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By: Dr. Sushma Shah - Naturopathic Doctor


Menopause is a normal biological event that marks the end of a woman's reproductive years. It is the point when menstruation stops permanently. On average, menopause occurs at age 51, but like the beginning of menstruation in adolescence, timing varies from person to person. Today, an estimated 50 million women in the United States have reached menopause and most women will spend at least one-third of their lives in or beyond menopause

Menopause is the last stage of a gradual biological process in which the ovaries reduce their production of female sex hormones. Estrogen production in the body diminishes slowly over a period of years, commonly resulting in hot flashes, night sweats, mood swings, and memory loss. This gradual phase before the permanent cessation of menstrual periods is sometimes called perimenopause. The process of menopause is considered complete when a woman has not menstruated for an entire year. Another type of menopause, known as surgical menopause, occurs if both ovaries are removed for medical reasons. This may be done at the time of a hysterectomy (removal of the uterus)


Each woman experiences her own variation of the typical symptoms of menopause. Some studies even suggest that the signs and symptoms of menopause may vary between cultural groups. For example, up to 80% of American women experience hot flashes during menopause while only 10% of Japanese women experience that symptom. Some researchers speculate that these differences may be due to differences in diet, lifestyle, and/or cultural attitudes toward aging

In general, however, the loss of estrogen that occurs during menopause causes the following symptoms:

  • Irregular menstrual cycles - menstrual bleeding slows, becomes erratic, and then stops permanently (the process takes about 4 years)
  • Hot flashes - flushing of face and chest (may be accompanied by heart palpitations, dizziness, headaches)
  • Night sweats
  • Cold hands and feet
  • Vaginal changes - dryness, itching, bleeding after intercourse
  • Urinary changes - frequent urination, burning during urination, urinating at night, incontinence
  • Insomnia
  • Mood changes - depression, irritability, tension (usually occurs with sleep disturbances)
  • Loss of skin tone leading to wrinkles
  • Weight gain and change in weight distribution with increased fat in the central, abdominal area

Over time, depleted estrogen levels can contribute to the development of more serious medical conditions, including the following:

  • Osteoporosis
  • Cardiovascular disease
  • Alzheimer's disease
  • Macular degeneration (a serious eye disorder and the leading cause of blindness in the Western world)
  • Glaucoma
  • Colon cancer


Menopause is caused by a gradual reduction in the amount of estrogen produced in the ovaries. In general, menopause is considered complete when a woman has not menstruated for at least 1 year. Estrogen, a female hormone produced primarily by the ovaries, is essential for the reproductive process and influences menstrual cycles, pregnancy, some aspects of mood, and the aging process. In the years leading up to menopause, the ovaries become less functional and produce lower amounts of estrogen and progesterone (another female hormone). Studies indicate that women who smoke may reach menopause at a younger age than those who do not smoke. Some researchers speculate that the timing of menopause onset may be hereditary, but the evidence to support this claim is limited

Although menopause usually occurs naturally, it can be artificially induced through surgical removal of the ovaries (this is called surgical menopause). Menopause can also be caused by ovarian failure from cancer therapy, such as chemotherapy or radiation treatments


Menopause is part of the natural aging process in all women, unless it is caused by surgical removal of both ovaries. (This operation, known as a bilateral oopherectomy, may be performed at the time of a hysterectomy). Surgical menopause tends to cause a more abrupt onset of symptoms. The following risk factors may also hasten the onset of menopausal symptoms:

  • Radiation, and / or chemotherapy
  • Premature ovarian failure
  • Smoking
  • Hypothyroidismódiminished production of thyroid hormone
  • Insufficient production of hormones by the adrenal glands


It is important to have a thorough discussion with your healthcare provider regarding the benefits and risks of different options for reducing symptoms and health risks associated with perimenopause

At our clinic, during your initial 1 hour one - on - one consult with our Naturopathic Doctor, Sushma Shah, you will be undergo a comprehensive symptom intake in detail, and at the end of the visit, you will be required to do some blood and urine testing. Her assessment is oriented toward determining what is impeding your body's ability to function normally. She will determine which assessment tools are most helpful in establishing a treatment strategy specific to your health needs

Dr. Shah may order some specialized hormonal testing, blood tests to determine hormone and cholesterol levels, and a bone density measurement, if need be in order to get all the necessary physiological information and to get a more complete picture of your symptoms. Following this visit, you will be coming in for your second visit, in which she will be doing a full physical check up, including a breast exam, a traditional Chinese medicine tongue and pulse diagnosis, body fat analysis and blood glucose testing. After having gone through your case, she will be giving you an INDIVIDUAL TREATMENT PLAN, that is specific to the symptoms you have.


The following preventive measures may help diminish symptoms and reduce the risk of serious complications (such as osteoporosis and cardiovascular disease) associated with menopause:

  • Quitting smoking - smokers tend to begin menopause 1 to 2 years earlier than nonsmokers; smokers are also at an increased risk for heart disease and osteoporosis
  • Taking calcium supplements - helps protect against bone loss
  • Exercising - slows the rate of bone loss, reduces hot flashes, and improves mood
  • Consuming low-fat diets - helps prevent cardiovascular disease by decreasing LDL "bad" cholesterol and by lowering the chances of weight gain
  • Avoiding caffeine - some studies suggest that caffeine consumption may be a risk factor for osteoporosis in postmenopausal women


The goal in treating menopause is to alleviate symptoms and reduce the risk for long-term medical conditions, such as heart disease, breast cancer, and osteoporosis. To help determine the most appropriate treatment, it is important for each woman to discuss personal risks and benefits with our Naturopathic Doctor

The information in this article is the property of SUSHMA SHAH N.D., and is not intended to treat, diagnose or cure any disease. For any questions, or concerns, please contact me at 416 913 4325 (HEAL) or email me at

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