Menopause is a natural transition, but that doesn't mean it always feels easy! As estrogen and progesterone decline, many women notice hot flashes, night sweats, changes in sleep and mood, lower energy, and stubborn changes in weight, especially around the middle.

Hormone Replacement Therapy (HRT) can be a great option for some women, but it isn't the only option. Some women can't take hormones, while others simply prefer to try a more natural approach first.

Here are a few of my favorite areas to consider.

Black Cohosh

Black cohosh is one of the best-known herbs for menopause. It has a long history of use for women's health and is most often used for hot flashes, night sweats, and sleep disturbances.

Research has been somewhat mixed, but several clinical studies have shown benefits for hot flashes and sweating, with possible additional benefits for sleep and mood.

Interestingly, we used to think black cohosh worked because it acted like estrogen. Newer research suggests it may instead affect serotonin and other brain pathways involved in temperature regulation, sleep, and mood.

Not all black cohosh supplements are the same, so I generally prefer standardized extracts that have actually been studied.

Siberian Rhubarb

Another botanical I really like for menopause is Siberian rhubarb (Rheum rhaponticum).

Most of the research has been done on a standardized extract called ERr 731. Studies suggest it may help with several menopausal symptoms, including hot flashes, sweating, sleep, anxiety, and mood changes. A 2024 review of the research also found improvement in overall menopausal symptoms, although more research is still needed.

Don't Forget About Food

One of the most frustrating parts of menopause can be watching your body change even though you haven't changed how you eat.

Declining estrogen can affect muscle mass, insulin sensitivity, and where we store body fat, which helps explain why abdominal weight gain becomes more common.

Rather than simply eating less, focus on eating better. Aim for protein at every meal, plenty of vegetables, berries and other fiber-rich foods, and healthy fats such as olive oil, avocado, nuts, and seeds. Cut back on added sugar, highly processed foods, refined carbohydrates, and excessive alcohol.

Lift Some Weights!

If there is one exercise habit I encourage women to prioritize during menopause, it's strength training.

Maintaining muscle supports your metabolism, blood sugar, bones, strength, and long-term health. Walking, running, biking, and other cardiovascular exercise are still wonderful, but don't let cardio replace resistance training.

And make sure you're eating enough protein to support the muscle you're working so hard to build!

Sleep & Stress Count Too

Sleep often becomes more difficult during menopause, especially when hot flashes and night sweats are involved. Unfortunately, poor sleep can then affect mood, appetite, energy, and weight, creating a frustrating cycle.

Regular exercise, a consistent sleep schedule, keeping your bedroom cool, limiting alcohol, and finding ways to manage stress can make a meaningful difference.

Putting It All Together

If you don't want to use HRT, you still have options. A good menopause plan might include black cohosh or standardized Siberian rhubarb, plenty of protein and whole foods, strength training, regular movement, better sleep, and stress management.

And remember, “natural” doesn't automatically mean safe for everyone. Herbs can interact with medications and may not be appropriate for certain health conditions, so it's always a good idea to work with a knowledgeable healthcare practitioner.

Menopause is a transition, not a disease. The goal isn't to fight your body, it's to give it the support it needs as it changes.

 ABOUT THE AUTHOR

Since 2005, Dr. Fey has helped women, men, and children find real solutions to their health concerns. She truly believes that giving the proper care and nutrients your body has an amazing ability to heal. She is committed to finding the root cause of illness by utilizing a whole body approach not just focusing solely on presenting symptoms. With her scientific background, Dr. Fey uses science based natural approaches to treating disease.

Dr. Amanda Fey is the owner and practicing Naturopathic Doctor at Complementary Medicine & Healing Arts, the Southern Tiers Center for Natural Healthcare located in the Binghamton NY area. The office website is www.naturallywell.us. Dr. Fey is currently offering telemedicine for patients all across the US. To contact the office, call 607-729-0591 or email cmhahealth@gmail.com.  

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