There are various treatment options available to manage perimenopausal and menopausal symptoms in conventional and naturopathic medicine. 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 menopause.

1. Conventional Treatments
2. Naturopathic Treatments


  • Hot flashes and other symptoms that may occur during the menopausal period are often treated with hormone replacement therapy, or HRT

  • HRT adds back in the estrogen and sometimes the progesterone that the body no longer makes

  • Premarin, the most common form, is taken from the urine of pregnant horses
    (Note: Many animal welfare groups question the treatment of the horses used for this process, as well as the treatment of the baby horses that result from the pregnancies, and urge women considering this therapy to ask their doctors about alternatives to Premarin).

  • HRT has long been believed to reduce the risk of osteoporosis and heart disease in post-menopausal women. Recently, however, studies have reported that HRT may not help prevent these conditions after all. In addition, the use of HRT may increase the risk of uterine and breast cancer


Current or past breast or uterine cancer, chronic or acute liver disease, endometriosis, current blood clots or a history of blood clots, a history of stroke, recent heart attack, pancreatic disease, gallbladder disease, fibrocystic breast disease, familial high cholesterol, high blood pressure that is aggravated by estrogen, migraine headaches that are aggravated by estrogen, uterine tumors, and undiagnosed vaginal bleeding.


  • Breast pain, vaginal bleeding, nausea, leg cramps, weight gain, depression

  • Increased risk of ovarian cancer ,endometrial cancer, breast cancer after 4 or more years of HRT

  • Increased breast density, making mammograms more difficult to interpret and possibly increasing breast cancer risk

  • Increased risk of blood clots

  • Increased risk of gallbladder disease

  • Increased risk of heart attack or stroke

  • Bloating and fluid retention, primarily associated with progestins

Given all this, it may be best for many women to seek alternative treatments for hot flashes.


At the Nature's Intentions Naturopathic Clinic, our focus is geared toward treating the root cause of the problem naturally. Our naturopath will do a comprehensive assessment of your health symptoms at the initial visit, and you will be required to do some blood and urine testing. She may also suggest additional hormone testing and other laboratory tests in order to assess any imbalances in the body that may be affecting your health. She may recommend some natural treatments for menopausal and perimenopausal symptoms * such as:

  1. Diet, exercise, lifestyle, stress management and counseling
  2. Nutritional supplementation
  3. Herbal Medicine
  4. Homeopathy
  5. Traditional Chinese Medicine / Acupuncture
  6. Natural Hormone supplemention (creams or supplements)
  7. Bio-identical hormone therapy and desiccated thyroid for women who are also suffering from hypothyroidism


Increase intake of the following foods:

  • Cold water fish such as salmon, tuna, herring, mackerel and halibut
  • Flaxseeds
  • Soy foods*
  • Legumes
  • Whole grains and seeds
  • Sea vegetables
  • Wild yams

  • Avoid spicy foods, caffeine and alcohol as can trigger hot flashes
  • Decrease animal and saturated fats
  • Regular physical activity – stretching, aerobic exercises : walking, jogging, yoga and weight bearing exercises
  • Relaxation for stress management


Approximately 80% of American women experience hot flashes, while only about 20% of women in many parts of Asia experience them. The difference between the two, researchers believe, is the amount of phyto-estrogens in the diet. These substances, which are found in plants, act a lot like estrogen when they get into the human body. Although these phyto-estrogens are much, much weaker than regular estrogens, they may help to ease the symptoms of the menopausal period for many women if your estrogen levels are low. However, women who have had a history of breast /cervical cancer, should talk to their naturopathic doctor before consuming soy products. Soy rich products include: tofu, soymilk, soy nuts, edame, soy burgers, soy hot dogs, miso, soy ice cream, and many other products to which soy or soy protein has been added.

In addition to soy foods, phytoestrogens are found in highest amounts in flax seeds, sunflower seeds, bean sprouts, and legumes like garbanzo beans and peas. The best and most well-studied source of phytoestrogens are soybeans and soy products. Increasing consumption of soy foods and also of vitamin E may really help ease the transition through menopause. I do recommend to first get a hormonal assessment done to see where your hormones are at before increasing your soy intake.


Getting a little tired of soy? Well the same substances in soy, the phytoestrogens, that are so good for menopausal symptoms, are also found in a number of other legumes. Chickpeas, lentils, and peas are relatively higher sources, but most other beans contain some phytoestrogens.

These phytoestrogens act a little like the estrogen that your body used to produce, but are much milder. Enjoying a plate of cooked beans over some brown rice, or a bean burrito or two may be enough to help you start feeling better. And with all of the other health benefits of beans, you can't go wrong.


Flaxseeds are the richest food source of substances called lignans. In the body, lignans act a little like estrogen, one of the hormones that women stop producing at menopause. Although these lignans are much weaker than real estrogen, they may have just enough of an effect to put a damper on those uncomfortable symptoms. Sprinkle some ground flaxseeds over your salad or into a bowl of oatmeal.

High-lignan flaxseed oil is also a source of lignans and can be used to replace other vegetable oils in salad dressings. (High-lignan flax oil is a specially-processed version of this oil that has been allowed to retain some of the particulates found in the seed). It is important, however, to never cook with flaxseed oil as it can damage the beneficial omega-3 fats.


Although flaxseeds are much higher in lignans, sea vegetables, including dulse, hijikis, and arame, also contain lignans that may be helpful with those hot flashes. Throw some hijiki on that salad, right on top of the flaxseeds, and eat your way to a symptom-free menopause.


The lignans found in high levels in flaxseeds are also found in a number of other foods. In particular, they have been found in rye, oats, barley, and wheat germ. Sunflower seeds and bean sprouts also contain other types of phytoestrogens that may be helpful. Including some of these foods in your diet may not only help with this natural stage of life, they will also add wonderful variety.


Reports seem to indicate that yams (those of the Dioscoreae family) may be helpful during the menopause. Some cultures believe that eating yams can be beneficial, especially around this time of life. Laboratory studies have shown that yams contain compounds that are similar to substances that the body uses to make progesterone, another hormone that is normally produced prior to menopause. Like estrogen, however, production of this hormone stops during the menopausal period. Unfortunately, it is unclear whether or not these substances are actually used by the human body to make chemicals that would act like the missing progesterone. But since yams are so nutritious anyway, it certainly couldn't hurt to give them a try!


  • Vitamin E
  • Magnesium
  • Calcium
  • Omega 3 fatty acids


Several studies have reported that Vitamin E reduces the frequency of hot flashes in some women. Vitamin E is especially recommended for treating the hot flashes of women with a history of breast cancer who cannot take HRT.

It is unknown exactly how vitamin E prevents hot flashes, though it is known that vitamin E is very good for stabilizing blood vessel function. It may therefore prevent hot flashes by preventing the blood vessels from dilating so much and causing flushing. In addition, vitamin E is also excellent for preventing atherosclerosis and heart disease. Mustard greens, chard, turnip greens, and sunflower seeds are a few excellent sources of vitamin E.


Magnesium may help decrease stress and promote normal sleeping patterns through its ability to relax and calm the nervous system. Chard and spinach are two excellent food sources of magnesium.


Calcium has been found to reduce bone loss that accompanies the drop in estrogen levels caused by menopause. Excellent sources of calcium include spinach, turnip greens, mustard greens, and collard greens.


Omega-3 Fatty Acids have been found to reduce risk of heart disease and may help regulate hormone levels. (When estrogen levels drop, women become at greater risk for heart disease). Some food sources of omega-3 fatty acids are flax seeds, walnuts and cold water fish, like salmon, cod, and halibut.


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 non-smokers; 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.

Please ask your doctor or naturopath before starting on any supplements. Its is better to first identify the cause and then treat it with the right remedies, even though those mentioned above have minimal side effects.

If you have any questions or would like to schedule an initial naturopathic appointment, please call us at 416 913 4325 or email us at

* DISCLAIMER: The information on this page is the property of Dr. Sushma Shah, Naturopathic Doctor, and is not intended to treat, diagnose or cure any diseases or promote any services or products mentioned on the website.

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