Losing weight after menopause

Hello

I just started listening to your podcast and love it! I heard you mention menopause and how you gained weight and lost it. I would love to hear you elaborate on this subject. Menopause and Hashimotos and weight gain and what to do. I feel desperate with trying to lose and so many different ideas out there from intermittent fasting to keto and I don’t know what to focus on that will work. Please consider doing a podcast show about this.

Thank you

Beth Axxxxxxxx

Thanks for this question Beth.

Weight loss in menopause while also having Hashimoto’s can be a bit challenging. There are a lot of things to consider.

It’s not about calories in and calories out. Calories do matter and what kind of calories you are eating matter but what matters more is what is gong on in your body hormonally.

If you are struggling with weight loss, you could be dealing with a hormonal imbalance of some kind. Maybe your thyroid medication isn’t optimized well. Maybe some other hormone is off, like cortisol, insulin and/or leptin.

Maybe you have estrogen dominance or low testosterone. These things will determine how fat you get from the calories you do consume.

Most of the time the weight loss struggle, when not thyroid hormones, might be an issue of cortisol. When cortisol is high over a period of time it can create lower levels of serotonin affecting mood (depression), keep you from sleeping well (increasing sugar cravings) and can cause you to store fat.

Too much cortisol can create that dreaded muffin top and this needs to be fixed before much of anything else can be taken care of. Higher cortisol can give you that wired but tired feeling, make you quick to anger and make you feel irritable. It also is a cause of fat gain. I spent years like this though the weight gain in my late 30’s and all of my 40’s was really minimal because I was still cycling so estrogen was helping to keep me thinner.

When dealing with low cortisol you can get tired easily or have poor stamina and low cortisol can cause you to look at things in more negative ways, you might find you get sick more often, and of course it contributes to thyroid dysfunction.

Cortisol is 100% related to stress and how you react to it which will sabotage your fat loss. When high, cortisol increases blood sugar which leads to higher insulin levels which can increase fat storage.

Remember stress can be mental/emotional, strained finances, toxic relationships, infections, poor or little sleep (even shift work), food allergies/sensitivities and over exercise.

Bottom line, working to lower stress and manage cortisol will help reduce body fat.

When cortisol is high it will also decrease conversion of T4 to T3 which causes a slowed metabolism which will probably lead to fat gain.

I mentioned leptin before. This hormone tells your body when you are full so if leptin is blocked, you don’t get the full signal and you may end up eating more calories than you need/want leading to poor blood sugar regulation, higher insulin, and fat storage.

Gut health is also important. Many of you know a large percentage of your immune system lies in your gut aka GI tract aka intestines. If your gut is unhealthy, so are you, and this includes your ability to lose fat.

GI dysfunction very simply can look like gas, bloating, undigested food in your stools, terrible smelling gas, constipation and/or diarrhea, bad breath, nausea.

If the bacteria in your gut are out of balance, this can affect the conversion of thyroid hormone from T4 to T3, slowing metabolism. It can also affect the body’s ability to excrete estrogen creating a recycling of the hormone and cause you to gain fat.

If you are not properly breaking down the foods you are eating then you are not absorbing nutrients either. You need adequate protein to be digested and absorbed in order to make neurotransmitters, repair tissues and build a healthy immune system. If you have poor digestion this can lead to anemia which causes muscles to fatigue easily and can make it difficult to exercise and will decrease your ability to lose fat.

Inflammation in the GI tract can cause a stress response in the body which will increase cortisol production which can cause immune system problems in the gut itself leaving you susceptible to infections which will cause more inflammation and more cortisol leaving your body in a cycle of inflammation.

Eating foods you are sensitive to can cause a stress response in the body leading to release of cortisol and, you guessed it, fat storage.

Now you all know that when your thyroid is sluggish it means difficulty losing weight and easy gain of weight. All the stuff I’ve talked about can affect thyroid function and poor thyroid function which can include being on medication that isn’t fully supporting optimal function can affect all the stuff I’ve already discussed.

Sex hormones like estrogen and progesterone, when out of balance, will definitely cause you to hold on to fat as well. These hormones impact your ability to feel emotionally well, have will power and have any kind of motivation. In order for your sex hormones to be in balance, you have to have balanced blood sugar, balanced adrenals, and a healthy GI tract. If your testosterone levels are high you will have trouble losing fat. In addition, if you are dealing with any kind of toxicity at all from xenoestrogens, fat loss will be difficult.

All of this needs to be corrected before fat loss happens and fat loss should not happen if you are not reasonably healthy because you don’t want to be losing fat tissue which will mobilize toxins from that fat tissue and if you are not eliminating them, they will redistribute in other tissue. Not good.

Think if you have some of this stuff going on and then you hit menopause. Our estradiol is lower in menopause and estradiol helps us be more sensitive to insulin. So now we are at higher risk for insulin resistance.

Insulin resistance means your blood sugar levels could be normal but you might have too much insulin in your blood. High insulin with no where to go means fat storage. This means that for some of you for the first time in your life, what you eat will greatly effect your weight. Sugar and anything that converts to sugar will be a problem for you in excess. This means less dessert, less treats, avoiding sugary drinks and for some of us it might mean quitting these things altogether. It just depends on how important getting rid of the belly fat is to you. And it isn’t forever. Just long enough to give your body a minute to get insulin levels regulated and then you can figure out what you can enjoy and how much of it. It’s called finding your carb tolerance. This doesn’t mean you need to go low carb either because that is a problem for hashimoto’s but you might need to reduce the amount of bread, white potatoes and rice until you get things regulated. This is something I can help you with and I recommend having some labs done to see just where your biggest problems lie with this. There are some extra markers you should ask your doctor for but before you do, I recommend meeting with me to figure out what might be going on, then you can go to your doctor and get your labs done with what ever add ons I think you need.

Now, a topic all on its own is detoxification and I’m giving a talk at an online summit in January. Sign up for my newsletter at outofthewoodsnutrition.com for info in that in the coming weeks. There is a fair amount of research tying pesticides to fat gain and to poor liver health. Some in the scientific community suggest that our body creates more fat to handle the load of toxins we get exposed to. I have a couple of different questionnaires you can take to asses your toxin level when you work with me. It is the best and cheapest way to determine toxic burden because most testing is not reliable.

There is an immune system marker called Interleukin-6 or IL-6 and when that is increased due to inflammation of some kind, it can make it difficult to lose weight and keep it off and it may be a trigger for fat gain. Fat tissue is now considered to be an organ in the endocrine system and it likely causes inflammation while inflammation causes us to store body fat. Another vicious cycle.

Decreasing inflammation through diet is a great first step in beginning to lose fat. Cutting sugar, processed foods and eating real whole foods is important. If you need meal plans, I can help you with that. If you are a client in my 6 month package, you get meal plans for free. If you just want a meal plan consult, we can work something out.

All of this is tied to your brain health which I won’t go into detail here but what’s going on in your brain physiology impacts sex hormones, thyroid hormone, neurotransmitters like dopamine, serotonin, GABA and more.

Dopamine helps to keep our metabolism going and when we have low dopamine we have low energy and the worst part- sugar and junk food binges. Don’t let anyone tell you this is about will power. They can seriously suck it if they do. If you are low on GABA, it can also cause cravings for fat and carbs. This is not to say you should supplement with GABA because you can do that but that won’t fix why you are low on it in the first place.

I’m not about bandaids for problems unless they are needed to get your body on the right track while we figure out what problems you are dealing with.

Most of this info really applies to anyone but this question was about dealing with menopause. I went in early. I think I was 46 or 47. Either way I was super happy to not have a period anymore because my periods were horrible my whole entire life. I’m reading a book about hypothyroidism that was written at least 40 years ago and thinking back on my childhood and my first periods- I had so so many signs that my thyroid might not be functioning well all the way back to 13 years old. Sometimes this makes me so mad because I feel like a huge part of my life was just subpar. It’s really why I worked so hard to get my masters and my nutritionist license. I have so much to offer you guys in the way of experience and knowledge around these topics so that you don’t have to suffer like I did. It’s the only way I can not just sit and wallow in losing so many years of well being. I’m so glad I woke up and fought for better health. Some days are still a struggle but those are fewer and farther in between as long as I manage my stress and diet. In all honesty, I’ve gone off the rails a bit with my diet. Sometimes eating super healthy all the time just gets old. And, I’m paying for it a bit. My digestion sucks right now and today my energy level is in the tank but I think that is mostly due to getting up too early, working out too hard and a couple crappy things in my personal life.

I really need to start meditating and journaling again. I have a locked document on my computer where I write out things I would never say out loud or want anyone else to read. It’s where I get all the anger off my chest and just let it go. I highly recommend it for a release, especially if you don’t have anyone you can talk to regularly or you don’t want to always be complaining about certain people.

Anyway, back to menopause. As I said, I was around 46 when it hit for me. The average age is around 51. And let me just tell you- life is not over once you hit menopause. Before you hit it though, you might be having some crazy symptoms- even if you are fit and your diet is dialed.

Anxiety, racing thoughts, heart palpitations, hot flashes, insomnia, depression and so on. You can even have these symptoms in your thirties if your body is going to go into early menopause. If you are fit, these may be milder than someone who isn’t but very few of us make it through perimenopause without some symptoms. Peri-menopause occurs because your hormones, estrogen and progesterone, are all over the place.

Abdominal fat gain in menopause is real and so is loss of lean muscle. This is due to decreased sensitivity to insulin as I mentioned earlier. Your blood sugar is likely higher and there is likely some insulin resistance which lead to fat storage.

Any high cortisol, again, also leads to fat storage. We also become less able to build muscle and you are losing bone mineral density. It becomes pretty imperative at this stage in life to start exercising if you don’t already, and lifting weights is the most beneficial.

Let’s talk estrogen, specifically estradiol or E2. This form of estrogen declines in menopause. It promotes muscle growth and muscle strength- you need to lift heavy weights to make up for loss of estradiol.

You have to watch inflammation and blood sugar too. When estradiol declines but estrone or E1 might be a little higher and progesterone is low, it can cause sore joints.

The average weight gain in menopause is 5-8 pounds. As I mentioned before it was 28 pounds over a couple of years for me. It didn’t help I was mostly sedentary for 2 ½ years sitting at my desk doing homework and not changing how I ate much at all. In fact, I probably ate more sugar and crap due to stress in school which contributed to my weight gain. The change in estrogen levels and cortisol make us gain fat in our stomach which puts us at higher risk for heart disease. If your fat is in your thighs however, you are less likely to be at risk for heart disease.

Exercise and a dialed diet are going to be key to fat loss in menopause. I’m not a trainer so I can’t speak well to exercise but Stacy Sims in her book Next Level recommends sprint interval training for fat loss along with lifting heavy.

Her book gives you plenty of ideas on what kinds of exercise you can do but if you are new to exercising, buy the book and ask a trainer to help you work out based on the principles in the book.

It might take you some time to find a trainer willing to do it- I hired a guy who agreed to read my copy of Next Level and he never did. He told me he knew enough that he didn’t need to after he had the book for a few months.

Then, when I got it back it looked like he spilled water or something all over it. I was slightly annoyed over the whole situation- also I didn’t speak up for myself- still a work in progress there!

Alright- so sprint training and lifting heavy. I use an airdyne bike at my gym and do 8 rounds of 20 seconds high intensity and then 10 seconds off. I also lift heavy using a program from the book Hangry by Sara Fragoso and Dr. Brook Kalinak. I’ve definitely gained muscle and lost some fat but the biggest change has been body composition. My thighs are smaller and the dimples on my behind are getting smaller.

This has been two years in the making for me. In order for this to be sustainable and enjoyable I go to the gym 3 days a week and I foam roll, warm up, lift heavy, sprint and then stretch. I hate working out but after 2 years, it feels good to go. I feel stronger and more confident and the weight is coming off slowly which in my opinion is the only way to do it.

I’ve been more mindful of what I eat but that needs to get more dialed in as well. Like I said, I’m kind of off the wagon which for me just means eating more gluten free bread and too many nuts. I’ve also cut back on chocolate and rarely drink coffee.

By the way, lifting heavy as defined by Stacy Sims is lifting six reps or less of the most weight you can of things like deadlifts, chest press and squats. Get the book, read the book and then find someone to help you write a program from the recommendations in the book. Don’t try to figure it out on your own unless you are well versed in the gym already.

Doing this will help increase your metabolism, help you lose fat, improve your stability so you don’t fall and break a hip and improve your body composition.

Let’s talk diets.

If you are exercising, it will be super important to fuel yourself before you exercise otherwise your body will be stressed which messes with your muscle gain and fat loss. Eat a little protein and a carb like banana and nut butter, toast and nut butter, or something like that.

I tend to forget to do a carb in the morning but I do cold brew and protein powder before I go to the gym and I eat as soon as I get home. Sims states in her book that women specifically need to eat within 30 minutes of a workout in order to build muscle and keep our body from further breaking muscle down.

If you don’t eat right after your workout, your body is in a stressed place, blood sugar is likely high and you are more likely to store body fat. So working out while intermittent fasting is a big big no no. Eat some protein- whey protein is ideal, animal protein is also good. Chicken, eggs, nuts, fish, greek yogurt, cottage cheese. Any of these before or after are good.

Then do your best to get around 100 grams of protein per day or around 30 per meal.

If you google Stacy Sims and Intermittent fasting you will find a good article on why you should not do it. A very brief summary of why you shouldn’t intermittent fast or the ketogenic diet is because both of these diets mess with a neuropeptide called kisspeptin which, when it is disrupted will make our brain think we are deficient in nutrients, especially carbs leading to increased appetite and increases insulin resistance which leads to fat storage.

Fasting and exercising leads to higher cortisol which leads to fat storage. Short term, the keto diet might be great- long term it can mess up your endocrine system and increase fat gain. The article is called Yes! You are an athlete. No! You shouldn’t practice intermittent fasting. It’s a quick read and pretty easy to understand.

Bottom line- no to dieting, yes to exercising. Yes to figuring out your carb tolerance. Yes to looking at your blood work. Yes to joining me for 6 months every other week to help you get and stay on track with all of this. If you are sick and tired of being sick and tired. If fatigue is winning at keeping you on the sidelines of life more than you are winning at having the life you really want, then we need to talk.

You can schedule a discovery call at outofthewoodsnutrition.com under the work with me tab. Let’s see if we are a good fit. I know I can help you get your life back! Let’s do this together! I am compassionate and I have a real passion for helping people just like you get rid of their fatigue!

If you haven’t signed up for my newsletter you can do so on my website as well and get 5 things your doctor won’t tell you about hypothyroidism. I send out recipes almost every week in my emails.

Thanks to Beth for sending in this question. I love when you guys do that. If you have a question, please email me at stephanie@outofthewoodsnutrition.com or fill out the contact form on my website. It’s so much more fun to answer your questions than come up with content or guess at what you might be interested in.

Thanks for tuning in. Until next time.

Perimenopause and menopause with thyroid issues. Episode 33.

I'd be interested in hearing you discuss hashimoto’s and thyroid medication during perimenopause and menopause, and/or how those hormones can affect your thyroid and the way your body absorbs thyroid medicine. I'm 51 with Hashimotos, Armour Thyroid (90mcg), with levels considered normal by the endocrinologist. 

I am gluten and dairy free and eating well. But I still struggle with constipation, weight gain, insomnia, facial puffiness etc--hypothyroid symptoms. In November I had the first period that I have had in about 8 months. In the weeks after that, everything seemed to be in good working order...lost the weight, digestion was great, puffiness went away. Now a few months later (with no periods), all those same symptoms are returning.

I had been on Armour from June until I saw the endo in November .  I saw the endo on 11/19 and my TSH was 4.6, Free T4 0.81 (those are the only ones they gave me and there isn't a patient portal where I can peek at others that might have been taken).  

They advised me to go up to 90mcg at that time as he likes the TSH lower.  The period that I had was on 11/13 and so when I saw him everything was going GREAT...had dropped 6 pounds without trying, sleeping well, digestion good.  Have been on 90mcg since November and am creeping steadily upwards, digestion sluggish, insomnia, etc.  Ahhh!

Michelle. 

Thanks for your question Michelle- it is quite likely there are hundreds of thousands of women in your shoes. Before I forget to mention it- work with your doctor to at minimum add in a Free T3 test. TPO and TgAb antibodies tests and Reverse T3 would also be helpful. 

This is a complicated issue and I can give you some good general information but as with everything- we are all bio individual so you will have to experiment to find what works for you. 

Women start to make less estrogen and progesterone as we near our 40’s. This alone can trigger our thyroid to slow down. It sounds like you might be on a hormonal roller coaster here which is totally possible as you approach menopause. 

I like seeing that your endocrinologist likes to see your TSH lower than 4.6. Ideally it should be around 1-2. But upping your medication might not be the solution. That is not to say you shouldn’t take it as prescribed- I’m just saying there might be things you can do that will allow you to take a dose and stay there without having these fluctuations like you are. 

You say you are eating clean and gluten and dairy free. That sounds good, but what does clean eating mean to you? 

How much sugar or starchy foods are you eating? Once we hit a certain age, those starchy carbohydrates can be a problem for some of us when we are looking to maintain or lose weight. 

Those of us with hypothyroidism whether caused by Hashimoto’s disease or not can encounter issues with insulin resistance. Our body cannot process and tolerate sugars like it used to- my body certainly can’t. This means that you will have to be very mindful of what you are putting in to your body and even what time of day you do it. 

Maybe you feel tired an hour after eating lunch- even a paleo style lunch. If it had some starches in it, and you are feeling tired- like a sugar crash- then you likely are not tolerating starchy carbs at that time of day. 

If you struggle with sleeping- falling asleep or staying asleep a bit of starch in the evening meal might help you sleep better. The only way to know is to try it for a couple of days. 

Let’s talk about what perimenopause and menopause are before we dive in to what might be happening with you. 

During perimenopause (the 2-12 years before you reach menopause) 

It can start in your late 30’s but is more commonly occurring in your 40’s. You can have hot flashes, sleep problems, mood swings, and heavier than normal periods (this part is the worst if you ask me) and these symptoms can wax and wane for a good 10 years. 

Your estrogen during perimenopause will be fluctuating significantly to the point that you will have more than you’ve ever had circulating through your body at some times and other times it might be low. It is much like the blood sugar roller coaster but is called the perimenopause roller coaster. 

Symptoms include: 

• heavy flow that is new to you or longer flow (high estrogen)

• cycles that are less than 25 days long

• changes in breast tissue: lumps, sore, swollen (high estrogen)

• waking in the middle of the night and you didn’t before

• worse or more cramping

• start of night sweats, especially before a period (low estrogen)

• migraines that are new to you or are worse

• mood swings before a period (high estrogen)

• gaining weight without changing what you are doing

You may have some or none of these symptoms. About 20% of us will have dramatic changes during perimenopause. The rest of us are lucky to have minor issues. 

Progesterone is gradually lost during this time which is kind of like a cruel joke from mother nature because it is the progesterone that helps counteract the affects of estrogen. 

It also helps us deal with stress and the loss of progesterone makes us feel more anxious, depressed and have poor quality sleep. 

Managing your diet and allowing some self care. 

• Don’t kill yourself in the gym- over exercising or doing too intense of a workout will affect your energy levels for days to come, especially if your adrenal glands are worn out or confused about what to do for you

• Learn to let stuff go- like dishes and cleaning the house. 

• Avoid alcohol- this alone can wreak havoc on your hormones at this stage in the game. It keeps us from getting rid of that excess estrogen AND lowers progesterone.

• Manage your blood sugar. Journal your food so you can see just how much starchy food and sugary foods you might be eating. 

• Take magnesium- it calms our brain, helps us sleep and regulates our brain communication with our body

• Exercise gently, especially if you are dealing with Hashimoto’s. Autoimmune Strong is a great place to start. 

If you are dealing with heavy bleeding, you need to avoid dairy which Michelle already is, avoid alcohol, eat fermented foods and lots of veggies to help keep your gut bacteria healthy. Gut bacteria clear estrogen from your body and so does fiber so eating more veggies than you already are can be really helpful. I also find my energy to be better when I eat more veggies- like 7-8 servings or more a day.  

If your hypothyroidism is not being managed well (meaning your TSH and free T3 are not optimal)  then you may have heavier periods as well. Work to get your TSH around 1-2 and some doctors think it is okay if it is a little below one (.3 to .5)— especially if you are on a natural desiccated thyroid hormone replacement- When T3 is optimal you might find a suppressed TSH. Finding a doctor that will allow your labs to look this way is another story. 

Also keep in mind that you might feel great at a TSH of 2 and someone else might feel good at .3. This is bio individuality. It is so important to know your body and learn how to tell when things are off. 

Your thyroid medication may need to be adjusted seasonally too. If you live in a climate with winter- even all for seasons then your TSH may rise in winter and fall during summer. Another reason to really be in tune with your body and its signals. 

Part of my job as a Nutritional Therapy Practitioner is to help you learn how to do this. 

Menopause starts one year after your last period and symptoms should be better. 

You will have much less estrogen and progesterone at this point. Your adrenal glands will be making estradiol in your cells and this is supposed to be enough to keep you feeling good. BUT- if your adrenals were taxed for years before this happens then you may have some issues. 

Your endocrine system is made up of the pineal and pituitary glands in your brain, the thyroid and parathyroid glands, the Thymus (works with the immune system), Adrenals glands, pancreas and your ovaries. All of these work synergistically together as a system and when one is off, they will all be off. 

You can’t just take a supplement for your adrenals and think that it will fix your issues. It will help in the short term but it is a band-aid and not getting at the root cause of your problem. 

If you have gained weight around your middle, you are more than likely dealing with insulin resistance. This means that your cells are not accepting glucose or sugar from insulin as it travels through your blood stream to bring your cells sugar. Your liver and your muscle cells are not accepting the sugar so it just stays in your blood stream and eventually gets transported to fat tissue for storage. This is why we gain weight.  

The best way to combat this is to quit sugar completely. No dessert, no sweet anything. Every time you eat sweets it makes your insulin resistance worse. Even fruit- so keep your natural sugars to below 25 grams of fructose

High fructose corn syrup in soft drinks is 55% fructose, sugar cane is 50% fructose and honey is 40% fructose. Eight ounces of orange juice has 18 grams of fructose.  So pay attention to what you are eating. If it is sweet tasting, it is likely contributing to your weight at this point. 

Starchy foods like potatoes and rice are mostly glucose and very little fructose but you might find you still have a problem with those as well and will need to test your carb tolerance with a glucose monitor. Start with sugar though. It is more important at this stage to remove sugar from your diet and then look at the starches. 

Hormone fluctuations during perimenopause and menopause can affect how your thyroid functions. 

You might end up with estrogen dominance (the highs on the rollercoaster) which can keep thyroid hormone from attaching or making their way into the receptors on your cells. This means your cells are not getting thyroid hormone creating hypothyroid symptoms. 

Thyroid hormones are similar in chemical make up to estrogen. Too much estrogen or eating too much soy can block the receptor sites as well leaving you with less thyroid hormone in your cells and hypothyroid symptoms. 

As we lose our progesterone, we may see or feel a need for more thyroid hormone. We need progesterone to get T3 which is what our cells use and need. 

Our thyroid naturally slows down as we get older and therefore will not be able to get enough hormone to our cells affecting not only our energy but creating all the other symptoms we have talked about before. 

If you are dealing with chronic stress, and most of us are, this will also affect our ability to make enough thyroid hormone. 

When your thyroid is not working optimally or you are not medicated optimally, all of your hormones will be disrupted. 

It will be important to know if you are in menopause or if you’re having a thyroid problem. If you take estrogen thinking you are in perimenopause or menopause and it is actually your thyroid causing the problems, you might end up feeling worse and the estrogen will affect your thyroid function. Vicious cycle as with so many things in our body. One can’t work well without the other. 

If you have crazy periods during your 30’s and 40’s it is more likely an issue with thyroid than perimenopause. Thyroid problems are often the cause of early perimenopause. I’m a textbook example of this. 

They make the symptoms of perimenopause and menopause worse, affect blood sugar, make you depressed, affect your ability to handle stress. 

You have options: 

• start with journaling your food to pinpoint

  • are you eating enough

  • are you eating too much sugar

  • is your ratio of protein fats and carbohydrates where it should be

  • are you eating a lot of processed foods or a whole foods diet?

• exercise

  • reduces hot flashes

  • better mood

  • lessens depression, less anxiety

  • higher sex drive

  • sleep is better

  • more energy

  • lowers insulin resistance

  • increases bone density

  • helps manage weight

• natural supplements- introduce 1 at a time and wait 2-3 weeks before adding another one

  • maca powder

    • will help your hormones adapt and balance as needed

    • can reduce hot flashes

    • supports the entire endocrine system, including adrenals and thyroid

    • can regulate menstrual cycles

    • can increase energy and stamina

    • don’t take it if you are on estrogen

  • soy- is supposed to be helpful as a phytoestrogen to help with menopausal symptoms. I’m not sure how I feel about this. Don’t supplement but get it in food form. I would go for tempeh and miso and NOT genetically modified. 

  • Black cohosh

    • helps to reduce hot flashes

    • helps insomnia, fatigue, anxiety, depression

    • helps with joint pain/body aches

  • Damiana- tea or tincture (2-3 ml 2 to 3x/day)

    • helpful for hot flashes, low sex drive and general well being

  • Dong Quai

    • hot flashes, insomnia, fatigue, anxiety

  • Vitamin D

    • helps regulate endocrine system

    • supports sleep

  • Chasteberry or Vitex

    • helpful for breast tenderness

    • balances progesterone

    • water retention

    • headaches, irritability, depression, fatigue

    • sleep issues

The Period Repair manual is a must read for every woman

Supplements suggested can be bought through this trusted source (my fullscript store)