--- title: "Menopause" entity: "page" canonical_url: "https://www.drsmithnd.com/menopause" markdown_url: "https://www.drsmithnd.com/llms/page/menopause" lastmod: "2026-08-29T08:50:05.782Z" --- # What is Menopause? ## Are you feeling exhausted, moody, overwhelmed and not in control of your health? ## Menopause 101 Menopause is the natural, programmed end of fertility that human females experience (as do some mammals like giraffes and certain species of whales). The entry into this phase of life is marked by hitting 12 consecutive months with no period. The average age to enter menopause is 51 years old, but it is normal anywhere between 45 - 55 years of age. It is important to note that many women spend around half of their lives in menopause! At menopause, your ovaries retire and make only very tiny amounts of estrogen, progesterone and testosterone. Because of this, we can experience a wide array of bewildering and challenging symptoms, some of which are temporary and some of which can plague us long term. We have all heard about hot flashes and night sweats, but there are many more symptoms that you may not realize are related to menopause. Did you know that low hormone levels can lead to musculoskeletal problems (frozen shoulder!), changes in your sense of taste, and even heart palpitations? Many of the challenges that come along with menopause are also symptoms of more serious medical conditions so it is important to speak with your healthcare provider to rule out other possibilities. Once we know menopause is the core issue, we can work together to manage these symptoms and get you feeling a whole lot better. ## Symptoms of Menopause Weight gain, especially around the midsection Increase in mood issues (anxiety, depression, panic attacks, rage) Hot flashes and night sweats (vasomotor symptoms) Vaginal changes: dryness, pain, burning, chronic infections, lack of elasticity Night sweats Memory loss Sleep issues/insomnia, trouble falling asleep, waking frequently Decreased libido Fatigue, both physical and mental Urinary changes: having to pee constantly, irritable bladder, chronic UTI's, stress incontinence Tingling in arms, hands, feet, legs or shock-like feelings Digestive issues: acide reflux, diarrhea, constipation, bloating Migraines Cognitive changes: brain fog, lack of focus, trouble with word/fact finding, memory, feeling like you suddenly have ADHD Dizziness Tinnitus Body aches, pains from muscles to tendons to joints Bone loss: osteopenia, osteoporosis Declining nail, hair, skin health, even hair thinning or loss Heart palpitations Burning mouth syndrome, gum inflammation, taste changes Dry eyes, itchy eyes An increase in allergies A change in body odour If you relate to this, you’re very much in the right place because this is my superpower: helping women go from drowning to steering the ship once again. ## What can you do? A discussion with your doctor of your symptoms can lead to answers and possible treatment with hormone therapy, if they are literate about both the current state of the research on hormone therapy and menopause and unfortunately most doctors have received no education in either [hormone replacement therapy](https://drsmithnd.hiveality.com/hormone-replacement-therapy) or even menopause. ## How Does Dr. Smith Treat Menopause? Dr. Smith’s unique scope of practice includes prescribing hormones, nutrition and botanical medicine. Naturopathic doctors who have a prescribing licence can have the greatest impact and ability to support women in this phase of life due to our scope of practice. Why? Because the best way to help women both short and long term is by using a combined approach. Dr. Smith has spent her 15+ long career specializing in treating this population and partnered for 11 years of those years with a MD who ran a busy practice focused entirely on delivering the most current health solutions available per the research. ## Proudly Certified by The Menopause Society As a Menopause Society Certified Practitioner, Dr. Kirsten has advanced training to support women through [perimenopause](https://drsmithnd.hiveality.com/perimenopause), menopause, and beyond. This certification reflects her commitment to evidence-based, compassionate care — so you can feel confident you’re getting expert guidance tailored to your unique journey. ## Dr. Smiths comprehensive, personalized approach to menopause care includes: Nutrition An anti-inflammatory approach to food reduces many symptoms of menopause like weight gain, bone loss, and the risk of chronic diseases such as heart disease and diabetes. Dr. Smith personalizes all aspects of her treatment solutions but there is a strong focus on reducing inflammation, increasing fiber and lean proteins and lowering sugar intake. Movement What does the exercise physiology research say for you at this stage of your life? How can you protect your muscle mass, bone density and prevent cardiovascular disease? With a personalized approach that begins with where you are at. Dr. Smith also separates trends and myths from facts in a simple, impactful approach. Menopause Hormone Therapy (FKA Hormone Replacement Therapy) We may discuss possible treatments to reduce symptoms such as hot flashes, night sweats, bone loss, premature estrogen deficiency, and genitourinary issues like vaginal dryness and frequent urination. Hormone Therapy (HT) has been approved by Health Canada to treat conditions related to menopause, and for many, this is a great option. For those who may not be good candidates for hormone therapy, Dr. Smith will discuss other treatment options that can be very effective in treating your symptoms. It is important to meet with your provider to review your wants, needs and family history, so that together, you can determine what methods and treatments are the best fit. Stress Reduction Stress reduction really does help in menopause as cortisol levels create some of the discomfort related to menopause. Dr Smith will take a look at how you manage stress currently and possibly provide some support in this area as you get to more stable ground. Sleep The quality of your sleep is an essential part of getting health back on track in menopause. Without 7 to 8 hours of sleep a night, cortisol levels increase and cause inflammation in the body potentially leading to lowered defenses in the immune system and an increased risk of developing many chronic conditions such as sleep apnea and insomnia. Dr Smith will work with you to ensure this is working well to prevent all the awful downstream sequelae. Book Now E X P L O R I N G T H E A D V A N T A G E S ## What Are the Benefits of Hormone Replacement Therapy? Reduces brain fog Promotes lean muscle mass & improves insulin sensitivity Promotes healthy sleep Increases energy Reduces inflammation & body aches Supports collagen & elastin; healthy skin & joints Reduces age-related hair thinning Boosts immune function, improving healing capacity Decreases bad cholesterol & increases good cholesterol Increases bone density; decreasing risk of osteoporosis Increases the desire & stamina for exercise may reduce risk of cardiovascular deterioration Improves libido Most effective treatment for vaginal changes of peri/menopause Book Now ## More Information About Menopause Hormone Therapy (MHT) Menopause Hormone Therapy (MHT) & Hormone Replacement Therapy (BHRT): What's the Difference? HRT or hormone replacement therapy is when a licensed medical provider prescribes a hormone product. This could be the birth control pill, a hormone secreting IUD, or any hormone product. But mostly when people refer to HRT, they are referring to the prescription hormones women get when needing support in perimenopause or menopause. BHRT or bioidentical hormone replacement therapy is the same thing as HRT! Most people think “bioidentical” means that the product was made by a special compounding pharmacy, and it doesn’t. Bioidentical/ body identical/human identical mean just that; that the hormone prescribed is molecularly identical to what we make in our bodies (however they are made in a lab). The first thing you should know is that we have FDA approved versions of bioidentical hormones that all healthcare practitioners prescribe. That is why mostly these days we just say “HRT” which means the same thing as “BHRT” because the products are almost all, (in particular when it comes to treating perimenopause or menopause) bio/human identical. The only non-bioidentical synthetic estrogen still in the market place is called premarin and of course there are many non-bioidentical progestin products found in birth control pills and hormone secreting IUDs. Bioidentical hormones are made using natural ingredients and are available through standard FDA prescriptions or through certified compounding pharmacists who must adhere to strict regulations. The types, combinations and dosages of bioidentical hormones are customized to fit each individual patient and will be discussed in the course of your treatment. Hormones are powerful chemical messengers that must be prescribed; thus it is very important to receive a comprehensive individual medical risk assessment before proceeding with treatment. Ongoing monitoring with blood work is important to ensure that patients are optimized and are well within safe limits. The frequency of the monitoring is entirely dependent on the case. Hormone Replacement Therapy’s Role in Prevention Often we think of replacing hormones as  way to balance things, as a way to address immediate nagging symptoms – and it does. However there is a much bigger role that having adequate levels of hormones plays, it helps us not only to age well but also it helps to prevent many of the diseases of aging such as cardiovascular disease, osteoporosis, muscle wasting, gynecological infections and conditions, Alzheimer’s disease dementia, memory loss, and even some cancers. Understanding Hormones And How They Work Hormones are proteins that behave like powerful chemical messengers. They are delivered to body tissues through the blood. Working together like a finely tuned symphony, they regulate everything from reproduction and emotions to general health and well-being. Maintaining the proper balance of hormones in the body is essential to good health. Factors that affect hormone levels include your stage of development (puberty through menopause) as well as sleep, diet, stress, exercise, medications and the environment. Hormone Imbalance Affects Women at Any Age Women of all ages can suffer hormone imbalances. • Do you have PMS, heavy or irregular periods? • Have you suddenly gained weight and are unable to lose it? • Do you have mood swings, hot flashes and night sweats? • Are you feeling stressed, tired and have trouble sleeping? I work with teens who are having challenging periods all the way up to women at the end of their lives; our hormones are our kryptonite, they play a huge role in overall health at every stage of our lives. In young women it is often poor nutrition, emotional stress, an erratic lifestyle, too much alcohol, the use of birth control pills, or the early onset of menopause that leads to hormonal imbalance. In mature women, perimenopause, menopause and untreated postmenopause are the most common causes of hormonal symptoms. Other contributing factors – at any age – include genetics, lack of exercise, obesity, poor quality sleep, trauma, inflammation, thyroid and adrenal problems, ovarian failure, as well as exposure to pesticides, chemicals, environmental pollution and toxins. In most cases, the symptoms of hormonal changes can be improved through lifestyle changes and natural therapies. Often, however, working with a menopause clinic/menopause specialist who has experience working with HRT (hormone replacement therapy which is the same as bioidentical replacement therapy as explained above)  may be required for optimal lasting results. My Process for Providing HRT 1) Assessment: We begin with an initial hour long deep dive assessment, reviewing all your symptoms in detail, your medical and family history, and then discussing your goals. 2) Lab Work: I then order appropriate lab work which leads us to your first follow up. 3) Follow Up: In the first follow-up, I’ll teach you about your lab results, explaining what I think is happening (the diagnosis) and then going over my rationale for the kind of treatment I am proposing: writing out your individualized treatment plan and doing hormone prescriptions (if indicated), and off you go – the beginning of getting back to feeling like yourself again. 3) Treatment Plan: My unique scope of practice means that treatment plans include everything from lifestyle medicine (nutrition, stress management, movement) to botanical medicine, and if indicated, prescribing hormone replacement therapy (same thing as bioidentical). 4) Second Follow Up: The second follow up involves reviewing how the treatment plan/ prescriptions went, how each symptom responded to treatment, going over any questions, and making adjustments as needed. From here, follow ups are on an as-needed basis. If HRT/ hormone replacement therapy is right for you, you will feel like yourself again – vibrant, energetic and on top of your game! With HRT, you are really supporting yourself as you age by reducing much of the physical and mental deterioration that comes with this time in life and paving the way to have some of the best years of your life! What Are the Long-Term Benefits of HRT? Hormone balancing help both in the short and long-term. Hormone replacement therapy helps reduce the risk for the top three diseases associated with aging for women: heart disease, osteoporosis, and dementia. How are Bioidentical Hormones Prepared? Hormones are made in a laboratory and the components are from plants; typically yam or soy, to make a hormone that is structurally identical to those naturally produced in the human body. Does BHRT Require a Prescription? In Canada, hormones require a prescription from a medical doctor, naturopathic doctor WITH a prescribing licence (this is an additional license on top of the regular ND medical license) or a Nurse Practitioner. After a thorough consultation and laboratory testing, Dr. Smith may prescribe a hormone or a combination of hormones to address your unique needs. The prescriptions are filled at a regular pharmacy if you elect to use FDA approved versions of bioidentical hormones, or by a compounding pharmacy if you require a customized formula (compounding pharmacies are useful when women have unique dosing needs). Is BHRT Covered by Insurance? Prescriptions of any hormone product are prescriptions and therefore covered by your insurance. How are Hormones Taken? Depending on many factors, I will help you find an amenable route of administration. The choices are varied and include but are not limited to: gels, patches, creams,  suppositories, injections, capsules. Certain routes of administration work better for certain conditions. Is BHRT Safe? Yes. A lot of research shows that bioidentical/ human identical hormones have little in common with the side effects and risks of the old fashioned “synthetic” hormones. Today, bioidentical hormone replacement therapy is recommended as the standard of care for peri/menopause for this very reason, it’s just that there is a massive delay in getting the word out. The North American Menopause Society (NAMS), the British Menopause Society (BMS) and many others around the world like these organizations, do a complete literature review every 5 years and then comment on HRT and safety in a position statement. The last two position statements have conclusively stated that HRT (which again, is the same as BHRT) is the safest and most effective way to treat symptoms of menopause. There is a growing body of evidence that absolutely supports the safety of HRT showing it can lower a patient’s baseline risks for breast cancer, cardiovascular disease, dementia and osteoporosis. Other research has found that hormones have a favourable action on blood vessels and even decreasing the risk of dementia (which is 3x more common in women!). These positive results have spurred further studies on human identical hormones, and will hopefully fuel the trend for physicians to ONLY use these forms of hormone replacement, and learn how to help patients with immediate symptoms, but also prevent or reduces the risks of certain diseases. Finally, studies of both bioidentical/ human identical estrogen and progesterone are showing that they are not associated with an increased risk of blood clots. Unfortunately it is taking the medical community a long time to separate the body of evidence supporting these human identical hormone products from the old fashion “synthetic” ones which have high risks associated with them. Does Dr. Smith Test Hormone Levels? Most of the time I order blood work because that is what the majority of the research is based on. In some cases I may also use saliva, DUTCH or genetic testing, but this is rare as it is not usually necessary. Is Lab Testing Covered by OHIP? No, but often people have insurance for either my time or labs or both, please contact your insurance provider to find out ahead of your visit. Does BHRT Increase the Risk of Breast Cancer? No. Studies have demonstrated the beneficial effects of bioidentical estrogen and progesterone THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now