Menopause Symptoms and Hot Flashes: A Naturopathic Doctor's Root-Cause Approach to Relief

Hot flashes. Night sweats. Nights spent awake. Mood swings, brain fog, weight gain, and an energy level that isn't what it used to be. If you're in perimenopause or menopause, these symptoms are exhausting, and you shouldn't have to simply put up with them.

I'm Dr. Elie Klein, ND, a naturopathic doctor (naturopath) with 23 years of clinical practice. My approach to menopause starts with something that often gets overlooked.

Who this page is for

This page is for you if you have:

• Hot flashes or night sweats
• Poor sleep or waking in the night
• Mood swings, anxiety, or low mood
• Brain fog or memory problems
• Weight gain, especially around the middle
• Fatigue, or low energy that started in your 40s or 50s
• Concerns about the side effects and long-term risks of estrogen-based hormone replacement therapy (HRT)

Ready to talk? Start with a free 15-minute conversation, or book your first consultation.

Book a Consultation or a Free 15-Minute Call

What most people miss: it's often about progesterone

Most attention goes to falling estrogen. In my approach, I pay close attention to progesterone, which in the perimenopause years tends to fall proportionally more than estrogen. The result is often a condition called estrogen dominance: too much estrogen relative to progesterone. In my experience, this imbalance contributes to hot flashes, poor sleep, mood changes, and weight gain.

About conventional estrogen-based hormone therapy

Estrogen-based HRT can relieve hot flashes and other symptoms, and many women do well on it. But it carries risks that deserve to be understood before you start, or if you're taking it now. Research, including the large Women's Health Initiative studies, has linked it to the effects below. How large the risk is depends on your age, the type, dose and length of treatment, and your personal and family history.

Short-term effects women commonly report:

• Breast tenderness
• Bloating and fluid retention
• Headaches, including migraines
• Nausea
• Irregular bleeding or spotting
• Mood changes

Longer-term risks identified in research:

• Blood clots in the legs or lungs, especially in the first year or two of use
• Stroke
• Heart attack, with combined estrogen-progestin therapy in the Women's Health Initiative
• Breast cancer, with combined estrogen-progestin therapy used for several years
• Cancer of the uterine lining, when estrogen is used without a progestogen in a woman who still has her uterus
• Gallbladder disease
• A possible increase in dementia risk when combined therapy is started at age 65 or older
• A possible small increase in ovarian cancer risk in some studies

These risks are one reason many women look for another way to feel better. Please talk to your doctor before starting or stopping any hormone treatment.

My root-cause, functional medicine approach

I pay careful attention to your symptoms, and I look at the ratio between your progesterone and estrogen and other metabolic markers, such as thyroid function, blood sugar, and stress hormones, which can affect how you feel. That lets us fine-tune your plan.

Your plan is individualized. It can include a personalized diet plan, lifestyle changes, targeted nutraceuticals, and, when appropriate, bioidentical hormones. I support you in putting it into practice. See also my approach to fatigue, sleep, and thyroid problems.

How we work together

1. Before your visit: you complete a health questionnaire and send me your recent lab work.
2. Your consultation: a one-on-one video visit where we go through your symptoms and history, unhurried.
3. Targeted testing: only what's needed.
4. Your plan: individualized, with my support.
5. Follow-up: we track your symptoms and adjust.

What we aim for

Fewer hot flashes, nights of better sleep, steadier mood, clearer thinking, and your energy back. If you'd like examples of the results other people have experienced, reach out to me and I'll send you a link.

Virtual care across Ontario, or in person in Vaughan (Greater Toronto Area)

Appointments are by secure video from the comfort of your home, whether you live in Toronto, Vaughan, Markham, Mississauga, Hamilton, Ottawa, or anywhere else in Ontario. If you prefer a one-on-one visit in person, you're welcome to come to my home office in Vaughan, in the Greater Toronto Area. Most extended health plans in Ontario cover naturopathic care.

Book a Consultation or a Free 15-Minute Call

Related reading

• Menopause symptoms: a naturopathic approach to hot flashes, sleep and mood
• Hormone imbalance: a naturopathic doctor's guide

Frequently asked questions

What causes hot flashes in menopause?

Shifting hormone levels, particularly the balance between estrogen and progesterone, can disrupt your body's temperature control.

What is estrogen dominance?

It means estrogen is too high relative to progesterone. In perimenopause, progesterone tends to drop proportionally more than estrogen, which can cause this imbalance.

Can menopause symptoms be treated naturally?

Yes. Natural treatment means identifying your hormone imbalance and supporting it with nutrition, nutraceuticals, lifestyle, and, when appropriate, bioidentical hormones.

What are bioidentical hormones?

Bioidentical hormones have the same molecular structure as the hormones your body makes. No hormone treatment is risk-free. We review the benefits and risks together, and I only use bioidentical hormones when appropriate for you.

What are the risks of estrogen replacement therapy?

Short-term effects can include breast tenderness, bloating, headaches, nausea, spotting, and mood changes. Longer-term risks identified in research include blood clots, stroke, heart attack, breast cancer, uterine cancer when estrogen is used alone in women who have a uterus, and gallbladder disease. See the full list above, and talk to your doctor.

Can menopause cause weight gain, fatigue, or poor sleep?

Yes. Hormonal changes often affect weight, energy, and sleep. See fatigue and weight management.

What's the difference between perimenopause and menopause?

Perimenopause is the transition leading up to menopause, which is often when symptoms begin. Menopause is the point when your periods have stopped for 12 months.

Do I have to take HRT for menopause symptoms?

No. There are other options. Talk to your doctor about your own situation.

Can a naturopath help with menopause?

Yes. As a naturopathic doctor, I look at your hormone balance, especially progesterone relative to estrogen, and at the metabolic factors behind your symptoms, and build an individualized plan.

Can menopause care be done virtually?

Yes. I see patients across Ontario by secure video, from my home office in Vaughan, in the Greater Toronto Area.

References

Sources for the estrogen therapy risks listed on this page:

1. Prescribers' Digital Reference (PDR.net). Estrogen product labeling: boxed warnings, warnings and precautions, and adverse reactions. pdr.net
2. U.S. Food and Drug Administration. Prescribing information for Premarin (conjugated estrogens) tablets. Boxed warning: endometrial cancer, cardiovascular disorders, breast cancer and probable dementia. FDA label (PDF)

This page is educational and isn't meant to replace your doctor's care.