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Writer's pictureDr. Sara Hart

Mysteries of Menopause, Part 2



  1. What is Going On?

  2. Hot Flashes and Night Sweats

  3. Mental Clarity & Fatigue

  4. Aches, Pains & Weight Gain

It’s fine to feel the pores open and the moisture build up on the skin surface...When pounding the pavement for that last 100 yards of a day’s run, or pushing yourself biking uphill on the way back from Boulder (or any other hilly ride)… Hot flashes are completely different, and feel like a completely inappropriate bodily response. Like when you’re in the grocery store and the person scanning your groceries notices you’re dripping onto your food as you transport them from the cart to the conveyor belt. Coupled with the panic of needing to get out of that place it can be pretty much a disaster.


Hot flashes exist as a conglomerate of symptoms with a varied degree of intensity. They’re most common presentation is a sudden feeling of uprising heat and sweating. They can be accompanied by headaches, weakness, dizziness, shakiness, nausea, irritability and can even be as extreme to include fainting or a feeling of suffocation.

“Hot flashes affect about three fourths of women and usually begin before periods stop. Most women have hot flashes for more than 1 year, and up to one half of women have them for more than 5 years. What causes hot flashes is unknown. They may be related to fluctuations in hormone levels and may be triggered by cigarette smoking, hot beverages, certain foods, alcohol, and possibly caffeine. During a hot flash, blood vessels near the skin surface widen (dilate). As a result, blood flow increases, causing the skin, especially on the head and neck, to become red and warm (flushed). Women feel warm or hot, and perspiration may be profuse. Hot flashes are sometimes called hot flushes because of this warming effect. A hot flash lasts from 30 seconds to 5 minutes and may be followed by chills. Night sweats are hot flashes that occur at night.” From the Merck Manual.

While there is no way to retain the hormonal balance of your younger self, there are things that can be done to assist the ease of the transition. Hormone Replacement Therapy (HRT) has been the gold standard for treating the discomforts of menopause for many years. However, long term studies observing the use of estrogen and progesterone therapies either alone or in combination offer significant concern over the increased risk of cancers, cardiovascular diseases, strokes and cognitive impairment. While some women are at higher risk of these diseases already, the use of exogenous hormones only makes the statistics worse. Like all pharmaceutical medications, HRT (even bio-identical) is best used for as short a time as possible to ameliorate the most difficult time while getting the system cooled off and balanced to no longer need it.


The first step involves recognizing the individual triggers to help mitigate the frequency and the intensity of hot flashes. Some of the most common triggers are:

Alcohol Caffeine Some medication Spicy food Cigarettes

Heat Stress Food sensitivities Tight clothing

While not all of these may cause hot flashes for every woman, they are important aspects to explore as they may significantly be causing more harm than good for your body. Alcohol, caffeine, cigarettes and stress will be beneficial to avoid for long-term health as they can significantly increase the body’s inflammatory load.


Improving the body’s physiology assists the gradual adjustment in hormones to a new normal. The organs most likely to contribute to hot flashes during menopause include the liver, spleen, heart and adrenals.


The Liver: Supporting detoxification is imperative in our modern world. Daily consumption of leafy green vegetables, turmeric and beets are all beneficial, particularly to phase 2 detoxification which is the process of eliminating toxins from the body. When stressed, the liver easily becomes stagnant and will manifest uprising symptoms and agitation. Many of the reflexive things people use when they experience liver stagnation can make it much worse.... cigarettes, alcohol, caffeine, sugar all may provide a temporary sense of relief but result in a greater burden on the liver afterward. It is always important to balance our stress levels with resources of self-care, but during menopause this may need to be at the center of a woman’s attention.


The Spleen: Responsible for building the blood, the spleen correlates to the quality of our nutrition. When nutrient density is adequate, the body has all the building blocks necessary to undergo the day’s work and provides a firm foundation. When deficient, the body is easily affected by changes and has difficulty returning to a state of balance. Allowing adequate time for digestion, assisting the digestive process when weak with enzymes or bitters and choosing the highest quality food that is appropriate for your body will all benefit the richness of the blood.


The Heart: Connection to life’s passion and existing with compassion are keys to a healthy heart. When the heart is vital there is a rooted-ness in the body that allows for grace through transitions as a whole.

At seven times seven a woman's heavenly dew wanes; the pulse of her Conception channel decreases. The Qi that dwelt in the baby's palace moves upward into her heart, and her wisdom is deepened,” The Yellow Emperor's Classic of Internal Medicine, a 2,000 year old Chinese text.

If the heart qi is deficient upon entering peri-menopause there may be significant struggle to realign one’s self with the values that ultimately strengthen the heart. Heart heat will often manifest as hot flashes, chest and head sweating and palpitations. This commonly presents with anxiety and insomnia as well.


The Adrenals: The “battery” that powers our daily activity is affected significantly by the level of stress we consider normal. When we push ourselves to do too much, we can exhaust this system in our bodies. Symptomatically, heat expressed inappropriately from the body, especially at night in addition to fatigue may occur. Adrenal insufficiency can be an intensely debilitating disease requiring years of restoration and learning to live a calmer life. The best support for the adrenal system is routine. Having ample rest (including naps), daily relaxation and moderate activity maintains and restores the adrenal gland health. The adrenals are linked to the kidneys and from a Chiense medicine perspective, we must be careful to not over-extend this energy of our bodies. Learning to live in balance with our authentic energy level is a key concept for health and healing of the kidneys and adrenal glands.


Supporting the body through times of hormone adjustment are what natural medicine can do best. The resources needed to improve organ health are widely available from the plant world. For states of significant deficiency, the combination of hormone bolstering nutrients can make a world of difference in how a woman’s body goes through this life transition. Bioidentical hormones can be an invaluable part of the formula to create ease through the menopausal transition but ideally is not used as a long term treatment strategy.


For support through menopause or other times of major life change having individualized healthcare is a key to success. While symptoms are annoying, it is important to have thorough evaluation to get to bottom of things and truly understand what is going on in the body. This helps us not only address symptoms but also prevent future disease patterns from occurring. Naturopathic doctors utilize comprehensive testing to look beyond the basics of symptom presentation and to get to the root cause of health imbalance. Resources like adrenal stress testing, circadian rhythm evaluation, neurotransmitter testing in additional to basic bloodwork can create a clear guide to restore balance.


Chinese medicine practitioners are able to identify patterns in organ function that reveal congested states in some parts of the body and weakness in others. These patterns can vary greatly from one body to another that may present with similar symptoms. Every body is unique so having healthcare providers who acknowledge and treat to the uniqueness of ourselves provides the best solution to improve health over time.


The transformation of maiden into crone or shifting from the reproductive era of life to that of an elder is a time of great reconciliation for the energy in a woman’s body. Through careful attention and natural medicine resources this transition can be a peaceful shift from one beautiful life phase into the next.

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