Menopause is a natural biological process that affects an estimated 1.3 million women in the US every year. Defined as twelve consecutive months without a menstrual period, menopause typically occurs in a woman’s early 50s and marks the end of reproductive capacity. While often an overlooked area in health care, the symptoms from these hormonal changes can be significant. Research has shown that nearly 80% of women report hot flashes, genitourinary changes, difficulty sleeping, and altered cognition, which can be severe in roughly 30% of women going through menopause. Following menopause, women are typically at a higher risk for developing diseases like osteopenia, cardiovascular disease, diabetes mellitus, and certain types of cancers due to the vast hormonal changes at play. Historically, the medical standard of care for managing menopause has been either no intervention or hormone replacement therapy (HRT), which many women have elected not to pursue. In recent years, a third approach emphasizing nutrition, lifestyle modification, and integrative therapies has gained increasing attention as a potential strategy for symptom management and natural hormonal support.

As women age, the number and function of ovarian follicles and their supporting granulosa cells decline, leading to a gradual reduction in estrogen and progesterone production. In response, the hypothalamic–pituitary axis increases secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), but ovulation can no longer occur. Because estrogen receptors are widely distributed throughout the body, including in the brain, bone, cardiovascular system, and urogenital tissues, declining estrogen levels lead to systemic effects. In the central nervous system, reduced estrogen signaling disrupts hypothalamic thermoregulation and contributes to vasomotor symptoms such as hot flashes and night sweats, while loss of estrogen’s protective role in bone remodeling accelerates bone loss and increases osteoporosis risk. Estrogen decline also results in changes in urogenital tissues, leading to vaginal dryness, dyspareunia, and urinary symptoms, and is commonly associated with sleep disturbance, mood changes, and fatigue.

A recent case study published in Women’s Health Research examined the use of a personalized nutrition and nutraceutical program to help manage menopause-related symptoms in a postmenopausal woman. The participant, a 61-year-old female, presented with fatigue, weight gain, mood instability, sleep disturbances, irritable bowel syndrome (IBS), depression, and other common concerns associated with hormonal decline. She was initially placed on hormone replacement therapy (HRT) in 2007 following a partial hysterectomy, but discontinued it in 2018 due to an increased risk of blood clots. Over the years, she had been prescribed multiple medications, including amlodipine for hypertension beginning in her early 30s, duloxetine (an SNRI) for depression in her early 50s, and losartan for hypercholesterolemia diagnosed three years prior. Due to ongoing health challenges and a desire to move away from prescription medications, she enrolled in an integrative health program emphasizing a more holistic approach to care.

The participant was instructed to start a 12-week protocol that included a personalized diet and nutraceutical program guided by the results of a comprehensive urine hormone panel. The first phase focused primarily on dietary interventions, eliminating gluten and dairy, incorporating healthy fats such as avocados, nuts, and coconut, and adoption of a circadian rhythm-based eating pattern that emphasized specific foods at designated times of day. Under her physician’s supervision, she also began tapering off duloxetine. After one month, hormone metabolite testing revealed markedly reduced sex hormone levels, including low metabolites of progesterone, estrogen, testosterone, and DHEA-S, prompting a customized nutraceutical intervention aimed at restoring hormonal balance. 

This protocol was designed to support hormonal balance, neurotransmitter function, detoxification pathways, and overall metabolic health. It included a comprehensive multivitamin–mineral formula with activated B-complex nutrients and trace minerals; targeted methylation and mood-support nutrients such as S-adenosyl-L-methionine (SAMe); amino acids and neurotransmitter precursors including L-glutamine and N-acetyl-L-tyrosine; and estrogen metabolism support featuring diindolylmethane (DIM) and calcium D-glucarate. Hormone-supportive botanicals and select hormone precursors such as dehydroepiandrosterone (DHEA) were also incorporated. One month later, 5-hydroxytryptophan (5-HTP) and magnesium were introduced in response to new-onset constipation, frequent crying, and increased irritability.

Following the 12-week intervention, the participant reported feeling “normal” again and experienced notable improvements in mood, energy, and overall well-being. Within the first 10 days, she reported losing 6.6 pounds, and benefits continued as the program progressed. She remained on the protocol for an additional 14 weeks, totaling six months of intervention. At the six-month mark, a repeat urine hormone panel demonstrated significant improvements across several endocrine markers. Progesterone metabolites rose dramatically (alpha-pregnanediol from 20.8 to 351 ng/mg CR; beta-pregnanediol from 318.7 to 4291.5 ng/mg CR), while estrogen markers showed similar elevations (total estrogen load from 12.2 to 20.8 ng/mg CR; estrone from 0.9 to 1.8 ng/mg CR). Androgen markers also increased significantly, with testosterone rising from 1.6 to 6.6 ng/mg CR and DHEA-S from 15.93 to 1046.6 ng/mg CR. The anabolic-to-catabolic ratio increased from 0.4 to 1.5, indicating a shift from a physiologically depleted state toward a more balanced metabolic profile. 

She reported high adherence to all recommendations, including increased consumption of plant foods, adherence to the circadian-based rhythm diet plan, complete avoidance of dairy, an estimated 80% reduction in gluten intake, and consistent use of the nutraceutical regimen. While follow-up testing indicated elevated DHEA levels were due to supplementation, she did not report adverse effects such as hirsutism, acne, oily skin, insomnia, hair thinning, or androgenic hair loss. The progesterone metabolite beta-pregnanediol was mildly elevated, while the remaining markers, including alpha-pregnanediol, total estrogen load, estradiol, and testosterone, were within optimal ranges.

Clinically, she reported resolution of night sweats, rare and mild hot flashes, improved memory, and a return to her usual personality, describing herself as “singing and laughing like my old self again.” A 12-month follow-up confirmed that she continued to feel significantly better on the nutraceutical regimen than she had on the prior SNRI. Although she still experienced arthritic pain in her knees and spine, she reported meaningful functional improvement, including the ability to get up from the floor independently, which she had previously been unable to do.

The findings highlight the importance of a comprehensive, individualized approach to menopause care that addresses hormonal balance, metabolic health, and neuroendocrine function through targeted nutrition and lifestyle strategies. By integrating dietary modification, nutraceutical support, and careful monitoring of hormonal biomarkers, the intervention was associated with meaningful improvements in both biochemical measures and overall quality of life.

Although hormone replacement therapy remains an important option for many women, this case illustrates the potential role of integrative, non-pharmacologic interventions as part of a broader management strategy, particularly for individuals who cannot or choose not to use HRT. As with any single case report, these findings reflect an individual response and should not be generalized to all populations. Further research is needed to determine the long-term efficacy and broader application of personalized nutrition-based protocols for managing menopausal symptoms.

Learn more about menopausal health:

Wellness Essentials: The Role of Key Nutrients in Women’s Health at Every Stage

The Postmenopausal Decline of Estrogen and How it May Influence Cardiovascular Health

Black Cohosh: Promoting Women’s Health and Menopausal Comfort

Taurine: Promoting Healthy Aging and Menopausal Comfort

By Jesse Martin, MS