Part VI:  Quick Reference for the Transition into Menopause

I have covered a lot of ground over the past five blogs and yet it isn’t an exhaustive account of the menopausal journey.  Here I hope to provide a recap, or a menopause/perimnopause resource guide, of the points I covered in my previous perimenopause/menopause posts.  Additionally, I have included  a to-do list of sorts…

My preferred step by step approach to navigating menopause:

Step 1:

  • Eat a nutrient-rich diet, exercise regularly, stretch, rule out other medical problems (thyroid,

    serious ob/gyn issues through a visit with an ob/gyn doctor and blood tests), implement a de-stress routine, get good sleep,  aspire to a balanced lifestyle, and don’t smoke.  If you drink alcohol, experiment with giving it up for a week or so to see if that alleviates hot flashes, headaches, and insomnia–some women over 40 find this really to help. (some of you may be rolling  your eyes)

Step 2:

  • After determining that you don’t have any medical complications and a doctor has ruled out other possible health conditions that can cause any of the symptoms you may be experiencing, try to fill any vitamin, mineral deficiencies by altering your diet or taking supplements if you can’t manage with diet alone.  Deficiencies can be found through blood tests and the help of an MD or a healthcare practitioner who interprets blood tests using what’s called functional blood analysis.

Step 3:

  • If diet and lifestyle aren’t enough, or you would like more support during perimenopause/menopause, try rebalancing your body through acupuncture, herbs (under the guidance of a practitioner–can’t help myself), biofeedback, or other alternative treatment.

Step 4:

  • If after trying steps 1, 2, and 3 to the best of your ability and you still feel lousy,  by all means, try Hormone Replacement Therapy or HRT.  

Perimenopause: the summary:

With your physician:

  1. Go for a routine checkup to rule out other causes of symptoms.  
  2. Request a complete thyroid panel (TSH, Total T4, Total T3, Free T4, Free T3, T3 Uptake, Reverse T3, TPO antibody, TGB antibody) to rule out thyroid involvement.  Irregardless, it’s a good idea to support your thyroid with selenium (2-4 brazil nuts daily if not allergic), vitamin D (careful sun exposure–if  you can–supplement with D3, or foods fortified with D), zinc (seafood, nuts, seeds, beans), iodine (seaweed, fish–get your iodine levels tested before even thinking about going on an iodine supplement as you can make things worse).
  3. Get blood tests:  CBC with differential, vitamin D, C reactive protein, homocysteine, thyroid


    panel (as suggested above) to ensure numbers are within optimal range. These tests will identify possible issues with blood sugar, cholesterol, anemia, digestive and thyroid function and more.  Make sure you are WELL hydrated the three days before you have your blood drawn–it can affect your numbers and give you false positives.  

  4. If considering HRT, start gathering information.  You can initiate a conversation with your physician and other healthcare providers.

At home daily care:

  • Eat right: leafy dark greens, fruit, nuts, seeds, good fats, plant protein, fermented foods.
  • Eliminate smoking, cut down/eliminate highly processed foods and alcohol.
  • Exercise-regularly, including stretching.
  • De-stress measures: meditation, walks, whatever calms you.
  • Practice good sleep hygiene.
  • Consider supportive therapies such as acupuncture, herbs, supplements, biofeedback, massage, etc.

For Bone, Heart health, CA prevention, blood sugar regulation and health in general:  

  • Ensure that you are ingesting fiber, good fat, plant protein, zinc, selenium, vit A, C, D, E, K, B complex, Calcium/magnesium.
  • Soy good, soy isoflavones not.  Soy protein powder and supplements are not recommended as they contain soy isolates (which may mess with hormone levels rather than benefit levels).  
  • Get rid of sugar:  also helps w/ brain, fatigue, blood sugar levels.
  • Avoid highly processed foods. Cut down on caffeine, alcohol, smoking, meat, sugar, and salt (Calcium is drawn out of bones to neutralize increased acidity), also carbonated drinks (phosphorus in these drinks competes for calcium absorption).

IF you have the following symptoms, seek the advice of a medical practitioner and add self-care:

blood pressure, high: Decrease:  salt, caffeine, alcohol, deep fried foods, processed foods, smoking.

Bleeding, heavy:  Eliminate caffeine, alcohol, spicy foods, no smoking.

Hot flashes:  Exercise (not right before bed) 0.5 hr x 3week, phytoestrogen (foods), soak feet in hot water before bedtime, no hot showers right before bed, maybe not during the day.  Liver cleansing foods (rose hip) dark greens. Eliminate alcohol, especially wine at night.

Insomnia: Eliminate alcohol before bedtime, take calcium/magnesium before bedtime (better absorbed) and if not lactose intolerant take with warm milk and a bit of honey if desired to take advantage of the enzyme that induces sleep. Don’t eat 3 hours before bed (acid reflux, hard to sleep on a full stomach) but if you find yourself hovering just below the surface of sleep, have a light protein snack before you go to sleep–it may be your blood sugar levels dropping causing your cortisol to spike inducing a lighter sleep.  

Libido, connection with a partner:

  • Foreplay, touch, emotionally engage, fermented foods.

Vaginal dryness:

  • Keep hydrated (watch diuretics and antihistamines), probiotics, keep active–the more you engage your lady parts in play, the better off they’ll be–use it or lose it as they say. Do Kegel and core exercises. Consider estrogen cream for <1 year.  Try a local personal lubricant such as vitamin E, aloe vera with vitamin E (brands available on Amazon:  Aloe Cadabra, Carrageenan) or Replens which is a lubricant that doesn’t have a natural base, therefore, Replens may affect condoms and may affect vaginal tissues.  Watch out for UTIs!

Fatigue, low energy:

  • Take a B complex vitamin (B vitamins are best absorbed together). You may wish to consider taking a B complex supplement in a pill form and add sublingual B12 (B12 is best absorbed sublingually as we get less efficient at absorbing B12 through our digestive tract as we age.  You can also get B12 shots administered by a doctor, usually a naturopathic doctor).  Cut out sugar. Eat plant-based protein, and take vitamin C, ground flax seed.  Get thyroid checked.

A few foods and supplements that can be especially helpful for mild-moderate symptoms.  Please seek professional help if they do not provide adequate relief.


  • 1-2 tablespoon ground flax seeds (can’t eat seeds whole as our body will just pass them through whole and flaxseed oil doesn’t have the phytoestrogen-rich lignans). For:  hormone balance, depression, joint pain, skin health and it’s a good source of plant fiber.

Brazil nuts 2-4 daily unless allergic to nuts.  

  • These nuts are high in selenium which is helpful for healthy cholesterol levels, thyroid, heart, blood vessels, and cancer prevention.

Multi-vitamin, Calcium/Magnesium (1:5), B complex::

  • If your food sources are not adequate, add high-quality supplements.  You may also want to consider a multivitamin.

Kathleen H Cutter








Please look at my Pinterest Boards to see foods high in various nutrients…you’ll notice a lot of overlap!


Parting Words:  


“The more you know, the more you know you don’t know.”  Aristotle


It is true that you aren’t the first and certainly not the last to go through the perimenopausal journey…you can take cues from the women that have come before you, you can take the advice from me, science, other alternative healthcare practitioners, other conventional healthcare practitioners…but your journey is as unique as you–it is your perimenopausal journey and yours alone.  This can be daunting and be freeing.  I hope that your path smooths out before you, but know that you will get through it and into your Second Spring!

Additional Resources:

Chinese and/or alternative perspective:

Maciocia, Giovanni Obstetrics and Gynecology in Chinese Medicine Churchill Livingstone 1998

Ni, Maoshing Second Spring: Dr. Mao’s Hundreds of Natural Secrets for Women to Revitalize and Regenerate at Any Age  Free Press, NY 2009

Welch, Claudia  Balance Your Hormones, Balance Your Life: Achieving Optimal Health and Wellness through Ayurveda, Chinese Medicine, and Western Science Da Capo Lifelong Book, 2011

Weed, Susan Menopausal Years:  The Wise Woman Way, Alternative Approaches for Women 30-90 Ash Tree Publishing 1992

Wolfe, Honora Lee Menopause: A Second Spring: Make a Smooth Transition with Traditional Chinese Medicine Blue Poppy Printers 1993

Western perspective:

Boice, Judith Menopause with Science and Soul: A Guidebook for Navigating the Journey (emotional aspects addressed more).

Brown, Ellen and Lynn Walker Menopause and Estrogen:  Natural Alternatives to Hormone Replacement Therapy    (somewhat dated but well written and easy to understand)

Corio, Laura E. and Linda G. Kahn The Change Before the Change: Everything You Need to Know in the Decade Before Menopause Bantam Books 2000   info. Resource  under “health info” look to “fact sheets” and “trusted resources”

Northrup, Christiane The Wisdom of Menopause (Revised Edition): Creating Physical and Emotional Health During the Change  Bantam Books 2012

Price, Catherine Vitamania: How Vitamins Revolutionized the Way We Think About Food Penguin House 2015

For online graphics on foods high in certain vitamins and minerals:  A few boards.  One illustrates which foods are high in various vitamins, minerals, good fats. Another on food for certain symptoms, still another for EFT, acupuncture, food journal templates, and recipes

Kathleen Hiatt Cutter, Licensed Acupunct on Facebook for health articles in news

Other references:

Marchant, Jo Cure:  A Journey Into the Science of Mind Over Body  Broadway Books 2017

Mukerjee, Siddhartha 9/11/17 New Yorker magazine article

This is to serve as information only, please seek the care of a medical doctor for symptoms and concerns you may be experiencing.  This is in no way to serve as treatment of any disease or illness.  The following is for information only.