Why Do Some Women Experience Unpleasant Menopausal Symptoms While Others Don't?

A common myth in conventional medicine is that menopausal symptoms are caused by a deficiency in oestrogen. In reality, oestrogen levels decrease by only 40-50 per cent at menopause, while progesterone levels can drop to nearly zero. Although oestrogen deficiency is a factor, it fails to provide a complete understanding of hormonal changes during the 10-15 years of perimenopause before menopause.

Menopausal symptoms are often treated with birth control pills, hormone-based IUDs, hormone replacement therapy, or bio-identical hormones. While these treatments may reduce some symptoms in the short term, they do not address the underlying cause(s) of all symptoms.

What else can be happening?

Low adrenal function is one of the most important underlying causes of peri and menopausal symptoms.

During the menopausal transition, the ovaries stop ovulating and decrease their production of progesterone and oestrogen. For some women, this decline in hormones can occur abruptly or slowly over time. To compensate for the decrease in sex hormone production, a woman's adrenal glands, also known as the "stress" glands, take over for the ovaries during this stage of life.

The adrenals, just like ovaries, can secrete progesterone and other hormones like androstenedione which is a precursor hormone for oestrogen and testosterone. However, until menopause, the adrenal glands play a minor role in producing female sex hormones.

Throughout our lives, the adrenal glands are also responsible for the production of cortisol, aldosterone and adrenaline, among other hormones. The adrenals allow humans to respond to changing life situations by regulating sugar levels, adjusting metabolism, moving blood to where it's needed in the body, controlling electrolyte concentrations and regulating blood volume, etc. In doing so, they affect energy levels, our sleep/wake cycle, our blood pressure, and our ability to do things we need to do day-to-day.

Many women experience significant stress and responsibility while juggling raising children and their careers, often starting families later in life in their 30s and 40s.

By the time women reach the menopausal transition, the adrenal glands are so depleted that they are unable to produce healthy levels of hormones. In whatever capacity they can, the adrenal glands focus on the production of baseline levels of cortisol rather than the production of progesterone and other sex hormone precursors. The result is clear: increased menopausal symptoms and related adrenal deficiency symptoms such as fatigue, insomnia, and cravings.

What Can We do?

As usual, prevention is best; keeping the adrenals healthy is an important factor in enjoying a smoother menopausal transition. Addressing the root cause of the stress and learning adaptation techniques that suit each individual is paramount. There are many effective ways to reduce the impact of stress on our daily lives. Some of these practices include taking regular naps or small breaks throughout the day, getting fresh air and sunlight by going outside, practising yoga, and spending more quality time with friends and family. By adopting these habits, we can greatly minimise the negative effects of stress on our mental and physical well-being.

When menopausal symptoms are affecting your day-to-day quality of life, it is important to assess for adrenal imbalances. In clinic we do this by reviewing a client’s symptoms and medical history, and by conducting a salivary cortisol test to assess for adrenal function (Dutch CAR test). We usually combine this with a dry urine test to assess female sex hormones (Dutch Complete or Cycle Mapping. This information will enable us to recommend a personalised treatment protocol to restore hormone balance.

In conjunction with lifestyle changes, specific vitamins and herbal remedies in medicinal doses can be administered to address the underlying causes and provide relief of peri and menopausal symptoms. Try my PCH Balance - a perimenopause and menopause formula made with an optimal combination of nutrients and herbs to help support the needs of women experiencing hormonal imbalances.

An approach that takes into account all relevant factors (causes), including adrenal dysfunction can provide better therapeutic outcomes in treating menopausal symptoms. Improved treatment outcomes can allow menopausal women to enjoy the transition for what it was intended...entering a new phase of life!