By Dr Victoria Wills 

Sleep is NOT Optional

If you are like me, you might find yourself exhausted yet unable to sleep. You are not alone. Sleep disturbances are common during menopause due to fluctuating hormones. Pay attention to sleep hygiene. Sticking to a consistent sleep schedule, creating a calming bedtime routine, limiting caffeine and screen time in the evening, and staying active during the day can help improve sleep quality.

Sleep is not a luxury. It supports hormonal balance, mental clarity and emotional well-being and is essential during menopause. Without adequate rest, symptoms like hot flashes, anxiety, and fatigue become even more challenging to manage.

Manage Your Stress

Menopause is both a physical and emotional transition. Stress can make everything feel so much worse, including hot flashes, mood, sleep, and weight gain. That’s why I encourage building in regular moments of calm: deep breathing, prayer, mindfulness, nature walks, anything that brings you peace. Just a few minutes a day can make a big difference.

It’s important to consult your own healthcare practitioner to have an in-depth conversation about the benefits and risks associated with treatments like hormone therapy before deciding on what is right for you.

Consider Natural and Hormonal Therapies… Carefully

You may want to explore natural or hormonal remedies, but it’s important to separate hopeful claims from what the evidence supports. Soy isoflavones provide gentle hormonal support. Although much weaker than your body’s natural estrogen, they may help reduce hot flashes and support bone density. Natural progesterone, often sourced from yam root, isn’t well absorbed orally and is typically used as a topical cream applied twice daily to soft tissue areas like the thighs or abdomen. Alternatively, oral micronized progesterone (Prometrium) is available and generally well tolerated. Other supplements, such as vitamin E, black cohosh, and chasteberry, are widely used but haven’t shown consistent results in clinical studies. Herbs like dong quai and licorice root offer little proven benefit and may carry health risks and interact with other medications and supplements. Despite claims, no herbal remedy has been shown to prevent or treat osteoporosis.

For more severe hot flashes, nonhormonal medications such as venlafaxine, paroxetine, fluoxetine, and gabapentin can provide relief and are generally well tolerated. Older blood pressure drugs like clonidine and methyldopa may offer modest benefits but tend to have more side effects.

Systemic estrogen therapy, either alone or combined with progestogen, is highly effective but carries risks including breast cancer, stroke, and blood clots. Low-dose estrogen-progestin contraceptives may be considered early in menopause. Certain progestogens can also help with symptoms. Again, it’s important to discuss all options, benefits, and risks with your healthcare provider to determine the best approach for you.

You are not alone in this journey. Menopause is a new chapter, and it doesn’t have to be a struggle. With intentional changes to your diet, activity, stress management, and self-care, you can navigate this stage with strength, clarity, and grace.

References:

Alexander, I.M. & Moore, A. (2007) Treating vasomotor symptoms of menopause: The nurse practitioner’s perspective. Journal of the American Academy of Nurse Practitioners. 19(3):152-163. https://doi.org/10.1111/j.1745-7599.2006.00206.x

Chang, J.G., Lewis, M.N. & Wertz, M.C. (2023). Managing Menopausal Symptoms: Common Questions and Answers. American Family Physician. 108(1):28-39. Retrieved August 23, 2025 from https://www.aafp.org/pubs/afp/issues/2023/0700/menopausal-symptoms.html

Nothing in this or any post on Southwest Healing is intended to diagnose or recommend a particular treatment. This is an educational site. Always speak with your own healthcare provider before relying on anything you read or see on the internet. No matter how skilled or experienced someone is, they can’t know YOU like your own provider does.