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The team supports a holistic approach to managing women’s hormonal healthcare. Our goal is to help our members be well-informed about their hormonal health, by providing them with evidence-based integrated health information that includes the current standard of medical care advised by qualified physicians, clinical insights from licensed allied health professionals (naturopathic doctors, nurse-practitioners, nutritionists, psychotherapists) and new health innovations that will be soon coming to market. Always consult with your doctor regarding your medical condition, diagnosis, treatment, or to seek personalized medical advice. 

Introduction to Menopause

Reviewed by Rina Carlini, PhD and Joanne Tejeda, PhD

What is menopause? 


Menopause is a natural biological process that occurs to all individuals with female reproductive anatomy and begins between ages 45-55. Menopause is clinically determined  12 months after the last menstrual cycle, when hormonal levels of estrogen and progestin decline, leading to changes in ovarian function that result in termination of menstruation since the ovary no longer produces eggs.

Menopause is categorized in 3 stages: 

  • Stage 1 - Perimenopause: a transition period associated with the onset of hormonal changes and symptoms which usually lasts from a few months up to 4 years.

  • Stage 2 - Menopause: period of 12 consecutive months with no menstrual cycle.

  • Stage 3 - Post-menopause: at this point, the symptoms start to subdue and get milder and may even disappear.


Menopause is not considered a disease; however, many health conditions arise as a result of the hormonal changes during menopause, these include: 

  • Cardiovascular disease

  • Osteoporosis

  • Type II diabetes

  • Colorectal cancer


Sometimes surgery (as in the case of hysterectomy) can trigger menopause to begin early in which case it is called premature menopause.


There may be a variation between the symptoms experienced by individuals: 

  • Vasomotor symptoms such as hot flashes (most reported symptom)

  • Irregular menstrual cycles

  • Vaginal dryness

  • Pain during intercourse

  • Trouble sleeping

  • Moodiness and irritability

  • Depression

  • Weight gain

  • Thinning of the hair or hair loss


Treatment Options

Symptom management for menopause includes both drug and non-drug options such as: 


Hormone therapies:


Non-hormonal therapies:

  • Low-dose paroxetine

  • Gabapentin

  • Venlafaxine


Drug-free treatments:

  • Physiotherapy and/or behavioural therapy, massage therapy

  • Exercise and nutrition management

  • Non-prescription water-based lubricant and moisturizers

  • Meditation, relaxation therapy

  • Naturopathy, homeopathy

  • Acupuncture

  • Herbal remedies


The transition through all stages of menopause occurs very slowly, lasting up to 8 years, and in some cases, symptoms can last up to 10 years after menopause. Menopause is a natural and inevitable progression of physically getting older. 


Menopause, perimenopause, post-menopause, vasomotor symptoms, hot flashes, therapy, drug, drug-free therapy, hormonal health, women’s health



To view the list of references, click on the plus symbol 

Menopause Article 2

Association of serum cortisol in women with brain biomarkers of Alzheimer’s risk 

Reviewed by Rina Carlini, PhD
April 22, 2024


Image licensed from Shutterstock #2188096049 

New research insights about menopausal women’s brain health was reported in March 2024 in a neuroscience research study led by Dr. Lisa Mosconi and co-workers of the Weill Cornell Medicine in New York City [1].  The research investigated the sex-specific relationship between serum cortisol levels and brain biomarkers associated with Alzheimer's disease risk. 

Alzheimer's disease is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss, with increasing evidence suggesting a link between stress-related hormones such as cortisol and the development of Alzheimer's Disease (AD). However, existing research has largely overlooked potential sex differences in these associations. 

To address this gap, Dr. Mosconi and colleagues conducted a study involving 277 participants, to examine the relationship between serum cortisol levels and brain biomarkers of Alzheimer's risk, while considering sex-specific differences. The study included both male and female participants aged 35–65 years who have risk factors for late-onset AD such as a family history and/or the APOE4 genotype, and who were assessed prior to the study of having normal cognitive function. The research methods used advanced neuroimaging techniques to assess various brain biomarkers associated with Alzheimer's disease, such as amyloid-beta deposits and neurodegeneration. 

The study revealed sex-specific associations between serum cortisol levels and brain biomarkers of Alzheimer's risk. Specifically, higher levels of serum cortisol were associated with increased amyloid-beta deposits in women but not in men. Amyloid-beta deposition is a hallmark pathological feature of Alzheimer's disease and is believed to contribute to the development and progression of the condition. The research findings suggests that elevated cortisol levels may exacerbate amyloid-beta deposition in women, thereby increasing their risk of developing Alzheimer's disease. 

Furthermore, the study found no significant association between serum cortisol levels and neurodegeneration biomarkers in either men or women. Neurodegeneration is another critical aspect of Alzheimer's pathology, and is characterized by the progressive loss of neurons and brain tissue. The lack of association suggests that cortisol may have a more specific effect on amyloid-beta deposition rather than overall neurodegeneration, in the context of Alzheimer's disease risk. 

The researchers did not observe reduced cognitive performance in women compared to men, nor did their study confirm the findings of a previous research study in 2018 that reported a stronger association of cortisol with memory in women compared to age-controlled men [2]. It was recommended that to advance this research, a broad range of cognitive tests might be needed to capture the subtle cognitive changes in men and women that are associated with cortisol levels.  

In summary, Dr. Mosconi's study sheds light on the sex-specific associations of serum cortisol with brain biomarkers of Alzheimer's risk. The findings underscore the importance of considering sex differences in Alzheimer's research and highlight the potential role of stress-related hormones in the development and progression of the disease. Further research in this area may contribute to the development of personalized strategies and therapeutic interventions for Alzheimer's prevention and treatment. 


  1. Mosconi, L., Williams, S., Carlton, C. et al. Sex-specific associations of serum cortisol with brain biomarkers of Alzheimer’s risk. Scientific Reports, volume 14, 5519 (2024).  

  2. Echouffo-Tcheugui, J. B. et al. Circulating cortisol and cognitive and structural brain measures: The Framingham Heart Study. Neurology 91, e1961–e1970 (2018).  

New study suggests that stress, age, BMI and some gastrointestinal factors are associated with severity of menopause symptoms

Reviewed by Rina Carlini, PhD
October 13, 2023

A group of physician researchers from Vilnius University in Lithuania examined whether there was any connection between the gut microbiome and menopause symptoms in women. They launched a study to investigate how gastrointestinal factors, stress, physical activity and other factors may affect the prevalence and intensity of menopause symptoms.

Study Overview

A cross-sectional study was conducted to determine if there were any significant correlations between gastrointestinal symptoms and perceived stress levels and menopausal symptoms such as gynecological health, vasomotor symptoms (hot flashes, night sweats), sleep and physical activity in women who were in pre-menopause, peri-menopause and post-menopause reproductive stages. The study enrolled 693 women participants who were approximately between 47-53 years of age, and analyzed their responses using the Perceived Stress Scale (PSS) and Menopause-Specific Quality of Life Questionnaire (MENQOL).


Key Findings

It was found that age and reproductive stage, perceived stress, body mass index (BMI), physical activity, diagnosis of depression or anxiety disorder, and some gastrointestinal symptoms (such as frequency of defecation, and Bristol stool consistency) had a significant association with the intensity of menopausal symptoms, especially the vasomotor symptoms of hot flashes and night sweats. The study authors reported that further research is needed to confirm the relationship between stress, gastrointestinal, and menopausal symptoms.


Menopause (2023):10.1097/GME.0000000000002259, October 3, 2023. | DOI: 10.1097/GME.0000000000002259

Related Readings

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A pragmatic approach to management of menopause

Source: Canadian Medical Association Journal
May 15, 2023

A recent article published by the Canadian Medical Association Journal recommends hormone replacement therapy (also known as HRT) as the first line of treatment for menopause patients who do not have health risk factors. The article also explains other hormonal and non-hormonal solutions to manage menopausal symptoms.

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Hormone therapy should be offered to more women with severe menopause: review

Source: CBC News
May 15, 2023

CBC News recently interviewed Dr. Iliana Lega, an endocrinologist at Women’s College Hospital in Toronto who is the lead author of a new Canadian Medical Association Journal (CMAJ) article entitled: “A pragmatic approach to the management of menopause”, which discusses the benefits and risks of hormone therapy to manage severe menopause symptoms.

Photo Image obtained from CBC News article (sourced by S_L/Shutterstock).

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