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The In Between: The Reality of Post & Peri-menopausal Stages in the States

20294012_10155722044044742_2052072613008118079_nThere is no doubt that the times have significantly shifted since my parents’ generation has been walking through their rights of passage in aging.

We all know the term midlife crisis.  But what does this actually look like?  It is certainly no longer an “empty nest” / “identity syndrome” where the retiree gets to roam the world freely.  It is no longer finding new hobbies and traveling to live the rest of your life. How has this changed over the past decade?

This transition in aging is the least studied developmental stage in science.  I truly believe that as my cohorts in social science begin to experience aging, we will find more definitive correlational research.  Until then, I cannot help but ponder the burden that this age group is carrying as I see more and more middle aged strong women in my office.  They carry the weight of the generation preceding and the generations to come on their shoulders.

Adult kids are increasingly dependent on their parents as a product of the 2008 recession, unfathomable student loans, and secondary degrees.  Their parents are on living longer.  The sum of these factoids looks something like parenting your adult children and parenting your parents, at. the. same. time.  One of my dear Portland moms explained her experience of walking her mom through the gaits of death as sitting with all the life phases in a condensed period of time and it lead her to clearly identify the changes she must make in her life now.  And boy, did she have a rebirth! Losing necessary weight with a 6 week Vedic program, gardening, and living abosultely FREE to do as she pleases.  Perhaps at some point, I can have her share the experience with you, as her words are much wiser than my own.

But for now, let us return to double parenting AND hormone shifts.  What is a wise woman to do?

At this point,  you’re either free from the monthly menstrual cycles or they are coming at you unpredictably, raging, and at times accompanied with a side of sweats, sleeplessness, and a dry vagina.

It is no wonder so many of my patients are diving straight into the Suzanne Somers hormone “magic” protocol before they come to see me.  It is pertinent to note that menopause is not roller coaster for everybody.  Menopause is often more symptomatic in our dried out, stressed, over-accultured world than other cultures tare still rooted seasons, natural transitions, community, and mama Earth.

The weight of carrying all 3 generations’ of your family without traditional community support is nearly impossible.  Still, I see many of my patients navigate these obstacles with their self-growth game strong.

As a 32 yo femme Physician that primarily works with women, I LOVE supporting women in this particular transition.  Seriously, they are like superheroes in my mind’s eye (ya’ll know who you are – heyyyyy).  I cannot pretend to know it feels like to live through the decades of peri and post menopause. What I do know is the tools to support you body and which are in attunement with your particular body’s ability to heal.  I also get deep in playing the self-work game.  Working through your own shadows of illusion is no joke.  It’s easy to get lost in there.  We all have dust bunnies hiding under the rugs and in the corners and it is so freeing to be able to name them so you can get curious about them.  Where we humans get lost, is trying to identify what is hiding in the shadows, alone.

How to Reclaim Your Authenticity During This Stage

1) Boundaries.  Boundaries in time.  Boundaries in pleasure.  Boundaries in finances.  Boundaries in who feeds you and who is draining you.  Boundaries in what you eat.  This includes food, media, moments, and more.  Set these boundaries with consistency.  Don’t worry, it’s a practice.  If you get it right 80% of the time, you will be doing 40-75% better than you were before 🙂

2) Support.  Find that friend that you can be authentic with.  Tell your deep secrets to them, make sure it isn’t the type of “try to fix you” friend.  This is huge.  Also, treat your kids more like adults.  They are beginning to understand that you are not perfect.  As your kids begin to become your best friend (or not), they can be supportive too (or not).  I worked on this hard with my mom and I am so happy to say that she is one of my besties now.  We are still pretty co-dependent, but hey, we’re never perfect.  And we are miles ahead where we were before.  Find community, this is the missing link discussed in the Blue Zone studies.

3) Medical Support.  Naturopathic Docs are the BEST at this!  We really are the ultimate primary care physicians with heaps of faith and trust in your ability to heal.  We are your life coach, your physician, your nutritionist, herbalist, and functional medicine diagnostician all in one.   We can help you identify obstacles to cure within 90-180 minutes of seeing us.  Naturopaths simply practice medicine that gives you options and guides you to the first steps to your healing path.  This is very different from most physicians, even functional medicine physicians.  One of the major tenants of Naturopathic medicine is Docere = teach.  We uphold an oath to teach you your options and if we are not a good fit, we refer out.  Our modalities are broad and varied so that you can choose which therapies are the best match for you and your lifestyle.

4) Spiritual & Emotional Support.  Find this in church, counseling, ceremony, or with a community of other badass womxn* such as yourself.  I happen to give my patients 5-element treatments that I learned from one of my favorite teachers.  This allows space for you to see yourself more clearly, from a balance of divinity and humanness.  It allows the space for you to be curious where to work what you see and where to be gentle.  It allows space for balancing, it allows space for truth and grace.  Own your authenticity.  You are a unique gift to this world and all of the stars have aligned so that you may carry your gifts to share with the generations to come.

Top Physiological Protocols?

First, let us cover the foundations of health.

1) Sleep.  Go to bed at the same time every night and wake up at the same time every day.  Even if you miss out on the full 7-10 hours, waking up at the same time every morning is the most significant factor for regulating circadian rhythm and hormones including melatonin, cortisol and sex hormones.

I have an 80/20 rule in almost all of my health habits because flexibility and social needs are real.  Oxytocin is my favorite hormone, which can be lifted through authentic social bonding, hugging dogs, and getting busy with your partner.

2) Anti-Inflammatory Diet.  The one with the most resources is Paleo (Whole30).  I say ditch the pork in it and sub out for bison and fish.  Quality of meat is most important.  Eat mostly vegetables, not too much and buy 80% local or organic.  Focus on organic meat first then check out the clean 15 and dirty 20 lists.  Considering low carb?  Check with your local physician about your adrenals (HPA axis), thyroid, and sex hormones first.  I personally prefer to see most of my patients on that 50-60 g/ day low carb diet if they are dying to try low carb rather than the traditional 30g/day Keto diet.  Personally, carb cycling according to my menstrual cycle is what I need.

3) Exercise for bone health, inflammatory modulation, and more.  Weight lifting is very important if your estrogen is declining.  Lifting maintains bone flexibility, density, and strength.  That’s right, our bones are pourous and full of light and cells.  Keep them breathing instead of ossifying to brittle dry death.Estrogen keeps you nice and juicy at a younger age, hence the increase in wrinkles, more brittle hair, and drying vagina.  (Vitamin K2 is beautiful for this!) Vitamin D3, when taken in excess, can cause your bones to become more brittle. Same with most bone strengthening minerals, so check in with your integrated Physician.

4) SEX!  Find a new love for sex with your partner.  Experiment, play around.  If you need it, I love suppositories to keep the vaginal wall moist and supple.  Lube is welcome, have plenty of it available.  Vaginal steams are magical.  All of these bring more blood flow to your vagina and allow for more pleasure in sex.  Reclaiming sexual power is so liberating, grounding, and oh so pleasurable.

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Now to Seeds & Herbs

1) HERBS!  Bi-phasic formulas to sink with the moon rather your cycling or not has been my new jam.  In summary, you take estrogenic herbs and foods during day 1-14 of the cycle (dong quai, flax, etc).  And take progesteronic herbs and foods during day 14-29 of your cycle (vitex, sesame, sunflower, etc).

Estrogenic Herbs & Foods. In a regular cycle, estrogen is produced during the first 14ish days (the follicular phase) as eggs in the ovaries ripen.  Then they drop with the LH FSH Surge and Progesterone takes over in order to maintain a fertilized egg.  As estrogen begins to decline, the estrogen : progesterone ratios and other hormones begin to shift.  Maintaining less drastic fluctuations in estrogen levels is one key to ease in transitions during menopause.

In a few studies, taking black cohosh with flax seeds, significantly reduced menopausal symptoms.  These are both great tools for estrogen modulation.

Keep up with balancing your HPA axis.  Your adrenals and kidneys need you to love on them in this over-accultured world that forces us to be confined to the 5 day a week, 8 hour work day.  We are never meant to be here in a mundane way and if we are trapped in the routine, we certainly need space for self-care and rest.  That is where creativity is born.

Tulsi. Period.  Tulsi is my favorite herb that almost goes into all of my formulas for HPA axis regulation (aka adrenal fatigue).

With all being said, the triad to approaching your optimal health is always a tightrope balance between harvesting your tools for body, mind, and spirit.  When something isn’t working, seek new tools that resonate with you the most.  And always, seek help from a licensed physician.  There are great certified healthcare providers around the world, but it is often difficult to find quality certification programs.  Navigating your own health while ill is like trying to read a book to close to your face.  It may be difficult to fiscally commit to your health, but it is almost always worth it.  Well, because you are worth it – duh.  And your health is directly related to happiness, creativity, and productivity.  So cheers to that!


*Womxn: All inclusive term for all who identify as female and for women of color.

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  1. Celia on July 24, 2019 at 10:23 am

    Just today, I recognized that as hard as it can be at times, being caught in-between actually positions me to receive a double gift if:

    1) I am in tune with the steps I need to continue to take in order to maintain health of body, mind, and spirit and if I am sharing with those close to me what I am learning in my journey with naturopathic medicine


    2) I am in tune with both by mom and my daughter…

    This allows me to watch how my example and efforts to guide them both result in positive changes toward health in each of their lives. My aging mother, while she has stubbornly resisted some of the steps I’ve encouraged, has courageously tried others. My 20 year-old daughter has begun to ask questions and learn from my example resulting in noticeable changes in her health that have surprised, delighted, and inspired her.

    So while balancing the needs of a mother entering the final leg of her journey in this life and a daughter just stepping out into hers, I receive the privilege of being able to watch them both…I see a member of the preceding generation trying to finish strong. I also see one who represents the future resolving to grasp the power and inspiration that arise out of recognizing the part that she can play in becoming all that she was created to be!

    This realization strengthens me as I navigate the “tightrope balance” that you have so eloquently portrayed!
    Thank you for taking the time to write such a thoughtful article for those of us in-between!

  2. Susan Kepler on July 25, 2019 at 9:43 am

    Just read your article and that resonated with me big time! Some of your advice I already knew, but it’s always good to have a reminder coming from someone else. I love what you are doing and offering your knowledge and insights regarding women’s health:) I just signed up for your newsletter. Looking forward to more readings from you.
    Thank you,

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