Whether you dread it or welcome it, reaching menopause (defined as going 12 months without a period) is an inevitable life stage for every woman. The average age of onset is 51, though it can happen in your 40s or in rare cases, even earlier. The transition stage just before menopause, when your period may become irregular or unpredictable, is called perimenopause.

Neither of these junctures needs to be a hellride, though female health lore will have you believe they will be. “Menopause gets a bad rap,” explains Jessica Sowards, MS, LAc, THE WELL Director of Chinese Medicine and Acupuncture, “but it is a natural, normal, healthy process.”

That said, the hormonal changes that occur with menopause (a decrease in the amount of estrogen and progesterone made by the ovaries) often come with unpleasant symptoms: hot flashes, night sweats, mood swings, weight gain, a drop in libido, insomnia and more.

Although many women choose to undergo hormone replacement therapy (HRT) to regulate their hormone levels, particularly when symptoms are more severe, some women prefer to treat the symptoms naturally — or seek relief holistically with a combination of medical and natural interventions.

As always, it’s important to consult with your doctor or other healthcare provider before embarking on a treatment plan for menopause. Here, some natural remedies that may help:

Traditional Chinese Medicine

“Chinese medicine practitioners believe in vital energy, called Qi,” explains Sowards. “We use various therapies to boost and regulate this energy force to improve health.” This ancient form of medicine focuses on the belief that mind, body and spirit are one and aims to find a balance between the complementary forces of yin (feminine, moon, nighttime and water) and yang (masculine, sun, daytime and fire). Sowards explains that in menopause, your yin factors are drastically reduced and “TCM can help to boost and nourish those yin factors.”

TCM methods of treating menopause include:

Acupuncture

A randomized trial in 2010 found that post-menopausal women who underwent two types of acupuncture, traditional acupuncture and shallow-needle acupuncture, had improvement in hot flashes; another study from Wake Forest University in 2016 found that hot flashes and night sweats associated with menopause were reduced by as much as 36 percent with acupuncture treatments. That research further found that those who received acupuncture for six months experienced its benefits even in the six months after treatment stopped.

It’s best to visit a licensed practitioner, such as the ones at THE WELL, who can customize acupuncture and TCM treatments to your particular symptoms.

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Herbal Remedies

Although there are several herbal remedies on store shelves that can treat the symptoms associated with menopause, medical herbalist Daniela Turley, MNIMH, MCPP, AHG, recommends working with a qualified practitioner. “Herbal medicine is a complex art and science. It is incredibly rare for an herbalist or naturopath to give one herb — most herbal prescriptions contain around five herbs, depending on individual needs.”

Some of the herbs Turley uses in her practice are red peony, sage, black cohosh, tribulus and hops to help hot flashes; red clover and ginsengs to help with stress and energy; and wild yam, shatavari, and licorice for adrenal support. She also says motherwort, verbena and bupleurum can help relieve anxiety associated with menopause, and damiana and tribulus can boost your sex drive.

Again, it’s important to consult with a licensed medical herbalist or doctor before embarking on a new herbal supplement remedy.

Adequate Calcium and Vitamin D

Though not related to the management of irritating symptoms, Turley recommends making sure you have adequate levels of calcium and vitamin D to support bone density, which declines with age and menopause. (The hormonal changes in menopause can increase your risk of osteoporosis.)

You can get calcium and vitamin D with over-the-counter supplements, but it’s also important to eat foods rich in these nutrients. Calcium is found in leafy greens like kale, spinach and collard greens, as well as in tofu, beans and sardines. Although the biggest source of vitamin D is the sun, you can also find it in certain fish such as salmon, herring and sardines and in egg yolks. Cod liver oil is also rich in vitamin D, if that’s your thing!

Avoid Refined Sugar and Increase Protein Intake

Eating processed foods (especially those containing refined sugar) can exacerbate menopausal symptoms, leading to an increase in mood swings, hot flashes, night sweats and difficulty sleeping. It can also result in weight gain, which can further worsen the symptoms.

Instead, eat a diet rich in whole foods including leafy green vegetables, fresh fruits (in particular berries and citrus fruits) and lean proteins. Women’s health and fertility expert Aimee Raupp, MS, LAc, author of the books Chill Out & Get Healthy and Body Belief, recommends eating protein at each meal to balance blood sugar and stay satiated. Eating adequate protein will also help you maintain muscle mass, which decreases as you age, and muscle tissue helps boost your metabolism.

Get Quality Sleep

Sleep issues can be a vicious cycle when it comes to menopause — it brings on insomnia and in turn, not getting quality sleep can increase the levels of the stress hormone cortisol and compound menopausal symptoms. Raupp recommends aiming for seven to eight hours of sleep a night. If you’re having a hard time clocking that many, try these tips.

Sleep Foundation recommends menopausal women avoid nicotine, caffeine and alcohol by the afternoon to achieve more restful sleep. They also suggest wearing lightweight, breathable pajamas to deal with hot flashes, keeping your bedroom cool, maintaining a sleep routine (going to bed and waking up at roughly the same time every day) and developing a wind-down routine before bed, such as turning off electronics, taking a bath and reading.

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Regular Exercise

Physical activity is always important, but even more so during menopause. Regular exercise helps reduce stress levels, relieve anxiety, maintain muscle mass and bone density and prevent weight gain, all of which are beneficial while going through menopause. Raupp recommends exercising for 30-45 minutes at least five days a week. A mix of cardio, strength training, stretching and balance and stability movement is best, according to the Mayo Clinic.

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