Perimenopause/Menopause Interview notes

Perimenopause is the time period where the body’s hormone balance is changing; menopause actually marks the one-year anniversary of the cessation of menstrual cycles (menstruation). Most menopause formulas are actually targeted at perimenopause symptoms.

The recent clinical evidence for, and availability of, products that don’t contain soy, isoflavones, or phytoestrogens should greatly help those who won’t or can’t use products containing those components. This now opens the perimenopause category to those who were previously shut out.

This is a strong category but with a lot of competition among products and claims that inevitably leads to some confusion; not only among consumers but for some store personnel, as well. Product information from manufacturers can either clarify or confuse, depending on the message that they’re trying to send: are they trying to tout their own product as better than everyone else’s, or are they accurately representing the science and trying to provide real consumer choice?


Vitex (Vitex agnus castus), or chaste tree berry, contains small amounts of Agnusides, the active component of chaste berry. Chaste berry extract has been researched to corroborate traditional usage for supporting healthy female hormonal levels during menopause.

Dong Quai (Angelica sinensis) root is a traditional herb for female hormonal support, but has not been historically used for perimenopause/menopause.

Ipriflavone (7-isopropoxy-isoflavone) is a natural-identical soy-free isoflavone (bioflavonoid) that supports bone health, helps maintain healthy bone density, and supports post-menopausal calcium metabolism.

Natural Progesterone Skin Cream typically provides 20 mg of Natural Progesterone USP per use. Look for products with no artificial colors or fragrances that are paraben-free. Synthetic progesterone is not nature-identical.

Black Cohosh (Cimicifuga racemosa) is an herb that has been traditionally used by Native Americans to alleviate the symptoms of menopause and other female complaints.

Red Clover (Trifolium pratense) is an herb particularly rich in biologically active compounds called phytoestrogens that are recognized for their role in the support of healthy estrogen levels.

Soy Isoflavones are naturally occurring phytoestrogen plant compounds (Genistein, Daidzein and Glycitein) that are particularly concentrated in soybeans and which support high or low estrogen levels.

Pharmaceutical Drugs, including synthetic forms of female hormones, have side effects that may contraindicate their use since they are isolated synthetic substances, so many women prefer to avoid them. Since the normal change of life is not a disease state, the use of traditional natural substances to manage health makes sense to most people.


Women need to carefully review any label cautions and interactions, as well as the usage suggestions, to avoid any known interactions with medications. Even if no interactions have been noted, caution should be used when adding any new substance, however natural, to a medication regime.

People often mistakenly think that all estrogen compounds are alike. However, phytoestrogens are plant-based food compounds found in virtually all legumes that are about 1,000 times weaker than the usual circulating body-produced estrogen forms. That difference and the source makes plant estrogens much safer. Even soy isoflavones, which are phytoestrogens, have some key differences from endogenous estrogens formed in the body: much like cruciferous vegetables, soy isoflavones may actually prevent the conversion of estrogens into harmful forms (like 16α-hydroxyestrone), promote their breakdown by Phase II detoxification, and increase their excretion in the urine.

Another myth is that symptoms of perimenopause can all be treated the same. Everyone’s hormone levels are unique and complicated, so not every product will work for every person. Some trial and error may be required, and some consumers elect to have their hormone levels checked to help them choose which products are most likely to be right for them.

Women's Health Interview, October 2010

Women’s biggest health challenges tend to be related to three general areas: hormonal health (including PMS and menopause issues), pregnancy, and maintaining health as they age (bone health and avoiding chronic degenerative conditions).

Women do seem to suffer more from certain problems related to inflammatory challenges and hormonal changes. Because of their regular, or sometimes irregular hormonal cycles, there are both advantages and disadvantages compared with men; at least until menopause tends to even the field regarding heart disease, for example. Regular menstruation lowers iron stores, reducing health problems related to oxidative and microbial challenges from free radicals that can be elevated due to the actions of uncontrolled free iron. Because of this, premenopausal women tend to have lower levels of heart disease than either post-menopausal women or adult men.

Also, because of their greater reliance on three major forms of natural estrogen as a dominant hormone complex, women seem to have greater risks of getting hormonal abnormalities and elevated cancer rates related to breast, endometrial tissues, etc. There are numerous factors involved, but oxidation of estrogens into more dangerous forms has been suggested as a major contributor to those risks. The fact that certain volatile plastics containing free BPA and specific other chemicals are known to be strong estrogen mimics makes exposure to those substances very dangerous to women, in particular.

Men do share some of those risks; for example, some estrogenic agricultural chemicals widely used on lawns, golf courses, and farms (herbicides, pesticides) are suggested to elevate the risk of prostate abnormalities. But men’s consequences tend to be more subtle and drawn out than the very real risks that women face from both these exposures and lack of protective nutrients such as a range of antioxidants and detoxification aids such as silymarin, broccoli and cruciferous vegetable consumption, and various liver supporting herbs and nutrients. The regular use of NSAID anti-inflammatory drugs – often utilized for PMS and other aches and pains – is associated with side effects that similar-acting nutrients and herbs lack: negative effects include reducing availability of some important nutrients, upregulation of pain triggers, negative effects on mood, stomach and GI problems, and degenerative cascades. Bless their hearts; many women don’t have it easy.

Women who eat enough legumes, flax seeds, and other sources of plant estrogens (phytoestrogens) tend to have more manageable menstrual cycles. Certain signs, like menstrual-related migraine headaches, indicate a deficiency of adequate natural progesterone levels that can be helped either by supplying the herb Vitex (chaste berry) if premenopausal or by applying natural progesterone cream to the skin. Certain herbal formulas and isoflavones from foods are utilized to preserve healthy and more comfortable menstrual cycles.

One thing that women should do to prepare for menopause is to maintain their bone mass by exercise and getting adequate supplies of not only calcium but also vitamins C, D, and K, magnesium, boron, and other bone support nutrients. The value of an alkalinizing whole food diet is of primary importance. The presence in the diet of legumes and flax seeds eases the transition to menopause, which is a normal part of a women’s life cycle.

The existence of biofilms informs our understanding of areas where bacteria and microbes can gown in the body. The fact that certain organisms – helpful or harmful – can create a mass that is layered like chainmail to resist removal is a powerful visual image that aids in understanding why it takes so long to effect changes in our inner ecology. Ideally, we have friendly probiotic bacteria coating our GI and urinary tracts to crowd out undesirable organisms. In fact, it was recently discovered that the purpose of the appendix was to serve as a reservoir of such probiotics to help “reboot” the system in case of problems that kill off the good bacteria; of course, with antibiotics, high sugar diets, stress, and other factors lowering the vitality of our probiotics, some people will grow the nasty stuff in their appendixes, presenting a serious health risk. The ability of Candida albicans live yeast and other organisms to overgrow at undesirable levels at the expense of more beneficial probiotic microbes means that some of our layered biomass colonies are undesirable and difficult to remove quickly. D-Mannose and cranberry (blueberries, too) tend to help prevent the spread of these colonies by preventing undesirable particles from adhering to the urinary tract walls but don’t kill off existing colonies. Still, these natural substances are helpful in curtailing their spread while other strategies are implemented, such as low sugar intake or even pharmaceuticals.

To support breast health it is wise to avoid BPA plastics, don’t microwave food in plastic, don’t consume agricultural chemicals on food, eat a plant-based diet providing antioxidant-rich produce, and eat plenty of broccoli, cruciferous vegetables, and non-GMO legumes, especially soy.

Various experts warn us against eating soy, with the suggestion that plant estrogens are dangerous. I have investigated the scientific literature to determine the risk and found that the scientific consensus is that there is no risk for healthy women, and even no indication that soy foods are unsafe for women who have had breast cancer! That is amazing when you consider all of the negative theories being hyped on the Internet. Soy prevents oxidation and conversion of estrogen into its more dangerous forms, aids in liver metabolism of these hormones and various toxins, and has been “proven” to protect against heart disease (soy actually has an FDA-approved qualified health claim related to this benefit).