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Natural Awakenings Metro Phoenix & Northern Arizona

Women’s Health and Hormones: Dr. Marianne Marchese describes naturopathic treatment options for perimenopause and menopause

Apr 30, 2013 06:23PM ● By Marianne Marchese, NMD

Most women’s health conditions are related to hormonal imbalance. In the reproductive years, a woman’s hormones cycle each month and women may experience symptoms of premenstrual disorder, called PMS. Later in life as women near menopause, the hormones begin to fluctuate, ovulation is inconsistent and menstrual bleeding patterns can change. This phase is called perimenopause.

After a woman has gone an entire year without a menstrual cycle, she is then in menopause. This is a natural body process, but may produce symptoms that require treatment. Naturopathic treatments for PMS, perimenopause and menopause are an effective way to help women balance their hormones in all phases of her life. Another hormone related to women’s health conditions is cortisol. Cortisol is produced by the adrenal gland, and if it is produced in excess in response to stress, it can interfere with estrogen levels, the menstrual cycle, moods and thyroid function.

Naturopathic Intervention

Dietary changes and exercise can help balance hormones. As little as 30 minutes three times a week of aerobic activity can improve mood, decrease irritability and increase tolerance to stress. Botanicals can be helpful in treating the symptoms of PMS, perimenopause and menopause.  However, some can interact with medications, including the birth control pill, so be careful self-treating with over-the-counter herbs. Some common botanicals for hormones include vitex, angelica, dioscorea, cimicifuga, withania, and hypericum. It is best to use both the whole plant and the standardized extract.

The signs and symptoms of perimenopause and menopause include menstrual irregularities and changes in the amount of blood loss, hot flashes, night sweats, vaginal dryness, fatigue, decreased libido, weight gain, depression, anxiety, sleep disturbance, hair loss, heart palpitations, headaches, urinary tract infections, urinary incontinence and the beginning stages of osteoporosis and heart disease.

There are several natural treatment options that depend on a woman’s symptoms. For example, if menstrual irregularities are the main concern, then controlling and regulating the bleeding is the first priority. Often, bio-identical hormone therapy is used to accomplish this goal, along with botanical medicine and dietary isoflavones. Treatment should be individualized, based on a woman’s risk for breast cancer, heart attack, stroke and blood clots. What works for one woman may not work for another.


Simple blood tests can determine which hormones are out of balance. Common tests include cortisol, thyroid, estrogen, testosterone and progesterone. Blood tests for nutritional deficiencies can also help individualize treatments so women do not take unnecessary supplements. A thorough history, examination and blood workup determine the best approach for balancing hormones.

More than ever, women with PMS entering perimenopause and menopause are educating themselves, asking their doctors questions and requesting information about options for treatment. Naturopathic treatment options are an effective way to address a woman’s hormonal conditions. After ruling out conditions with similar symptoms, testing hormone levels in the body and assessing women’s risk factors for future health conditions, an individualized treatment plan is created.

Due to the complex nature of bio-identical hormone replacement therapy, herb-to-herb interactions and drug-to-herb interactions, it is recommended that menopausal women seek the expertise of their naturopathic doctor.

Dr. Marchese is the author of 8 Weeks to Women’s Wellness. She maintains a private practice in Phoenix and was named by Phoenix magazine as one of their top naturopathic physicians. To learn more visit and

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