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Menopause Symptoms: Adrenal Health is Key

By Stephanie Deppe, M.D.


Most women I know dread the idea of going into menopause. We have all heard of the variety of infamous symptoms that come with the perimenopausal transition–hot flashes, night sweats, mood swings, and painful intercourse, amongst others. In a perfect world, a woman would never even know that she was entering into menopause except for the gradual departure of monthly cycles. Every woman should be able to enjoy a painless transition into the golden years. Fortunately, it is possible. The secret lies in addressing adrenal health.


A woman’s sex hormones–estrogen, progesterone and testosterone–are primarily made in the ovaries. During menopause, the ovaries shut down resulting in a fall of these hormone levels. However, they don’t disappear completely. In a healthy woman, the adrenal glands should continue to generate a smaller amount of testosterone, estrogen and progesterone through the production of DHEA and pregnenolone in the adrenals. We can actually test how the adrenal glands are functioning by measuring levels of these sex hormones and cortisol.



Adrenal fatigue is not well recognized in mainstream medicine. Most physicians who have not had any functional medicine training will think about the extremes of adrenal disease when asked about adrenal fatigue. Addison’s disease (or adrenal crisis) is a severe version of adrenal exhaustion, which necessitates cortisol replacement and is dangerous if left untreated. Fortunately, Addison’s disease is rare. In functional medicine, adrenal fatigue is recognized as a less severe version of adrenal dysfunction, which doesn’t lead to life threatening symptoms but results in real physical issues, such as fatigue, insomnia, compromised immunity, reduced muscle strength, and hormone deficiencies. In other words, adrenal fatigue matters!


It is mind boggling to consider all of the functions carried out by the adrenal glands. Sitting on top of the kidneys, these small fortune cookie-sized organs control blood pressure, blood sugar, sex hormones, and the fight or flight response. They are critical to life, and any great demands placed on the adrenal glands over long periods of time can lead to burnout. Optimizing adrenal health is multifaceted. It includes addressing blood sugar issues through diet control and weight maintenance, managing emotional stress, minimizing physical stressors, avoiding over-exercise, reversing insomnia, reducing caffeine consumption, providing nutrients required for adrenal repair and hormone synthesis, supporting with calming herbs, and sometimes supplementing with physiologic amounts of bioidentical DHEA and pregnenolone.


In functional medicine, we look at the whole picture to find out why “dis-ease” is occurring. The relationship between adrenal and hormonal health is another great example of a root cause approach to diagnosis and treatment. Lifestyle factors and targeted nutritional and supplement support results in better adrenal health and sex hormone synthesis, which can make a significant difference in easing the transition through peri menopause. Additionally, bioidentical hormone replacement when used in conjunction with adrenal support can also provide an added layer of symptom relief.


Imagine menopause as a time in your life when hormones are stable, when you get to enjoy life without menstrual cycles, mood swings, periods of fatigue, and all of the downsides of cycling. We should all be able to breathe a sigh of relief knowing that perimenopause doesn’t have to be difficult transition and can look forward to the benefits that come from menopause.



To your health,


Dr. Deppe



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