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Menopause, More Than Just Hormones

When we as women talk about 'menopause', the majority of us refer to the dreaded hot flushes, fatigue and irritability.

Several other symptoms such as a raging anger, poor memory, anxiety, depression, fatigue, sleep disturbances/insomnia and decreased libido are also associated with the cessation of periods. What's important to acknowledge is menopause is challenging and different for every woman. After 20 years of clinical practice supporting women through it, I know the best way to beat it is to start by being kind to you. By providing support for your mind, body and soul you will get through this complex transitional time of change.

There are so many changes happening within your body during menopause beyond hormones; which is why researchers now refer to these symptoms as the 'Menopausal Symptom Complex'. The complexity of menopausal symptoms is wide and extensive, involving total body health. This means several areas not normally associated with menopause such as the immune system, brain neurotransmitters and even the digestive system are now acknowledged by researchers to play a role. The secret to good health after 40 is to start picturing menopause as a total body health condition. Once you do this, it's easier to get your health and hormones back on track again.

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Let's look at oestrogen for example. The usual assumption is that a decline in oestrogen levels is to blame for all of these symptoms. Which is a little narrow minded given menopause is so complex!

There is in fact little evidence that dropping levels of oestrogen are responsible for any of them apart from hot flushes and vaginal atrophy. Even hot flushes are debateable, with both research and clinical experience showing that hot flushes do not always improve with hormone therapy.

So what does this new 'term' mean for women going through menopause? Finally, we are one step closer to those around us understanding effective menopause support is not just as simple as taking oestrogen or an anti depressant.

So what is causing all these symptoms then? And how can you regain a sense of self and improve them? The first step is to look at the basic essentials; Body, Mind and Soul.


Medical researchers agree a healthy menopausal body is a more metabolically active body. This means you metabolize everything faster, including eliminating excess hormones and fat stores.

This means, the first step to improving metabolic wellness is to let us reassess your health and identify the underlying causes of what's slowing down your metabolism.

For many women this can be a complex mix of hormones, poor digestion, genetic weaknesses, inflammation, toxins, nutritional depletion, infection, environmental exposure, medications, stress, bacterial overgrowth, poor liver and kidney excretion and overall stagnation.

With this in mind, identifying these causes with targeted pathology testing is a fantastic place to start and this is one of the services we offer at MassAttack!


Restoring psychological wellness through calmness, positivity and mindfulness reduces feelings of anxiety, stress and anger; bringing back a sense of control to healthy dietary choices and stopping emotional eating in its tracks. Simple as it may sound, mindfulness transforms how we relate to stressful events and experiences. Research from around the world shows stress levels cause weight gain even when you're sleeping!

Mindfulness transforms how we relate to events and experiences that have a profound impact on our health. It creates a more positive way of managing stress and supports good habits to get you healthy. This was you maintain optimal health through menopause and beyond.

Neurotransmitters involved with brain chemistry also influence menopausal symptoms. New and exciting research supports the brain is changing with age, and that around the time menopause comes around, it has become less receptive to neurotransmitters, especially to serotonin, noradrenaline and GABA.

There are many factors that reduce sensitivity of the brain to neurotransmitters during menopause including:

Chronic stress

When you approach menopause, you have usually been under ongoing stress for many years, trying to balance a job with raising a family and having a social life, financial worries, aging parents, relationships and work security and so on. You may also have suffered trauma or Post Traumatic Stress Disorder. Even ongoing exposure to other peoples stress as seen in work situations such as nursing etc can trigger vicarious trauma; which is something often overlooked. All of these factors reduce sensitivity of the brain to neurotransmitters, especially during menopause.

Chronic inflammation

This can be in joints, digestive tract, muscles, fibromyalgia; the result of endometriosis, PCOS or other reproductive conditions; allergies, poor digestive function, bowel dysbiosis, candida or leaky gut. This is an interesting link, given many women have suffered from intolerances and stress etc. Recent research links chronic inflammation and generalized stress to Post Traumatic Stress and many menopausal women have experience one or more of these conditions for quite a while when they approach menopause.

Insulin resistance or obesity

As you age, your metabolism changes and your body becomes more predisposed towards insulin resistance. However, years of stress, inflammation and possibly a not-ideal diet may have impaired your glucose metabolism and decreased sensitivity to insulin. This creates a flow on effect to reduced sensitivity of the brain to neurotransmitters and is more pronounced during menopause.


is not uncommon during menopause as by the time we hit it, there's half a lifetime of poor dietary choices and environmental exposure. Regular detoxification routines is helpful to counterbalance toxicity due to poor elimination (constipation), bowel dysbiosis/candida, exposure to heavy metals, or simply systemic acidity due to stress and poor food choices.

Nutritional deficiencies

Poor diet, excessive alcohol and coffee consumption and refined carbohydrate intake all contribute to poor nutrient uptake.

When you break it down to simple points like this, it's easy to see how one or more of the above influences will have an influence, making your brain during menopause less sensitive to serotonin and noradrenalin. So let's take a look at neurotransmitters and how they influence menopause.

Serotonin is involved in temperature regulation, and low levels can contribute to hot flushes and sweats. Serotonin is also involved in mood regulation, memory, learning, sexual behavior, good quality sleep and in general exerts a calming influence. Low levels of serotonin can contribute to depression, mood swings, poor concentration and memory, low libido, and poor sleep.

Noradrenalin increases alertness and arousal, and also regulates vascular tone. Low levels can lead to poor concentration, low libido and again to hot flushes and sweats.

GABA is like yoga for your cells. It calms everything down and is especially useful in times of anxiety driven anger, hot flashes and post trauma care.

All of these symptoms are typical menopausal symptoms, and research has shown that they can be managed by modulating serotonin and noradrenalin levels and improving brain sensitivity to these neurotransmitters.

Recent research showed all these symptoms improved and all but disappeared with pharmaceuticals that modulated serotonin and noradrenalin levels. A previously published paper showed that influencing serotonin levels alone improved hot flushes by 60%, although newer research suggests a combination of serotonin and noradrenalin modulation is most effective.

This makes neurotransmitter modulation a very attractive, non-hormonal option to assist women through menopause and the good news is, levels can be tested and natural treatment options are available.

Although the research referred to above used a combination of pharmaceutical drugs in their trials, as a naturopath, I recommend a wide range of herbs, vitamins, minerals and pharmaceutical grade amino acids to improve sensitivity and optimize levels of neurotransmitters to help reduce menopausal symptoms.


At MassAttack we believe developing a positive, happy peaceful soul during menopause is just as important as eating right, exercising regularly and restoring healthy neurotransmitter balance.

We understand at times, life during menopause can leave you feeling a little flat and ordinary, questioning why you even get up in the morning. Rediscovering your life purpose and sense of self with individual coaching will help to get you back on track. Without a strong sense of purpose you can easily slip into not caring about your health and find yourself on a slippery downhill slope to illness.

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There are so many triggers to menopausal symptoms. Getting to the cause takes time and expertise. My program provides the first crucial steps towards restoring wellness during menopause so why not send me an email to arrange a time to discuss the best approach for you?

This research was brought to you by Narelle Stegehuis MHSc, BHSc (Naturopathy), a practicing medical herbalist and naturopath specializing in restorative endocrinology for women, with over 14 years clinical experience. She is an accomplished writer, editor and technical training advisor for the media. A recipient of the Australian Naturopathic Excellence Award, Narelle adopts an integrated approach of both medical science and traditional complementary health care principles and can be contacted at, www.massattack.com.au


Jaffe SL, "Menopause, cessation of menses, vs 'menopause', a primary brain disorder? - Advances in bioscience and biotechnology, 2013, 4, 15-19

Albertazzi P, "Noradrenergic and serotonergic modulation to treat vasomotor symptoms" - British Menopause Society Journal, 2006, March 1, vol 12, no1, p 7-11

Rossmanith WG, Ruebberdt W, "What causes hot flushes? The neuroendocrine origin of vasomotor symptoms in the menopause" - Menopause, 2009, vol 25, no 5, p 303-314