What to do about it.
Simply put, the idea is not to restore a prior hormonal profile, i.e, return to full reproductive status and never go through menopause. It’s a natural process that half the planet will go through (and we hear it’s great once you’re on the other side of it). It is about easing the symptoms by addressing the underlying dynamics.
During perimenopause, excess estrogen and the volatility of estrogen causes issues. And, for the most part, it’s not really possible to stop your body from producing estrogen without serious intervention so the best approach is to get rid of it, i.e., metabolize and or flush it out of your system. Milk Thistle (known to improve liver function which filters the blood and is the body’s main detoxifier) is like priming the pump. Indole-3-carbinol is a phytochemical found in vegetables like kale and Brussels sprouts and research shows it has an anti-estrogenic effect.
For waning progesterone, Chaste Berry (or Vitex agnus-catus) is the plant medicine used for hundreds of years in the Mediterranean region. There is also topical plant-based progesterone cream that can be bought without a prescription and can be used daily and easily by rubbing it into the skin.
During once periods become less frequent and then stop, estrogen is now waning. Consensus is now building around supporting this phase with estrogenic compounds like the phytoestrogen found in soy to lessen the symptoms but also to ease the transition and mitigate some of the more severe longer term health issues like cardiovascular disease and osteoporosis.
Now, let’s talk hot flashes. We still do not know exactly how or why they happen. But they happen and they are unpredictable and disruptive. There are many traditional plant remedies with long histories in different cultures around the world and new ones being discovered and studied. Clinical research results are inconsistent as are women’s reported experience. Unfortunately, we are still at a “try and see if it works” stage for most plant remedies. The more common ones are soy isoflavones, black cohosh, red clover, rhubarb root, swedish flower pollen extract.
The conventional medicine approach is to prescribe hormone replacement therapy (HRT) which could be estrogen, progesterone or both. Controversy continues regarding this course of action. New research shows the risk for breast cancer are twice as high than in an early study. And, counterpoint is that women do find relief (which makes sense if we believe that the volatility is the driver of symptoms, having a consistent daily dose might relieve those symptoms).
This points, again, to more self-awareness and more education to make the best decisions for our health and well-being.