I was answering this question asked by a journalist recently but since I often had to answer it as a naturopath also trained in bioidentical hormone therapy, I thought I would share my clinical observations of the last twenty years with you.
Note: Let us take for granted here that we are dealing with an average woman who has no illnesses and does not use medication on a regular basis. Nor would she have any contraindications to her medical records.
Can menopause really be relieved only through naturopathy?
First of all, we must understand that naturopathy is a patient-centered approach that doesn’t focus only on the patient's medical condition. Diseases - as understood and diagnosed in conventional medicine - are part of a medical logic or paradigm of its own. Although the naturopath takes them into account in his or her assessment, we adhere to a paradigm that is rather focused on the overall health of the individual.
Naturopathy is also a vitalist approach, that is, it aims first to identify the causes that hinder the free flow of vital energy which generates an imbalance, possibly manifested by one or more symptoms, and correct them.
Moreover, naturopathy is a so-called holistic approach, which means that a symptom - hot flash or other - cannot be dissociated from the current process of which it represents only a manifestation. The naturopath considers the various factors that have an impact on the individual's health: the diet, lifestyle, level of physical activity and stress, exposure to different toxic substances, vitamin deficiencies, etc. It is therefore understandable that each case is unique and needs to be the subject of consultation. We don't have a 'magic recipe' or CURE anything! Conventional medicine does not either, since healing occurs spontaneously when the causes of imbalances are discarded and the body has what it needs to repair itself. Everything else we do - both naturally and pharmacologically - serves only to support this innate mechanism of self-healing specific to every living being.
Before the advent of hormones, how did our ancestors manage the symptoms associated with menopause? Did they use stuff from nature?
It should be noted that menopause is not a disease but rather a normal period of cessation of menstruation occurring around fifty years of age. Nature had anticipated this and when ovarian production of the hormones progesterone and estrogens decrease, our adrenal glands usually take over. The problem is that our adrenal glands also produce our stress hormones including the famous cortisol and that progesterone serves as the raw material to make it. So, the more chronic stress we experience, the less effective our ability to manage this hormonal transition, resulting in symptoms of uncomfortable hormonal imbalances.
My mother went through menopause without taking hormone replacement but it seems that nowadays, most women can no longer tolerate symptoms. How can this apparent intensification of discomfort be explained?
The traditional way of life was less stressful and more in tune with natural cycles. It exposed us less to different sources of toxicity such as pesticides and other chemicals acting as endocrine disruptors in our bodies. The diet also contained more fibre - to eliminate hormonal and other residues via the intestine - and different vitamins and minerals involved in the biotransformation of our hormones, such as B vitamins and magnesium for example. Soil depletion, the use of chemical fertilizers, cooking and storing food methods, the consumption of vitamin thieves such as coffee, alcohol, medications, etc. are all factors that can lead to nutrient deficiencies despite the daily calorie intake.
Traditional diets also typically included items such as soy, yam and turmeric that provide phytoestrogens. Phytoestrogens are plant molecules which can attach themselves to and modulate the activity of estrogen receptors in our body, attenuating hot flashes and other unpleasant symptoms.
Of course, medicinal plants such as black cohosh, yarrow, milk thistle and many others have been the natural allied of women for millennia. Along with phytoestrogens, medicinal herbs supply us with valuable phytochemicals, nutrients and fibers which provide many benefits via their nourishing and detoxifying properties, supporting the production of bile and acting as mild laxatives, allowing the restoration of the natural hormonal balance.
As a general rule, are there symptoms that naturopathy treats more effectively? Which natural recommendation or supplement has been most proven with your clients during your years of practice?
Again, we do not treat a symptom or a medical condition, but a person with a biochemical individuality of their own and evolving in a specific environment. There is no 'best recipe' and you must get out of this mentality inherited from conventional medicine once and for all: 'Which supplement should I take to cure my symptom? Naturopathy is a truly personalized form of traditional medicine, looking at the individual in a wholistic perspective, and the results also depend on whether or not the person will follow our recommendations.
Naturopathy should be understood as a process of health optimization and not as a 'magic pill' that makes a symptom disappear. For us, the symptom is not an enemy to be eliminated at all costs, but rather an ally that informs us like a flasher on the dashboard of a car that tells us that there is an underlying disturbance that we need to be concerned about. It does not occur to us to unplug the blinker and ignore the problem, so why do we want to remove the symptom without addressing the cause of the imbalance? In doing so, the process of imbalance may continue to evolve until a new symptom emerges, often more severe and intense than the previous one.
In comparison, when you consult an acupuncturist, you do not ask them which point of acupuncture is most effective for a particular problem, nor do you ask the psychologist what is the key phrase to say to relieve someone who is going through a particular crisis. It is understood that the clinician must conduct their own assessment based on the knowledge of their respective medical approach or paradigm and through the lens of their client’s state. They then use the proven techniques pertaining to their healing art to restore homeostasis or balance. The process will gradually take its course with the participation of the person concerned and through follow-up meetings. The same goes for naturopathy. We have subjected our bodies to different forms of abuse or a poorly adapted lifestyle and diet for decades, so we must understand that the process of returning to optimal health will not be achieved in a single consultation or through some magic pill. We need to get fully involved in the process and allow ourselves the time and space to restore our health.
Is it utopian to believe that you can regain a hormonal balance past the age of 50?
No, not at all! What is utopian is to believe that all women are willing to adhere to the necessary changes and to adopt the good habits essential to the restoration and maintenance of this dynamic balance. For many, it is easier at least in the short term, to seek a pharmacological approach that will reduce the intensity of the symptoms without having to change anything to their lifestyle.
In my clinical experience there are about 1 in 10 women for whom the naturopathic approach will not be sufficient to effectively relieve the symptoms associated with menopause and who will eventually need an additional boost. In these cases, bioidentical hormone therapy can be considered. However, naturopathy should be incorporated in conjunction with this treatment or hormone replacement therapy in order to reduce the potential side effects associated with these treatments and to potentiate their effectiveness.
For a gynecologist, the most natural option is to prescribe hormones. For naturopaths, what is the most natural option?
The path of nature and respect for the biochemistry of women is always the most natural way. It is also necessary to distinguish between what is 'natural' and what is 'usual'. For example, for a smoker it is usual to smoke an x number of cigarettes per day, but does that mean that it is natural.
We seem to hear two different speeches about naturopathy: some argue that naturopathy has 'saved' them, while it does not work for others. How do you explain that?
The simplest answer is that neither the naturopath nor the naturopathy have control over what people do with our recommendations. If for example you suffer from a sprained ankle and the doctor prescribes 1 tylenol tablet every 6 hours, applications of ice and lift your ankle but instead, you buy a generic product of which you take only one tablet daily and sporadically without applying ice or immobilizing your ankle, will you blame the medicine and the doctor for your lack of result? We must also understand the importance of the individual's involvement in the process, and the fact that this process does not always take place in a straight line. For example, when you consult in psychotherapy and an exchange plunges you back into the heart of a painful emotion that sometimes disturbs you for a few days, will you reject the psychologist and blame the psychotherapy? Or will you understand that discomfort is part of the process of returning to your optimal state?
The other aspect worthy of mention is that the naturopathic profession is not regulated by a professional order in Quebec therefore, anyone can claim to be a naturopath. The person who suggested a supplement to you in a store after a three-minute discussion about your symptoms is not necessarily a naturopath and has not conducted a naturopathic consultation per se. A complete naturopathic assessment typically lasts about one hour and should be performed before making any recommendations. Members of l’Association des Naturopathes Agréés du Québec (ANAQ) have completed a serious 1500-hour training validated by an entry exam and identify themselves with the initials ND. A.
How long do I have to wait before I can see results?
It really depends on several factors including your general health, your naturopath's competence, your involvement in the process and how quickly you will implement the proposed changes, your stress level, your willingness to take supplements, etc. On average, you can expect to feel a difference by the end of the first month and get increased benefits after three to six months of follow-up.
Why is naturopathy a better option for a healthy woman during menopause?
Firstly, because it is respectful of our biochemistry and therefore without harmful and potentially dangerous side effects like those associated with hormone therapy. Secondly, because naturopathy considers the whole person in their environment and thirdly, because the factors on which we will work together will allow the optimization of her overall health and not just the suppression of the unpleasant symptoms. Our approach is truly personalized, and it works preventively. Indeed, the new science called epigenetics has taught us that most chronic diseases are largely the result of our modern diet, lifestyle and of our toxic environment which act directly on our genes and modify they function. By addressing these factors from the perspective of menopause and adjusting them according to the specific needs of each woman, the vital energy is restored and allows the body to regain its dynamic balance or homeostasis, which results in an optimal state of health on all levels.