Adaptogens for menopause and stress - can they help?

Menopause: a brief recap

If you only have a few minutes, jump straight to the section about ‘Menopause and stress’

Menopause, that natural hormonal change that happens in humans and two species of whale (yes, really!). The word comes from the Greek menos for month and pausos for ending, and describes the cessation of menstruation. A natural biological process, it takes place over many years and can start up to 10-15 years before the final periods eventually stop.

The symptoms commonly associated with menopause usually start towards the end of the perimenopause and continue for anything from a few months to 10-15 years after the menopause date.

Every person’s experience will be different. Some factors are genetic, and talking to your mother may give you an idea of what your experience might be, but overall health, diet and, significantly, stress will also play a part.

The most common symptoms, experienced by 70-75% of women, are the infamous hot flushes and night sweats. There are, however, many others which lower quality of life including tiredness, insomnia, poor concentration and memory (brain fog), low energy, aches and pains, vaginal dryness, reduced libido, gut and urinary tract problems, dry skin, heightened anxiety, low mood, or self-esteem. The symptoms will change over time: hot flushes reduce, but anxiety can increase.

Symptoms can return or be prolonged during times of stress.

The role of hormones

Levels of female hormones are notorious for fluctuating wildly throughout perimenopause and finally reducing once periods have stopped. However, as the body utilises oestrogen and, to a lesser extent, progesterone for other purposes (beyond their involvement in the reproductive cycle), these hormones continue to be produced at much lower levels after menopause.

Oestrogen is produced and stored in adipose tissue (body fat), and this may be why the body, post menopause, tends to lay down more fat. The most significant source of post-menopausal oestrogen and progesterone is the adrenal glands. Oestrogen, in particular, has many positive impacts on the brain including boosting serotonin, increasing blood flow, and supporting memory.

Serotonin is linked to temperature control, mood, and sleep. This may be the reason for the symptoms of hot flushes, low mood and difficulty sleeping.

Once your body gets used to the lower but steady level of sex hormones post-menopause, the symptoms generally diminish.

Stress, both in the lead up to menopause and afterwards, can upset this normal progression. It has been shown to worsen symptoms that are already present and can even trigger symptoms to recur long after they have stopped.

The effect of stress on our body

The stress, or fight/flight, response evolved to increase our survival in the face of a life-threatening event. In response to a short-term threat, such as facing a sabre-toothed tiger, the adrenal glands produce two hormones: adrenaline and cortisol.

Adrenaline increases heart rate, blood pressure, breathing rate and causes the liver and muscles to release stored glucose into the bloodstream - all the better to escape or battle your foe.

Cortisol increases blood sugar and fat levels, enhances immune system responses and perceptions, suppresses the digestive and reproductive systems (as the latter two are not needed for immediate survival), reduces pain perception and impairs short-term memory.

The production of these two hormones ceases once the stressful event has passed and your body returns to its normal state. However, long-term (chronic) stress can disrupt almost all of your body’s processes and systems, as levels, particularly of cortisol, remain high.

The problem is that our body responds to a perceived or imagined threat in the same way as it did to the life-threatening incidents of our ancestral past. Anxiety, worry, high-sugar diets, problems at home or work, or illness can all lead to the adrenal glands sustaining high levels of cortisol production.

This can lead to depression and anxiety (as cortisol reduces serotonin), insomnia (due to cortisol reducing melatonin production) and brain fog. As well as high circulating blood sugars and fats, high blood pressure and reduced gut function, meaning vital nutrients are not absorbed.

Menopause and stress

Sadly, chronic stress is very common in women of menopausal age. As women have children later in life, many reach menopause juggling children, work, and home life.

Around their 50s, they may be dealing with teenagers going through puberty while also managing the health issues and care of ageing parents and grandparents. They may have negative emotions relating to the loss of their fertility and youth, an emotion felt both by mothers and those still hoping for children.

As the menopausal transition itself is a stressor on the body, cortisol levels are already higher than normal. Consequently, women arrive at this key transition exhausted and stressed by the effort of holding everything together. In many cases, their adrenal glands are overworked and depleted.

How stress affects our experience of menopause

1. By diverting the adrenal glands away from the production of female hormones.

The adrenal glands are the most significant source of oestrogen and progesterone post-menopause. When stressed, the body turns its focus to producing cortisol to manage that stress, because a perceived threat will always take priority over fertility. Reduced levels of oestrogen and progesterone can trigger or worsen menopausal symptoms.

Someone experiencing chronic long-term stress, whose menopausal symptoms were reducing, can find they all come back as the adrenals start producing cortisol instead of oestrogen and progesterone and the body finds itself dealing with lower levels than it had adapted to.

2. Stress has a bigger effect on our bodies as our hormone levels decrease.

Pre-menopause, progesterone and oestrogen can buffer the impact cortisol has on our body, enabling it to cope better with long-term stress. Once these hormone levels start to lower during perimenopause, the cortisol-buffering effect weakens.

3. Stress reduces gut biodiversity.

It is widely acknowledged that chronic stress significantly and detrimentally affects the diversity of our gut microbiome. The depression of gut function and lower levels of beneficial bacteria in the gut affect menopause because of their role in the metabolism and processing of our food and hormones.

Our liver processes and excretes hormones, recycling them where necessary. Our gut microbiome, through the enzymes produced, is responsible for a significant portion of our digestion. Without these helpful microbes, phytoestrogens (another significant source of support post-menopause) such as soy or herbs (like black cohosh) cannot be absorbed and would have little effect on symptoms like hot flushes.

4. Depleted adrenal glands will eventually not be able to produce cortisol.

At some point, chronically stressed adrenal glands will no longer have the resources to make cortisol. In this situation, you can get extreme exhaustion coupled with menopausal symptoms. Many women have so many calls on their time there is no opportunity for the adrenals to recuperate, leading to adrenal exhaustion.

Adaptogens for menopause and stress

Given the role of stress in our experience of menopause, adaptogens (plants that help us adapt to stress) can play a crucial role in the management of menopausal symptoms by supporting the underlying functions of the body systems, especially those made worse by stress.

(Read more information on what adaptogens are here).

Here are some of the specific ways that adaptogens can help with menopause:

Supporting adrenal gland function and hormone production

By supporting the adrenal glands and keeping stress hormone fluctuations to a minimum, improving mitochondrial function and giving the body consistent energy levels, adaptogens are well placed to help reduce menopausal symptoms. Herbalists often find that there is no need to provide hormonal support for patients suffering from menopausal symptoms, as just treating the adrenal glands can often sort out the problems.

Gut function and microbiome

Adaptogens, particularly mushrooms, play a significant role in improving gut flora. They contain prebiotic polysaccharides that promote the growth of beneficial gut flora, support microbiome diversity, and enhance the production of digestive enzymes.

Liver function

A significant manager of hormones in the body, the liver is responsible for the breakdown and excretion of excess hormones, as well as being able to activate and inactivate hormones. If the liver is overworked or under-resourced, you can get a build-up of hormones.

In studies, adaptogens have shown various hepatoprotective mechanisms, such as reducing oxidative stress and inflammation and increasing the number of Kupffer cells, boosting the liver's ability to process toxins.

Stress relief

Stress and anxiety are key symptoms experienced by women at menopause. As plants that were revered through the ages for reducing cortisol and decreasing the symptoms of stress, adaptogens are ideal to use in this situation. Studies have revealed that adaptogens exhibit neuroprotective, anti-fatigue, antidepressive, anti-anxiety, nootropic and nervous system-stimulating activity.

Mood support

Adaptogens, with their mood-regulating properties, can help relieve menopausal anxiety and lift depression. They do this by supporting neurotransmitter balance and calming the nervous system, thereby reducing feelings of anxiety and restlessness.

Sleep regulation

By regulating the body's circadian rhythms and promoting relaxation, adaptogens can pave the way for restful sleep. They can reduce cortisol, allowing the body to produce the sleep hormone melatonin, and calm your nervous system leading to a more relaxed state.

A 2019 double-blind, randomised, placebo-controlled human study found that 300 mg of Ashwagandha taken twice daily for ten weeks improved both sleep latency and the percentage of time spent in bed asleep.

Libido support

Libido often declines in menopause but is also reduced by stress, in part triggered by lowering hormone levels and declining fertility. Levels of cortisol are also a factor, as reproduction is rarely a priority when faced with a threat. By balancing hormones, enhancing overall vitality and reducing fatigue, adaptogens can help reignite sexual desire.

Brain and cognitive function

Adaptogens support brain health, enhancing clarity, focus, and memory. This can help with the feelings of "brain fog" and the decline in concentration or memory during menopause.

Many adaptogens are nootropics and help support blood flow to the brain. Clinical trials have demonstrated that adaptogens exert an anti-fatigue effect that increases mental work capacity against a background of stress and fatigue, particularly in tolerance to mental exhaustion and enhanced attention.

In summary

Given the pivotal role the adrenal glands play in managing stress and hormone production post-menopause, it shouldn't be any surprise that adaptogens, those plants that have such an impact on our adrenal glands, can play a crucial role in managing menopausal symptoms.

Menopause is a natural transition in every woman's life, but that doesn't mean you have to navigate it without support. Adaptogens offer a multifaceted approach, and their holistic action on various body systems ensures that they address the root causes, providing comprehensive relief.

The Herbtender products recommended for menopause

• Focus & Clarity with Lion’s mane, Holy basil and Rhodiola. This nootropic-filled formulation is ideal for helping with brain fog, poor concentration and memory issues that sometimes come as part and parcel of menopause.
• Doze & Dream with Ashwagandha, Reishi, Passiflora, Chamomile, Nutmeg and a sprinkle of sea greens to help you ease into a restful sleep and stay there for longer.
• Calm & Collected containing Ashwagandha, Lion's mane and Holy basil, a soothing formulation to bring a moment of calm when anxiety is running high. Useful when you feel wired in the daytime, and need help in the evening to wind down when your mind has a life of its own.
• Rise & Shine with Ginseng, Reishi and iodine for daily energy, immune support and focus. Helping you to feel more productive and present as you go through this sometimes turbulent transition.
• Uplift & Revitalise containing Nettle seed, Rhodiola, Reishi, Liquorice and vitamin C to fight fatigue, restore energy and maintain stamina.

** It is always essential to be aware of potential side effects or interactions. While adaptogens are considered safe, they might interact with certain medications or conditions. Always start with a low dose and monitor your body's response. If you are on other medications, we advise you to always check with your healthcare provider before taking a new supplement.

References:

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Brandilyn A Peters, Nanette Santoro, Robert C Kaplan, and Qibin Qi (2020) ‘Spotlight on the Gut Microbiome in Menopause: Current Insights’, Int J Womens Health, 14: pp1059–1072. Available at: www.ncbi.nlm.nih.gov/pmc/articles/PMC9379 (Accessed: 16th October 2023)

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Deepak Langade, Subodh Kanchi, Jaising Salve, Khokan Debnath, and Dhruv Ambegaokar. (2019) ‘Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study’, Cureus  2019 Sep 28;11(9):e5797. Available at: pubmed.ncbi.nlm.nih.gov/31728244/ (Accessed 16th October 2023)

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