level than the ovaries did. It is the fluctuation in these hormone levels and their overall decline that causes the unwanted symptoms of perimenopause.

It is our goal - with support through diet, supplementation and lifestyle adjustments - that we can manage the symptoms of perimenopause and support the body as it goes through these hormonal changes.

Step-by-step approach to treatment

Comprehensive intake and relevant lab testing
We always start by gathering your complete health history, assessing not only the symptoms specific to your perimenopause, but also those which relate to the foundations of health - including stress and energy levels, sleep and your digestive health. Relevant lab testing is always discussed. By obtaining lab results - specifically bloodwork - we get a clearer insight into the function of your body’s physiology. These insights are a great tool for guiding treatment. Naturopathic doctors are trained to look for lab results to be within optimal ranges, not just what may be considered conventionally “normal”. This is because you may be within all the normal lab parameters but still experiencing very real symptoms.

The lab tests commonly run aren’t looking to diagnose perimenopause, but rather to see what other hormonal changes and nutrient deficiencies may be occurring at the same time. Some of the common lab tests include:

• Nutrient status

• Blood insulin and glucose markers

• Cholesterol levels

• Thyroid panel

• Liver health and oxidative stress
  

Diagnosis of menopause includes the absense of a menstrual period for one year or longer. A female hormone panel (including estrogen, FSH and LH) can be done to confirm perimenopause but is not necessary unless symptoms are occuring earlier than 40 years old and there are concerns of premature ovarian insufficiency (early menopause due to low ovarian reserve).

Supporting the foundations of health
As with any health concern, supporting the foundations of health is essential, and always where treatment starts. This includes assessing and addressing stress levels, sleep quality, energy levels, inflammation, insulin regulation, digestive function and nutrient deficiencies.

Customized treatment plan
Once lab results have been interpreted, a customized treatment plan will be created just for YOU. This is not a one-size-fits-all treatment plan, but one that is specific to your individual health concerns and addresses your body’s physiology. You will leave your appointment with your written treatment plan as well as any relevant handouts so that you feel equipped to start your treatments when you get home.
We understand that starting on a new regime of supplements and implementing lifestyle and dietary changes can be overwhelming. If you need support along the way, know that we are here for you. Additional check-in appointments can be made to support you on your journey to optimal health.

Common treatments for symptomatic relief of perimenopause symptoms may include:

• Nutritional recommendations to support hormone balancing

• Nutritional supplements such as omega-3 fatty acids

• Herbs such as black cohosh, maca root and passionflower

Follow up testing and treatment adjustments
Once symptoms feel well managed we typically book a follow up appointment 3 - 6 months later to reassess symptoms and retest necessary labs. It is our goal that, after treatment has begun, you will start to feel noticeable improvements. Finding the right combination of diet and supplementation to treat perimenopausal symptoms can sometimes be tricky and thus, until symptoms are under control, we want to have semi-regular appointments to tweak your protocol as necessary. Know that if you’re not seeing improvements, we can always reassess, do further testing and make adjustments to your plan along the way. The goal is to get you not only feeling better, but feeling like YOU again!

Hormone replacement therapy has become a common and popular symptom management tool for perimenopause. Naturopathic doctors in Manitoba do not have prescribing rights and thus are not able to prescribe hormones. Should this be an option you wish to pursue you would be referred to your medical doctor or nurse practitioner.

Maintenance - addressing any new concerns
While we are here for you at any time along your health journey, it is not our goal to have you come in for regular appointments. As your hormones continue to change you may require additional support. Know that we are here for you when that happens. On-going care may look like annual, bi-annual or as-needed appointments. In these appointments we assess the original concerns you presented with as well as any new symptoms or concerns you are experiencing.