Expert Contribution


Key symptoms & Hormone Replacement Therapy

MENOPAUSE is the point at which a woman is past her childbearing years and her menstrual cycle has stopped for 12 months. The transition leading up to this is called PERIMENOPAUSE and can take a few months or up to a decade! 

Symptoms of Menopause: 

  • Irregular menses 
  • Hot flashes, night sweats 
  • Insomnia/sleep issues 
  • Vaginal dryness, dry skin 
  • Weight gain/slowed metabolism 
  • Mood changes/anxiety 
  • Hair loss. thinning 
  • Bone loss 
  • Thyroid/adrenal hormone issues 

The 4 key lifestyle changes you can make to have a smooth transition include: 

  1. Blood sugar balancing (this includes regular meal spacing without snacking and not feeling “shaky, extreme hunger or anger” before the next meal) 
  2. Healthy weight for your body with some physical movement daily 
  3. Regular sleep cycle (see our “sleep hygiene” article for more tips) 
  4. Address stress & adrenal issues 

Once your ovaries are no longer producing estrogen, it becomes even more important that your adrenals are “in good shape” as this will be your main source of estrogen. 

For those that have been living a life of “pedal to the metal” this can be problematic. This is part of why women facing peri-/menopause living a life with constant high cortisol production will produce excess belly fat. Not only is that an impact of high cortisol, but fat is a source of estrogen. 

What to do if you are concerned about peri-/menopause or facing uncomfortable symptoms? 

The first step is to get some reliable testing. The best test is the DUTCH test which demonstrates estrogen, testosterone, progesterone (& how estrogen is metabolized) along with cortisol, DHEA, and melatonin. 

It is a simple urine test performed at home. Our office is an expert at reading this lab, we also teach other physicians how to use it. 

Once you know exactly what is going on, there are a host of natural options or bioidentical hormone therapies to consider. 

For those considering or currently using Hormone Replacement Therapy (HRT) there has been much issue over safety for years. It can be protective for some cancers and risky for others. 

What we do know is that you want to avoid taking estrogen by itself “unopposed” (particularly synthetic estrogen) and avoid progestins in all forms (synthetic progesterone). There are many bioidentical hormones options to choose from including topicals and creams. The lowest dose necessary is always ideal. 

One more item to consider as our medical understanding of SNPs (“genetic error codes”) expands is the significance of having the COMT SNP. For women who have this genetic marker, it means that not only will you have difficulty clearing your stress hormones (leading to higher prevalence of anxiety) but you will also have difficulty clearing estrogen, and that means a higher risk of estrogen cancers (particularly when exposed to estrogen over an extended time period). It can be helpful to know if you have this marker and if yes, there are many options to either support the clearance of estrogen or use other menopausal symptom support. 

Questions? Contact us by calling (925) 788-6300 or emailing 


About The Author

Functional Medicine & Nutrition
Dr. Brandy Zachary, DC, IFMCP
Body Love Cafe

Dr. Brandy Zachary, DC, IFMCP discovered the power of Functional Medicine first hand when a “mystery illness” left her declared permanently disabled. Unwilling to accept that diagnosis, she fought back and launched Body Love Cafe, an award-winning holistic health clinic.

BLC is all about natural medicine that meets cutting-edge science to provide answers as to why you don’t feel well. We hear you. We see you. We believe you. It’s not in your head and we’ve got the technique and labs to show why.

Patients have said “Dr. Zachary figures out why you feel like crap but your MD says you’re fine.” 

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