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Menopause is the time in a woman’s life where she has cessation of menstruation with a decreased production of hormones, such estrogen and progesterone.

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Menopause typically occurs from the ages of 45-55 with the average age of onset being 51. A woman is said to be postmenopausal when she does not have her menstrual cycle for one full year. Women who have a hysterectomy will still experience symptoms if they still have their ovaries. Women who have had their ovaries removed went through “surgical menopause” at the time of surgery.

Common symptoms and complaints of menopause include

  • Hot flashes
  • Night sweats
  • Insomnia
  • Headaches
  • Poor memory
  • Inability to concentrate
  • Frequent urinary tract infections
  • Atrophic vaginitis (vaginal dryness)
  • Depression

These symptoms can last 3-5 years perimenopausally. Although menopause is inevitable, the symptoms can improve with a Nutritarian diet and exercise, especially if implemented before reaching menopause. A lower body mass index and less estrogen produced by fat (adipose) tissue before menopause will help decrease the severity of menopausal symptoms. Less circulating estrogen before menopause turns up the estrogen receptors, allowing for a smaller drop and less symptoms of estrogen deprivation after menopause.


Action Plan


  • A Nutritarian diet will decrease body fat, decreasing the amount of estrogen made by fat tissue, but to be maximally effective it has to start years before menopause. If started after menopausal symptoms begin, it will take time for the body to acclimate to the lower amount of estrogen.
  • Cruciferous vegetables, like kale, collards, bok choy, and broccoli, affect estrogen metabolism, producing a strong anti-estrogen.
  • Mushrooms have powerful anti-aromatase activity, protecting against breast cancer and easing menopausal symptoms if their regular use is started years before menopause.
  • Low sugar, high fiber diets improve gut bacteria that is beneficial in blocking the reabsorption of estrogen. This lowers circulating estrogen levels and improves symptoms.
  • Soy products, such as edamame, tofu or tempeh, supply compounds (isoflavones) that may reduce menopausal symptoms. Consider adding 20-25 grams of non-GMO organic soy a few times a week. Whole food soy, such as edamame or tempeh, is the healthiest forms.
  • Avoid caffeine and alcohol which can worsen symptoms.
  • Many women find that improving their health with excellent nutrition and the use of flax, soy, and mushrooms is helpful for their symptoms. Of course the anti-cancer benefits of these same foods are important, regardless.


Moderate to intense aerobic exercise may be effective for symptoms such as hot flashes and night sweats. Exercise also improves depression and fatigue associated with menopause.


  • Hormone replacement therapy is often recommended for the treatment of hot flashes and vaginal symptoms. Because of the increased risk of breast cancer, stroke, heart attacks, and clots, it should be used for the shortest duration at the lowest effective dose if the nutritional approach has not produced the desired effects or if symptoms are otherwise intolerable.
  • Bioidentical hormones, which are derived from root vegetables, still carry the risk of long-term side effects of synthetic hormones.1
  • Oil-based vaginal lubricants are helpful and can minimize the need for estrogen.

Find additional help

ONLINE: All members of can search the Ask the Doctor archives for discussions on this topic. Platinum and Diamond members can connect with Dr. Fuhrman by posting questions in the forum. Not a member? Join now.

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  1. Committee opinion No. 532: compounded bioidentical menopausal hormone therapy. Obstet Gynecol 2012, 120:411-415.

Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


I am 51 years old and it seems like if I even look at food I gain 5 pounds! Why is this? Is it related to hormonal imbalances due to pre-menopause or actual menopause? How does one regulate hormones with a Nutritarian diet? I eat a Nutritarian diet, have a BMI of 20, and no body issues at all except belly fat! Is it stress related? I have been stressed for a few years. I exercise but still can’t seem to get rid of it. Is it an unavoidable part of life for aging females?


The metabolism slows with aging and you need more micronutrients, but fewer calories. So you have to eat less, but very healthfully, and avoid recreational eating. You keep your hormones safe and low by eating properly and keeping slim. During peri-menopause and the early years of menopause, many women struggle with unrelenting stress from trying to do too much. As a result, cortisol, a stress hormone, is continually elevated, which is associated with increased belly fat. Chronically elevated cortisol increases hunger, raises blood sugar, fosters fat deposition, increases insulin resistance, lowers thyroid hormones, estrogen, and progesterone, and essentially ages us prematurely. So, along with diet, other self-care strategies should help, such as good sleep, regular exercise, yoga, and other enjoyable activities. If you are insulin resistant, your diet will resolve this and reduce abdominal fat over time.


I am 49 and am starting to feel symptoms of pre-menopause. I have muscle pain, extremely tired, hair loss, name a few. Any suggestions on how to prevent these symptoms? How to make them better? How to get through menopause with the least amount of changes? My mother went through menopause and didn’t even know she went through it, which is what I would like for me.


These perimenopausal symptoms can be diminished with attention to lifestyle; how you eat, move, sleep, and think. Avoid caffeine, processed foods, sugar, and alcohol. Eat raw greens and cooked mushrooms and have 2 tbsp of ground flax or chia seeds/day. Get exercise—at least 30 minutes/day. Hit the pause button and take a little time for yourself each day to reduce cortisol levels. Make sure you’re getting to bed at a regular time and getting 7-8 hours of sleep/night. This should help to re-balance your hormones and have fewer symptoms.


When I started on a Nutritarian diet over a year ago, I was getting an occasional hot flash at around 4 am that would wake me up. My diet seemed to make these go away completely. Over the year, I’ve lost 30 pounds and now have a BMI of 21.3. I follow the diet perfectly, including a tablespoon of ground flax daily, lots of high omega-3 dark leafy greens, and an ounce or two of nuts, but not often walnuts. I also take the Women’s Daily Formula and DHA/EPA Purity. I’m 52 and not in menopause yet, but getting quite irregular. I exercise vigorously most days. A few weeks ago, I started getting hot flashes throughout the day. Is there anything more I can do to make them stop?


In addition to what you are doing, adding soy to your diet may be of benefit. Soy contains isoflavones which modulate the amount of circulating estrogen in the bloodstream and can bind to the estrogen receptor. A few ounces a day have been shown to be effective. Also, try to increase your daily intake of raw cruciferous vegetables. These enhance liver detoxification capacity and facilitate rapid disposal of excess estrogens. Lignans in flax seeds also reduce re-circulation of estrogen metabolites. You can do a trial of increasing your flax seed intake to 2 tbsp/day for several weeks and monitor for improvement. Finally, there is recent evidence that low blood sugar is a trigger for hot flashes. Make sure your evening meal contains beans.