All Change – Embracing The Transition Of Menopause

Pamela Spence Blog

This month we invite Pamela Spence, medical herbalist, writer, educator and established industry expert on herbal medicine to share her advice on embracing menopause. Here Pamela covers both common and not so common symptoms, and explains how plant base dietary support, lifestyle and an understanding of what is happening to your body all have important roles to play in managing your menopause.

Menopause is such a different experience for each individual woman but sometimes the barrage of information around us makes it feel as if we should all be the same. It is important in my clinical practice to recognise that while there are of course common symptoms like flushes, mood swings, and weight gain, there are also less well-known issues like anxiety, overwhelm, joint pain and brain fog. There are heavy periods – flooding even – to contend with for some and others suddenly find they get a hangover after just one glass of wine. As for libido? Forget it!

Some women don’t realise their symptoms are all related and feel their lives are unravelling. And underneath all those outward manifestations – are individual women, with individual lives being impacted in individual ways. I often hear from women who are struggling that their menopause ‘isn’t as bad as others’ – the key thing for me is that if it is impacting on quality of life then there should be help at hand. And often there is – if we know where to look.

Some women with troublesome symptoms will happily choose to navigate the transition by taking HRT however the recent study showing that side effects may be worse, and persist for longer than we previously thought, and reports of issues with supplies, means that many women are not keen or, worse, more confused than ever.

Over the counter remedies can be a lifeline to some women either to get through this transition entirely, or during the early stages. Other women may still be left with some symptoms and need further support. It can often seem overwhelming to understand which way to turn and my job is to help women make a plan and walk it with them as best I can. Helping women to understand what is going on in their bodies is one way that I try to do that.

I often find that women who have the most trouble have led busy, stressful lives. Stress causes the adrenals to work very hard and at menopause they are asked (as well as other sites in the body) to take a role in oestrogen production for the first time. If your adrenals have been overworked (deadlines, pressure, little time for self-care) and are just coping, imagine what impact a whole new job has? They can’t maintain their current workload and they certainly can’t keep up with the new demands for oestrogen, so the result is anxiety, overwhelm and sometimes even panic. That’s why supporting adrenals is such a key part of my strategy.

My go-to herbs for this are ashwaganda (Withania somnifera) and liquorice (Glycyrrhiza glabra) – both prized adrenal tonics. Ashwaganda is my favourite herb where anxiety is also an issue and as its name ‘somnifera’ suggests, it can also promote better sleep. In terms of diet it is important to reduce caffeine, because drinking a lot of it is a bit like poking your adrenals with a stick. Herbal teas containing valerian (Valeriana officinalis) for stress, or even simple chamomile (Matricaria chamomilla) can be helpful here.  If a caffeine type boost is needed, chewing cardamom (Elletaria cardamomom) seeds or adding them to hot water and drinking can help lift energy. It may be that this time of transition also requires a reassessment of lifestyle. Time out and the ability to switch off our brains really helps our adrenals to rest and recuperate to take on this new task of theirs. Meditation, yoga, walks in nature – whatever it is the effort is well worth it, particularly if you are reading this thinking you are too busy to do any of these things!

The liver is also asked to do a lot at this time and commonly women experience this as being unable to tolerate alcohol in the same way as they have previously. Using herbs like milk thistle (Carduus marianus) we can support the liver which in turn helps with digestion and often improves headaches and migraines too. Taking bitters before meals will help prime digestion and if alcohol is becoming less of a treat and more about dreading the morning after then of course going alcohol free for a while is recommended.

Finally, and perhaps most importantly, we give the body a source of plant oestrogens to use while the adrenals get up to speed. Think of hot flushes as the body shouting for oestrogen – plant oestrogens can help out until the adrenals get on top of their workload and then the body doesn’t shout so much.  Herbs like red clover (Trifolium pratense) are high in plant oestrogens which, when delivered appropriately can help plug the gap. Dietary sources like soya products are also helpful but be aware that many are made from GM soya so look for organic, traditional preparations like tofu and tempeh. Rather than using pre-made remedies, medical herbalists create prescriptions specifically for their patients and use a blend of herbs to support the body holistically. Herbal medicine can play a vital role in menopause transition and a medical herbalist can give you the support and guidance you need on your unique journey.


Pamela is a medical herbalist and member of the National Institute of Medical Herbalists writer, educator and established industry expert on herbal medicine. Find out more on her website.

She writes and lectures on herbal medicine plus is the sole herbal advisor to Twinings Tea International and Deep Heat.  She has also sat on expert panels including The Food People and Potter’s Herbals to advise high street brands on harnessing the power of plants in their products.

She regularly appears in the media as a herbal expert, most recently in Woman & Home, the Financial Times and Hello Magazine. She also has her own columns and has written and presented an online series for BBC Scotland.

She runs her own private health clinic where she empowers patients to improve their health through the safe use of natural medicine.  She looks at the whole person, rather than only trying to fix a symptom, and then writes a prescription and creates bespoke herbal medicines.

Pamela believes in integrated healthcare solutions and promotes working in partnership with GPs and other healthcare providers. She is a member of the National Institute of Medical Herbalists, the UK’s leading professional body of herbal practitioners, and a member of the College of Medicine and Integrated Health.

As an educator on herbal medicine, she has taught and led workshop internationally and in the UK as well as teaching students of herbal medicine in the UK and US.  She is also an adviser to Discover, an NGO dedicated to training health workers in Africa to teach safe, natural medicine in rural communities.