Menopause: What happens, causes of problems, and how to manage

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“When estrogen and progesterone levels fall, they often unmask problems in other departments, most notably a tendency to low blood sugar, a tendency to allergies and a tendency to poor adrenal and thyroid function – two conditions which are reaching epidemic proportions!” – Dr. Sarah Myhill, MD

What Happens at the Menopause

The menopause is a natural process caused by failure of the ovaries. The ovaries normally produce the sex hormones estrogens (of which there are three) and progesterone. The menopause is said to have happened when one year has elapsed without seeing a period. The average age at which this occurs is 49, but the age of onset of menopause runs quite strongly in the family, so when your mother went through the menopause will give you a clue about yours.

As the ovaries start to fail, the pituitary senses this and sends out hormones to try to kick them into action. Measurement of these hormones [follicle stimulating hormone (FSH) and lutenizing hormone (LH)] is the basis of tests to diagnose the menopause. However, the ovaries do not fail in a smooth way – sometimes they get a “second wind” after a few months of missed periods to produce another egg and another menstrual cycle, so that FSH and LH come back to normal for a short while.

In other words, do not rely too heavily on high levels of FSH and LH to diagnose the menopause!

After the ovaries have failed, there are still some sex hormones made in the adrenal glands and body fat.

I always think that there is an evolutionary explanation for everything! My view is that the menopause is necessary to allow the woman to raise her own children to an age at which they become independent (and help her children raise their children) without having the burden of more babies coming along!

The menopause may also occur to protect the woman from her own hormones. Estrogen and progesterone are both growth promoters and therefore risk factors for cancer…


The problems and symptoms of the menopause occur because of falling levels of estrogen and progesterone. These are steroid hormones and share some of the properties of the adrenal steroid hormones. All are important modulators of the immune system and also have profound effects on blood glucose levels.

So, when estrogen and progesterone levels fall, they often unmask problems in other departments, most notably a tendency to low blood sugar, a tendency to allergies, and a tendency to poor adrenal and thyroid function – two conditions which are reaching epidemic proportions!

My educated guess is that menopausal symptoms of flushing and sweating are related to hypoglycemia.

• A tendency to hypoglycemia is a major cause of disturbed sleep, and that makes everything worse!

• If sleep is greatly disturbed, then in the short term I would recommend taking whatever herbal or prescription medication is needed to get a good night’s sleep on a regular basis.

See “Sleep is Vital for Good Health.”

Management of the Menopause

• See links to articles on Hypoglycemia, Allergies, Hypothyroidism, and Adrenal Problems .

• Implement “The General Approach to Maintaining and Restoring Good Health.”

• Put in place all the anti-ageing instructions. See “Slow the Ageing Process.”

• Wobbly hormone levels – see below.

I’m coming to the view that as we age, we acquire “metabolic dyslexias.” That is to say that we get less good at making certain key molecules.

Some of these molecules, such as melatonin, DHEA, D-ribose and Coenzyme Q10, I am fairly sure about; but there are bound to be others.

As we age, our metabolism becomes less efficient and therefore we need more raw materials in order to produce the essential molecules. This means we have to work even harder at the general approach to health, and now is the time to review diet and lifestyle

Wobbly Hormone Levels

The major symptom of the menopause which is a major nuisance by day and can disturb sleep by night is hot flushes and sweating.

This is probably caused by what I call “wobbly hormone levels” and explains why some of the herbal remedies are helpful. Herbal remedies such as Black Cohosh (up to 2400mgs daily), Agnus Castus (20mgs daily), Red Clover, Wild Yam and so on, are partial agonists.

In pharmacology, an agonist is a drug that has an affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances, such as female sex hormones.

A partial agonist is a compound which has an affinity for a cell receptor, but unlike a full agonist, will elicit only a small degree of the pharmacological response peculiar to the nature of the receptor involved, even if a high proportion of receptors are occupied by the compound.

This means that:

When hormone levels are high, the herbal compounds occupy relevant cell receptors and block the effects of the hormones.

Conversely, when hormone levels are low, then these partial agonists still occupy hormone receptors but produce mild agonist activity.

The idea here is that we iron out and flatten some of the wobbles. This can be very helpful in preventing hot flushes.

Having said that, I am increasingly coming to the view that many hot flushes are triggered by hypoglycemia.

The clue here is that diabetics, who don’t control their blood sugar levels very well, often flush with alcohol. Alcohol is extremely good at destabilizing blood sugar levels, and the diabetic flush is very similar clinically to the menopausal flush.

So, work hard on doing a “Stone Age Diet,” which is of low glycemic index.

There are also nutritional supplements which can be taken to stabilize blood sugar level. See “Hypoglycemia – the Full Story.”

What Happens If You Have a Late Period?

As hormone levels decline, the periods may become irregular, heavier or lighter. So long as the “pattern” of the period is the same (that is, heavier on the first day or two, then lighter for the next few days), then I am happy to think this is a normal period. However, if there is irregular vaginal bleeding (that is, dribs and drabs, not related to a period), or any bleed for more than one year after a period, then this should be fully investigated, try a gynecologist.

See “Vaginal Bleeding – When it is Abnormal.”

Hormone Replacement Therapy (HRT)

My view is that there is now no good clinical reason for starting a woman on HRT. Progesterone has now been classified as a class one carcinogen by the World Health Organization. This applies to progesterone and estrogens, whether they are synthetic, natural, by pill or patch.

Progesterones and estrogens are addictive, which is why it can be very difficult for some women to stop their prescriptions, but applying the above interventions eases withdrawal symptoms.

Prevention of Cancer (Female Cancers and Prostate Cancer)

Female Cancers
The greatest worry when using sex hormones is the long term risk of cancer. Estrogens are converted in the body to different estrogens:

• Some “good,” such as 2-hydroxyestrone,

• Some “bad,” such as 16-alpha-hydroxyestrone.

The enzyme which controls this balance is inhibited by a natural substance – indole-3-carbinol  – found in cabbage and all brassicas [e.g., broccoli, cauliflower, Brussels sprouts, kale, collards, mustard greens, kohlrabi, rutabaga, turnip].

Indeed, a study by Dr. Marie Bell  demonstrated complete regression of cervical cancer in over 40% of women simply as a result of taking indole-3-carbinol. This ration of 2/16-alpha-hydroxyestrone is critical and improved by eating cabbage.

So the message is, if you want to prevent cervical and womb cancer, eat up your cabbage!

Prostate Cancer
It has long been thought that testosterone is the cause of prostate cancer. But this does not really make sense since it is the older men with declining levels of testosterone who get prostate cancer.

It appears to be abnormal metabolism of testosterone which is the cause of the problem. As men age, their metabolism goes awry and a disproportionate amount of testosterone is metabolized (by an enzyme aromatase) to estrone and oestradiol.

It is these female hormones which are the culprits in prostate cancer.

Therefore, it is important to monitor levels of not just testosterone but also estrogens in men on testosterone. If the estrogens are raised, then the offending enzyme aromatase can be inhibited by crysonine (a natural constituent of passion flower) 4 capsules of 500 mg daily.

Furthermore, there is evidence to suggest that, as with estrogens and female cancers, men also have “good” and “bad” estrogens and the 2/16-alpha-hydroxyestrone ratio is also important.

As stated above, the ratio can be improved by eating cabbage and other brassicas – so keep chewing!

What the Papers Say

The drug companies have a huge vested interest in getting as many women as they can onto HRT…. In order to get the results they want the drug companies have controlled and manipulated the trials in order to come up with a positive outcome.

If the outcome is less than positive then the trial is not sent to the publisher (because the sponsor controls the results). This is done through a pernicious system of giving money to doctors to set up such trials. The doctors know that unless there is a positive outcome, there will not be money for future trials and their publishing records and therefore chances for promotion will be compromised.

Medical charities, government committees, medical “education” (I call it “brain washing”), NHS departments [in the UK] and professorial chairs are all paid for by the drug and chemical companies.

One example of the nonsense that drug companies are trying to get away with at the moment is the use of Tamoxifen. They argue that Tamoxifen (an estrogen blocker) should be used to prevent breast cancer (lots of money to be made here!), but at the same time trying to kid us that extra estrogen (in the Pill and HRT) is perfectly safe to take.

So when you read about a new trial extolling the virtues of HRT, ask yourself, “Who paid for it?”

Related Test[s]

Thyroid profile: free T3, free T4 and TSH – Lab 21

Related Articles (in addition to those mentioned above)

“Nutritional Supplements – what everybody should be taking all the time even if nothing is wrong”

“Osteoporosis – Practical Nutritional Considerations”


* Dr. Sarah Myhill, MD, is a UK-based fatigue specialist focused on nutrition and preventive medicine. This article (#124, updated Sep 2009) is reproduced with kind permission of the author from her educational website ( ® Sarah Myhill Limited, Registered in England and Wales: Reg. No. 4545198. For ME/CFS patients, a special feature of Dr. Myhill’s site is her frequently updated, free 179-page online book – Diagnosing and Treating Chronic Fatigue Syndrome.

Note: This information has not been evaluated by the FDA. It is generic, includes opinions, and is not meant to prevent, diagnose, treat or cure any condition, illness, or disease. It is very important that you make no change in, or addition to, your healthcare plan or health support regimen without researching and discussing it in collaboration with your own professional healthcare team.

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