Hormonal vs Non-hormonal Therapies for Menopause with Dr. Christina Christoforou, ND

Dr. Christina is a Naturopathic Doctor who primarily deals with patients going through menopause.

Q. What is menopause, and what are the associated signs and symptoms that women experience?

A. Women can be in perimenopause for a while before they hit menopause. It’s a confusing time for women to know whether it’s perimenopause or menopause because many of the signs and symptoms overlap. The way we define menopause is by not having a period for 12 consecutive months. If you’re fluctuating between having a period and no period, it’s still considered perimenopause. Some main symptoms you see are hot flashes, night sweats, insomnia, irritability, weight gain, migraines and depression. Sometimes, women also have urinary incontinence.

Q. What is the naturopathic approach you take for women dealing with perimenopause or menopause?

A. Testing is a good way to start so we know what’s happening with the hormones. We check for estradiol, cortisol, and progesterone. If there are complaints about weight gain, I run a thyroid panel. Another essential level to check is FSH. During menopause, FHS levels tend to double or triple, which is a sure indicator of menopause.

Q. What lifestyle recommendations do you make for women undergoing perimenopause or menopause?

A. I make recommendations depending on the severity of the symptoms. If symptoms like hot flashes and night sweats are debilitating, I recommend supplementation along with diet and lifestyle changes. If it’s not too bad, then focusing on diet is enough. I find that the Mediterranean diet is beneficial. Eating foods with phytoestrogens, like flaxseed, chickpeas, lentils and beans, are also beneficial as these foods bind to the receptor that the estrogen goes to. This helps in creating a balance, so your estrogen levels don’t see fluctuations. I also like to focus on brassica family foods. Vegetables like broccoli, cauliflower, Brussels sprouts etc., tend to have something called hydroxy or indole-3-carbinol, which ensures that your body is not making bad estrogens.

Regarding lifestyle changes, I find that women who are more stressed and anxious tend to have more symptoms. Focusing on stress reduction can be helpful. Incorporating things like mindfulness, whether it’s meditation or yoga, can help. We also look at sleep patterns and a good bedtime routine—putting lights out, dropping the temperature down a little bit, wearing looser clothes, and avoiding things like alcohol or coffee and spicy foods as they tend to exacerbate symptoms.

Q. Do you have any particular supplements, herbs or things that you find effective on patients?

A. Chasteberry, also known as Vitex, is a hormone balancer. During menopause, estrogen and progesterone levels go down. Vitex helps balance these hormones and reduces a lot of symptoms. I find that Black Cohosh helps with night sweats. I recommend using a product that combines Chasteberry and Black Cohosh. Also, adding supplements for adrenal support like Ashwagandha helps women manage stress. It’s important to balance out cortisol levels because high cortisol can worsen symptoms.

Q. For patients on whom the supplementation or herbs don’t work, do you put them on bioidentical or synthetic hormones?

A. As naturopaths, we can now prescribe bioidentical hormones. There’s been a lot of controversy around synthetic hormones since the 2002 study that was stopped short when women started to experience severe side effects of synthetic hormones. They saw a 200% increase in blood clots, a 40% increase in the risk of stroke, and a 26% increase in breast cancer risk. That’s when medical doctors stopped synthetic hormone replacement therapy.

Bioidentical hormones have been around since the 1930s. But since that study in 2002, even medical doctors started to use more of them. These hormones are plant-based and very identical to the ones in our bodies. Taking them as pills or creams is the best way to go. Bioidentical hormones can prevent breast cancer as they inhibit breast cell division. They are also heart friendly as they prevent clots and osteoporosis. So the benefits are multitude. The estriol cream, which you apply vaginally, works amazing for vaginal dryness. You can even play around with the dosages and figure out what works best. As for synthetic hormones, I don’t think medical doctors even prescribe them to their patients anymore.

Q. What are some benefits of using bioidentical hormones in terms of seeing a reduction in symptoms?

A. Within a week or two, most of my patients start to notice a reduction in hot flashes and night sweats. With progesterone, they also notice weight loss. They find that their mood is much more balanced and see a decrease in feelings of anxiety and depression. Overall, most of them come back saying that they feel fantastic.

About Dr. Christina

Dr. Christina Christoforou graduated with a four year Honours Bachelor of Science degree in biology from McMaster University in Hamilton, Ontario. Her keen interest in the health and well-being of others led her to study Naturopathic Medicine at the Canadian College of Naturopathic Medicine in Toronto, Ontario where she received her degree in Naturopathic Medicine. Upon graduation, Dr. Christina Christoforou furthered her knowledge in Portland, Oregon, where she trained and worked with established Naturopathic Doctors. She is currently a member of the CAND and OAND and is a licensed Naturopathic Doctor in the province of Ontario, and regulated by the College of Naturopathic Doctors in Ontario (CONO). She enjoys educating the public on health and wellness and has done seminars at various health centres such as the Mississauga Health Show, Planet Organic, Goodness Me and Lunch and Learns at various companies. She currently practices and owns The Holistix Naturopathic Health Clinic in Oakville, and is committed to providing compassionate and thorough Naturopathic Care. Her practice is a general family practice where she treats all ailments and diseases. Her general focus is on digestive health/food sensitivities, hormonal health, stress/mental health and pediatrics. With over 13+ years experience and as a mother of 4 kids, Dr. Christoforou understands the demands of being a new mom with young kids and balancing work life with family life. With raising four of her own kids she has extended her knowledge of Naturopathic Medicine in pre and post pregnancy and pediatric care. She also understands managing stress and anxiety. Holistix Naturopathic Health Clinic has been nominated number one in Mississauga since 2008 with the Reader’s Choice Award and continues to win yearly since.