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Resources and Links – Women’s Health

Natural Remedies for Menopause, Perimenopause & Hot Flashes

Resources | Symptoms | What Works | Diet | Exercise
Herbals | Relaxation & Stress Mgt | Sexuality

There are several ways that we can help your body’s natural transition through menopause and peri menopause. Hot flashes, night sweats and menstrual irregularities can affect your mood and level of energy during the day. Loss of sleep and the resulting irritability is also a common complaint. One path to managing these symptoms is through the use of healing herbs like black cohosh and Siberian rhubarb extract. Acupuncture and traditional Chinese herbs can also be helpful for menopausal symptoms and osteoporosis. How we eat and how we deal with stress are vital to our hormone balance; these will also be taken into account during any menopausal evaluation.

Bio-identical Hormone Replacement Therapy

Sometimes diet, exercise and herbs are not enough. For the treatment of menopause/perimenopause/postmenopause, we may suggest supplemental doses of hormones that your own body may have difficulty producing by itself. As an expert in managing menopausal symptoms, Dr. Warner is recognized as the bioidentical hormones expert in the Philadelphia-Princeton region. Each patient undergoes a thorough evaluation including blood work; a treatment program will be uniquely tailored to each woman.  Not everyone needs hormone therapy, and not everyone is a candidate, but it is an option that can be discussed.


Integrative Holistic Management of Menopause, Grand Round Talk by Dr. Warner at Jefferson Hospital, Philadelphia, PA. Click on the “Link to Presentation” on the top right of the page.  At this website, Dr Warner has both written and video answers to common women’s health questions.  The website was started by Dr Mehmet Oz, and has a wealth of health information from various sources.

Menopausal Years, the Wise Woman Way by Susun Weed. This is a classic, left-of-center compendium for the menopausal woman. Susun gives good, practical advice from what to eat to what herbs to use. She tends to start with the least invasive options, moving to the more invasive options, always saving conventional medicine for last.

The Herbal Menopause Book by Amanda McQuade Crawford. Amanda is a British-trained herbalist living and practicing in the States. She gives good practical advice on what herbs to use for different symptoms, and is a bit more “conventional” than a lot of herbalists.


Usually, women will experience symptoms such as hot flashes/flushes, vaginal dryness, and mood swings as their menses end. When 12 consecutive months go by with no periods, women can consider themselves menopausal. Other symptoms can also occur, such as memory loss, achy joints, changes in skin and hair and sleep disturbances. Keep in mind that other medical conditions can cause these same symptoms, so don’t blame everything on menopause. See your care provider to determine the cause of your symptoms.


What Works

Few decisions are as difficult for most women as the decisions involved in settling on an approach to menopause. These are very important choices that, among other considerations, should be based on medical history…yours and your family’s. There are no “right” answers, and our own decisions may change with time. For example, some women choose hormonal replacement, while others choose nonpharmacologic ways to deal with symptoms and support their bodies as they move through this change. Others start with holistic treatments to treat symptoms while they are still menstruating, then switch to hormones later.



Watch your diet! During this time hormone levels fluctuate and your liver and kidneys work hard to keep everything in balance. Don’t make them work even harder!

Avoid processed foods and soda as much as possible-stick to fresh fruits and veggies. (With its high phosphate load, soda can be punishing to bones and increase your chance of developing osteoporosis).

Add plants to your diet, as their isoflavones will help allay hot flashes and may help protect against breast cancer. Good sources of isoflavones are parsley, apples, barley, carrots, cherries, fennel, garlic, green beans, oats, red beans, rice, sage, tomatoes, yams, soy.



Most studies show that the more physically active a woman is, the less noticeable and intrusive her flashes. Any exercise is good. If you haven’t been active and are looking for something to try, consider yoga. Yoga is a gentle series of stretches and bends that build flexibility and strength, as well as balance.

Walking is also a simple way to start exercising—shoot for 30-40 minutes 4 times a week. Among other things, brisk walking promotes cardio-vascular health.

If you already are fairly active, add weight lifting. Many studies show that strength training is especially good for preventing osteoporosis.

Of course, check with your health provider before beginning a new exercise routine.



For hot flashes/night sweats:

  • Black Cohosh – Gaia Brand is my favorite; there is a lot of lousy black cohosh on the market, so be careful!
  • Siberian Rhubarb extract—only currently sold by Metagenics in this country.
  • an adrenal adaptogen herb, such as ashwaganda.  Might vary per patient.

For sleep disturbances:

  • Valerian – Use 200 mg extract as needed, or hops 1/2 to 1 1/2 cc tincture at bedtime.
  • “Relaxozyme” – This is a combination product from Enzymatic Therapy, which includes valerian, hops and passionflower.
  • dealing with adrenal issues will likely help calm down this symptom

For vaginal dryness:

  • Borage oil – Take 500-1000 mg daily. (Dong quai, black cohosh and vitex also help with dryness.)
  • Vitamin E gelcap – Puncture a vitamin E gelcap and squirt the contents inside. This works best if done daily for several weeks.
  • Also helped by Siberian Rhubarb Extract

For mood swings:

  • 5-HTP – – If the mood swings are caused primarily by anxiety, take 50-100 mg of 5-HTP once or twice daily. (May cause drowsiness.) Don’t use this without consulting your care provider, if you are on an antidepressant of any kind.
  • sAME – Take 100-200 mg daily. Don’t use this if you are already on an antidepressant of any kind before consulting with your care provider.

For improving poor libidos:

  • Ginseng – May help increase testosterone levels, therefore improving poor libidos. However, it may increase blood pressure, worsen insomnia, and cause postmenopausal bleeding. Please be sure to discuss this issue with your care provider, as it is complex and may need to be addressed on many levels.

Note: Please inform your care provider of whatever herbals you are currently taking, and be aware that some of them need to be stopped prior to any surgery, as they affect your blood clotting abilities.


Relaxation & Stress Management

Make time for yourself. It’s ok to be selfish at this time. Start a journal, meet with women friends who are either going through or have gone through menopause, soak in a tub with candlelight. Find a “room of one’s own.” Consider learning meditation, guided imagery or reiki as a way to feel balanced and grounded.



Between your changing body, sleep deprivation from night sweats and mood swings, it’s sometimes challenging to maintain a satisfying sex life.

Please see Rachel Abrams, MD’s lovely book, “The Multi-Orgasmic Woman”.  The energy movement exercises and body awareness discussed can be invaluable.

If you’re developing vaginal dryness, making intercourse uncomfortable, use a nonhormonal lubricant such as Astroglide or Liquid Silk. (Both are available Also go to for lubricants, toys and a marvelous blog and all things sexual. Be sure to talk to your care provider if you are having changes with your sex drive that make you or your partner unhappy. It’s a complex issue, but fairly easy to address.


Women’s Health

Women’s Bodies, Women’s Wisdom by Christiane Northrup, MD. A wonderful book of basic information to help you understand your body and plan your own healthcare. Keep it around for reference and give it to your daughter when she comes of age.

Herbal Healing for Women by Rosemary Gladstar. Rosemary is a well known herbalist; this book contains lots of herbal information including recipes for homemade remedies that really work.

Herbal Remedies for Women by Amanda McQuade Crawford. This book is imminently readable and especially helpful for younger women, who tend to get less attention from herbalists than menopausal women. An especially good section on PMS.

Healing Fibroids: A Doctor’s Guide to a Natural Cure by Allan Warshowsky, MD. Dr Warshowsky is a holistic gynecologist and a friend of Dr Warner’s; this is a great book that explains causes of hormone imbalance leading to fibroids as well as a thorough holistic approach to their management.

Women’s Encyclopedia of Natural Medicine by Tori Hudson, ND. Dr Hudson is a well known, well published naturopath who practices in the classic naturopathic tradition, but with a good understanding of conventional medical practice. Lots of good advice.