Making Menopause Your Friend—a Key to Profound Wellness

By Lyra Heller, MA

There comes a moment in our mid-40s, when we notice distinct changes in how we feel and look. This perception is deeply personal and, typically, not shared. Suffering quietly is common. Our bodies and skin appear different—less supple, dry, fine lines. Weight is more difficult to lose. Our ability to multitask seems challenged. Sex is less interesting. There are menstrual cycle changes: PMS erupts, blood flow thickens or thins, cycles are shortened, periods are skipped. We feel more emotional, reactive, and self-reflective. Feelings, once restricted to our monthly menstrual cycle, have no boundaries.

Awareness of this shift may be subtle, dramatic, or toggle between extremes. The familiar rhythm of how things are gives way to a sense of unpredictability. We blame it on stress.

Most of us don’t connect these initial experiences, the fluctuation and decline in estrogen and progesterone, to the beginning of perimenopause because we are still having periods. Yet, for most, this is how it begins.

Taming Your Hormonal Rollercoaster

Recognize the start: Knowing when our individual journey begins can incentivize making healthy choices that lessen our vulnerability to inevitable hormonal dips. For example, eating a colorful plant-based diet containing those foods and herbs typically reserved for menopause could dampen the impact of hormonal fluctuations and decline later. It’s never too late to start.

Hormone facts make you strong: Understanding some hormonal physiology dispels misconceptions that link hormones to accelerated aging. Yes, sex hormones are powerful. They influence our mood, appearance, behavior, bones, heart, brain, and reproductive organs. That said, our bodies are able to compensate with help.

5 Common Menopause Misconceptions

  1. Belief: Hot flashes are the only symptom of menopause.
    • Reality: The best-known symptom, yes, but not the only one. Sleep disruption is also a classic sign, resulting from alternating night hot flashes and sweats leading to fatigue. Other common symptoms include irritability, mood swings, and foggy thinking. Writing down your symptoms is the best way to keep tabs on them. Using a perimenopause symptom tracker, like the Kupperman Index, captures the complaint, frequency, and intensity of your experience. If fatigue is an issue, every morning ask yourself: How did I sleep last night? How many times did I wake up? What made me get up? How many times did I feel hot and/or sweaty? How often is it happening? How severe is it? This can help you and your health care provider zero in on the most helpful strategies for you.1
  2. Belief: Menopause is the beginning of the end.
    • Reality: It’s not a disease. Repeat: Menopause is not a disease. Physically, menopause is a term that describes a process of estrogen decline beginning, on average, at age 45 and terminating at 55 when your period stops for six consecutive months. Some researchers suggest one year. Menopause is divided into stages: perimenopause, menopause, and postmenopause, marking the beginning, cessation, and aftermath of hormone loss.2
    • This aftermath can be significant because estrogen is protective of your heart, cognitive function, bone and joints, gut, and reproductive organs.2 The great news: Dietary and lifestyle habits influence each of these systems. Knowing your body is key. The more challenging part is creating a plan. Finding a health partner may be the answer.
  3. Belief: Menopause makes you gain weight.
    • Reality: Our hormones are in flux, and yes, this can affect our metabolism and muscle mass. Many times, the appearance of “packing on fat” is loss of muscle. Another interesting finding suggests that as estrogen declines, testosterone, the male sex hormone, may influence our metabolism in favor of metabolic syndrome (MetS). A major MetS sign is increased tummy fat. Another consideration is low thyroid levels. This metabolic spark plug needs assessment. The recipe for weight gain is sedentary lifestyle, hormone fluctuation, and the possibility of low thyroid levels and/or MetS. Weight gain is not inevitable. Entering perimenopause is a time to evaluate your relationship to food, physical activity, and self-care. Achieving a healthy weight can translate to better health in the postmenopausal years. Plus, it will make you feel better now.3
  4. Belief: My sex drive will disappear.
    • Reality: Some women experience a dip in libido, but in other cases, it’s not desire that’s the issue. As your estrogen levels drop, you may experience vaginal dryness that makes having sex uncomfortable. Plus, vaginal tissue can thin out and loose elasticity. Lubricants like coconut oil help to make sex more comfortable if condoms are not being used, but oil can break down condoms. You can also ask your doctor to prescribe vaginal estrogen in the form of a ring, tablet, or cream.2
  5. Belief: Prescription hormone replacements are dangerous.
    • Reality: If a woman is in her mid-40s to early 50s and her period is slowing down or stopping, and if she is generally healthy, she is a good candidate for short-term hormone replacement therapy (HRT). Older than 60 is not a good age to start for the first time. HRT benefits include the reduction of hot flashes along with bone and colon protection. The major drawbacks are increased risk to breast and endometrial cancer, deep vein thrombosis (clots), fecal incontinence, and stroke. Elevated cholesterol and hypertension, unexplained vaginal bleeding, obesity, and history of smoking are considered risk factors.4
    • Consider HRT if hot flashes, mood swings, sleeplessness are “ruining” your life. No one should feel they have to “grin and bear it.” These complaints tend to be worse when you are younger. Another complaint is related to rapid bone loss.

Menopause is not a disease. All of us embark on this inevitable journey. Each of us experiences the decline of estrogen differently. The heart of the HRT debate is philosophical. Replacing what is naturally and gradually disappearing raises the question of “why replace?” Plant-based diets rich in fruits, vegetable, seeds, nuts, legumes, and grains, food derivatives like amino acids from protein and fatty acids from oils, and botanicals ease our menopausal transition and may protect our bones. Know your body. Talk to your healthcare partner.


  1. Nelson et al. Lancet 2008;371:760-770, Santoro et al. Clin Obstet Gynecol 2008;51:539-48, Paramsothy et al. Menopause. 2017;24(2):142-149.
  2. van Dijk GM et al. Maturitas. 2015 Jan;80(1):24-30.
  3. Janssen I et al. Ann Intern Med. 2008;168(14):1568-1575.
  4. Umland EM. J Manag Care Pharm. 2008;14(3 Suppl):14-19., NAMS position statement. Menopause. 2015;22(11):1155-1172, Staller K et al. Gastroenterology. 2017;152(8):1915-1921.

Lyra Heller, MA

Metagenics cofounder Lyra Heller, MA is an anthropologist who explores how different belief systems shape the patient-practitioner relationship and our innate capacity to improve health outcomes. She has helped create numerous science-based dietary and herbal formulas, was co-architect of the therapeutic lifestyle change program known as FirstLine Therapy Certification, and lectured globally on various topics.


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