Some women experience absolutely no symptoms during their transition through menopause but if you are like 80% of women who do, it’s reassuring to know there are treatment options available. Help for menopause is here.

Perimenopause is the stage where most of the symptoms begin and these can persist for over a decade. Menopause officially commences 12 months after your last period. Women can go through menopause anywhere between the ages of 40 and 58 years but the average age is 52 years.   Symptoms can occur due to the falling levels of estrogen and progesterone, which has a multifaceted impact on organs and tissues throughout the body.

Most women identify menopause with hot flushes, night sweats, vaginal dryness, mood swings, poor libido and fatigue. Symptoms usually occur in the perimenopausal phase due to declining progesterone. Oestrogen actually increases to levels 30% higher than before but can go through periods of variations similar to a roller coaster leading to insomnia, depression, poor concentration, irritability, anxiety and poor stress tolerance and lethargy. In the later stages of perimenopause, oestrogen declines which may contribute to other symptoms such as heart palpitations, joint pain, osteoporosis and mental health issues.

One of the associated effects of estrogen decline is an increased risk of osteoporosis.  This is due primarily to the 1-2% loss of bone density per year of menopause, as well as 10 years post-menopause.  Estrogen decline is also associated with elevated cholesterol, cardiovascular disease, hypothyroidism, urinary tract infections and thrush.

Some women have concerns about the use of hormone replacement therapy (HRT) or are unable to use this option due to breast or ovarian cancer risk. Fortunately, there is now a large body of evidence that supports the use of herbal and nutritional medicines during the menopausal transition.


Phytoestrogens are naturally occurring estrogen-like compounds found in plants, fruits, or vegetables and are commonly divided into three main classes: isoflavones, lignans, and coumestans.

Isoflavones are found in the legume family, with high amounts in soybeans and soy products.

Lignans are found in high-fibre foods such as unrefined grains, cereal brans, and beans, with flaxseed being a particularly good dietary source of lignans. A recent systematic review found that women who consumed protein bars containing flaxseed (410 mg of lignan) for  6 weeks reported a 50% decrease in hot flushes. Seed cycling can be helpful for women who want to boost their intake of fatty acids and lignans.

Coumestan-rich foods include alfalfa and clover sprouts, peas, pinto beans, and lima beans.


Hops (Humulus lupulus) dampens tension and anxiety.  The active ingredient in hops, 8-prenylnaringenin, is a potent phytoestrogen and has been demonstrated to reduce vasomotor symptoms by improving the ability of the blood vessels to expand and contract. Numerous clinical trials have also documented significant reductions in the frequency of hot flushes, sweating, insomnia, heart palpitations and irritability in women who used a hops extract for 6 weeks.

In clinical practice, a combination of herbs is often used to support women during the transition through menopause. Korean ginseng (Panax ginseng), which is considered to be a “buried treasure medicine”, is another popular herb for active women suffering from fatigue. Ginseng’s active constituents include saponins, amino acids, vitamins (particularly folic acid and niacin), alkaloids, phenolic compounds, and flavonoids. Ginseng has been widely used in traditional medicine to assist with building resilience to stress and used as an energizer, to increase libido, and testosterone and alleviate menopausal symptoms. Clinical trials have shown ginseng significantly reduced depression and improve perceived well-being, exercise performance and energy in perimenopause.

Another popular herb is chasteberry, or vitex.  This herb has shown positive results in reducing PMS, anxiety, hot flushes and breast tenderness in perimenopausal women.  Vitex is used to support the transition from perimenopause to menopause due to its ability to increase progesterone levels and help maintain a healthy balance between progesterone and estrogen.

For women experiencing persistent hot flushes or night sweats as a result of menopause, Red Clover (Trifolium Pratense) may often be prescribed.  This herb contains high levels of phytoestrogens for improving hormonal balance, as well as helping improve bone density in those at risk of osteoporosis.  Several clinical trials demon straight the isoflavones present in red clover inhibit bone resorption and therefore reduce bone turnover associated with osteoporosis.

Ginkgo Biloba is similar to red clover because of the phytoestrogens it contains and its ability to naturally elevate estrogen levels.  Studies show that Ginkgo Biloba can reduce mood fluctuations associated with both PMS and menopause, as well as improving libido in 84% of trial participants after 4 weeks.

Sage, most commonly prescribed as a tea, has long been used in the management of fevers.  However, there is also evidence to support the use of sage for menopausal hot flushes and night sweats.  A study that assessed the use of fresh sage leaves in food or as tea demonstrated that the intensity and frequency of hot flushes were significantly reduced over a period of 8 weeks with consistent use.

Hormones play an integral role in your health, and changes in hormone balances can be challenging. There are many different ways that nutrition can be used to navigate menopause, without having to experience the numerous, negative side effects of HRT.

As with any element of health, there is never a one-size-fits-all approach and therefore we recommend individualised treatments for menopausal symptoms.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.athletesanctuary.com.au

Natural immune support such as herbal medicines can provide effective solutions to athletes who suffer from recurring colds and flu’s and other immune issues. When most people think of issues for athletes they usually think of musculoskeletal injuries such as sprained ankles, pulled muscles, or knee pain, but a recent study suggested immunity issues cause up to 50% of disruption to training or performance in athletes.

According to research, exercise improves immunity at moderate intensity but impairs immune function at high intensity (and duration) making many endurance and elite athletes more susceptible to respiratory infections.  Infection, such as fever and fatigue, can weaken muscles, impair exercise, and predispose athletes to other injuries. For example, fever impairs coordination, muscle strength, and aerobic power while viral illnesses contribute to tissue wasting and muscle breakdown.

Drugs commonly used to treat the symptoms of infectious diseases have variable impacts. Antibiotics can cause diarrhoea and ongoing gut issues, antihistamines can cause sedation, and many ephedrine-containing compounds like Sudafed are prohibited during competition over certain amounts under the Australian (ASADA) and World Drug Agency Association (WADA) guidelines.

To explain this immunity phenomenon perhaps a recap of how the human immune system is set up may be helpful. There are two parts to the immune system, the Innate Immune System and the Adaptive or Acquired Immune System.

Innate Immune System

The innate immune system includes our first line of defence providing physical barriers such as the skin, mucous membranes, nasal hairs, and eyelashes.  Functional barriers such as the gastrointestinal tract and defence mechanisms such as secretions, mucus, bile, gastric acid, saliva, tears, and sweat also protect us.

This part of our system also houses our infection-fighting cells such as our natural killer cells and phagocytes which act like Pac-men against microbial invaders, and proteins such as tumour necrosis factor which program cell death and cytokines which play roles in cell-to-cell communication.

The complement system is an additional cascade of proteins that “complements” other aspects of the innate immune system. The innate immune system is always ready to battle with foreign invaders, irrespective of whether they have come into contact with the microbial invader before.

Acquired Immune System

The acquired immune system is a collection of cells called T and B lymphocytes, immunoglobulins produced by the lymphocytes, and cytokines that regulate the immune response. Through a complex pathway of intercellular interaction, immunoglobulins are produced after exposure to a new pathogen, so they can recognise the invader the second time around and have an inbuilt immunological memory and enhance the immune response accordingly.

Gut-Associated Lymphoid Tissue (GALT) is a collection of several types of lymphoid tissue that store immune cells, such as T and B lymphocytes and is our major defence mechanism against pathogens entering the digestive system.  Peyer’s patch is a collective of lymphoid cells attached to the gut lining which is the initiation of the immune response when an infection is detected.

Secretory IgA is another substance produced by the acquired immune system produced in all areas where a protective mucosal layer exists such as the digestive, respiratory and urinary tracts to provide front-line defence. It forms the backbone of our immune system because it protects the immunoglobulins from being destroyed and protects the immunoglobulins from invading microbes.

This part of the immune system provides long-lasting protection against anything it has encountered before. When the two systems (innate and acquired) combine, they form an incredible defence against the constant barrage of infectious threats an athlete faces each day.

How does exercise impact on immunity?

So let’s examine how exercise can affect immunity. There is a substantial body of knowledge suggesting moderate exercise of up to 60 minutes at 60% of maximum heart rate improves immune cell counts and salivary IgA concentrations. Studies also show that 61% of new runner’s report fewer upper respiratory tract infections after starting running.   However, there is always a flipside to everything and in the case of exercise, the term moderation is wise to observe.

Intense exercise and prolonged exercise greater than 60 minutes may reduce immunity. While there is no doubt hard efforts increase VO2 max, it also forces most athletes to transition from nose breathing to mouth breathing, bypassing the nasal hairs and turbulent flow that protect the lungs from pathogens.

Inhaling larger volumes of colder and drier air thickens the mucous and disrupts the mucociliary elevator which is like our own inbuilt elevator designed specially to clear mucus from the respiratory tract. Hence why many athletes find they need to do a fair bit of “hoiking” to clear the phlegm during hard efforts in cooler months, especially when coupled with the ingestion of proinflammatory and mucous-producing foods such as dairy, coffee and bananas.

As more foreign particles are deposited in the lower airways, the ability to clear them is diminished, and airway inflammation results. Studies show our natural killer cells and secretory IgA fall after intense or prolonged exercise. The key members of our acquired immune system are also affected by neutrophils and B cell function declining.

With repetitive hard and long sessions that most endurance athletes over the marathon, ultra-marathon, ironman, triathlon or cycling do on a regular basis, hormones such as cortisol, prolactin, adrenaline, and growth hormone are constantly elevated and these also impair cellular immunity.

While most upper respiratory infections start off as viral infections, athletes who develop symptoms that are ongoing may also have a secondary bacterial infection.

What can be done about an underperforming immune system?

Few athletes stop training because they get a few annoying sniffles.  When on a mission, athletes should always seek out a solution to overcome or manage the issue.

At this point, it may be wise to seek help from a healthcare practitioner. Natural medicine has plenty to offer in regards to boosting the soldiers of the immune system. Most people are aware of the immune cell turbo boost vitamin C, and zinc provide but what about nature’s little wonders?

Natural remedies such as garlic and horseradish, Andrographis, Echinacea, Cat’s claw and Astragalus can increase immune cell count and function, and anti-microbial herbs like Thyme, Garlic, Thuja, St John’s Wart or Pelargonium have antiviral and antibacterial properties.

Maintaining digestive system integrity and gut health through quality probiotics will also help support GALT and sIGA in the adaptive immune system. Herbal adaptogens also assist with improving immunity integrity and resilience to future invasions. As with any treatment, these options are not going to be a magic bullet, but they can certainly reduce the severity of the infection, reduce recovery time and get you back to what you love doing. We always suggest athletes listen to their bodies and if needed modify training loads and convalesce to some extent.

Many studies use incorrect dosage ranges and timeframes for herbal medicines, so the evidence may be unclear and confusing to the untrained eye. However, when used in the correct dosage ranges, herbal medicines are viable options for athletes with few side effects. Research shows that seeking treatment quickly can reduce the impact respiratory illness may have on athletic performance.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au