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Last week I discussed hormone health in women under 50, and this week I’m addressing hormone health in women over 50. Today, I’ll primarily talk about hormone changes during menopause and what you can do to keep your hormones balanced so you don’t have to suffer as much as you would if you just tried to “hang in there.”

What to Expect During Menopause

Menopause actually refers to the day in a woman’s life that marks the passing of one year without menstruation. The time leading up to menopause when the ovaries gradually begin to make less estrogen is known as perimenopause, which lasts for a few years. During perimenopause, hormone levels fluctuate and are imbalanced, and most women experience an array of symptoms, most notably mood swings, hot flashes, and sleep issues. Perimenopause usually begins during a woman’s 40s or 50s but can begin prematurely in a woman’s 30s. It usually last for five to 10 years.

Fluctuating hormone levels can trigger menopause symptoms in women. Conventional doctors often prescribe synthetic hormones without actually testing for hormone deficiency in the first place. But not all women who are going through menopause have low estrogen.

Lifestyle Changes and Supplementation

Healthy diet, regular exercise, and herbal supplementation can go a long way to minimize menopause symptoms. A low-sugar diet, in particular, has been found to be helpful. The diet I recommend almost across the board—one that includes plenty of low-sugar fruits and non-starchy vegetables, healthy proteins, beneficial fats, and probiotic foods—will keep you feeling your best during your menopause years.

If you eat well and exercise but still experience some symptoms, trying an herbal supplement might help. I like Natural Factors WomenSense MenoSense, which contains dong quai, Vitex, black cohosh, gamma oryzanol, and hesperidin. This formula is recommended for hot flashes and night sweats, in particular.

Hormone Replacement Therapy

For some women, diet, exercise, and herbs aren’t enough to ease menopause symptoms. When you have done all you can and still can’t get relief, it might be time to talk to an integrative physician about bioidentical hormone therapy. Bioidentical hormones are identical in shape to your body’s own hormones (unlike synthetic hormones, some of which are made from horse’s urine and increase the risk of breast cancer, heart attacks, and stroke).

The saliva hormone assay is the test used by integrative physicians to determine whether hormone deficiency is present. Considering your estrogen levels (estrone, estradiol, and estriol) as well as progesterone, testosterone and DHEA, and even thyroid and cortisol hormones, will give you a better picture of what is happening with your hormones as a whole.

You can obtain a prescription for bioidentical hormones at a dosage that is tailored to your body’s hormone levels. Regular hormone testing and symptom evaluation by your physician will help to ensure that you continue to take the appropriate dose for you.

If you are struggling with menopause symptoms, you’re not alone. Educate yourself about the options available to you, and most importantly, listen to your body.