Your Menopause, Your Menotype
by Angela and Mark Stengler, MDs

Menopause can be a confusing time in a woman's life. The fact is that many women (and their doctors) struggle with choosing the best method to relieve menopausal symptoms. Gone are the days when menopausal women pop synthetic hormone pills that doctors have touted as a magical solution.

Known as the Women's Health Initiative; this study found significant increases in the risk of coronary heart disease, stroke, blood clots, and breast cancer. It also found an alarming rate of dementia amongst senior users of these hormones.

In order for a woman to find the treatment options that are right for her, she must take into consideration her own unique symptoms. Each woman's diet, heredity, and lifestyle all contribute to the menopausal symptoms, and a one-size-fits-all approach to treatment to the wide array and severity of symptoms is not the best option. Through our clinical work with menopausal women, we found that three different universal patterns exist, which we have coined "menotypes." Based on their unique symptoms and physical and emotional changes through menopause, most women will find that they fit into either menotype A, B, or C.

Those women who fit the description of menotype A have an easier time than the other groups in deciding which course of action to take because A types really do not experience strong menopausal symptoms such as hot flashes, night sweats, and so on. They do not have any signs of osteoporosis, and hormone analysis does not show a major deficiency. This group accounts for 5-10% of the menopausal women we see in our clinic (in other cultures it is much higher). Menotype A women will find that a natural protocol, including a diet rich in plant foods to balance hormones and supplements such as Vitamins C and E to protect the heart and bones, can keep them healthy through their menopausal years.

Women who fit the profile of Menotype B have more choices to make. In our experience, this represents the largest menotype group, making up approximately 55-65% of menopausal women. Many women in this category experience mild to moderate menopausal symptoms including occasional hot flashes, mild insomnia and reduced libido.

The symptoms of Menotype B are strong enough to cause women to seek help for relief of symptoms. Natural therapies such as the well publicized herb Black Cohosh is a safe and effective hormone balancer and can be used to treat hot flashes, depression, and vaginal dryness. Blach Cohosh, which has minimal side effects, can also be used to relax muscles, reduce pain, and soothe nerves. Natural progesterone can also offer substantial relief of symptoms. Proper dosing and testing are essential for optimal benefits.

The protocol for Menotype C's very straightforward. Simply put, this category is for menopausal women who, for one reason or another, require hormone replacement therapy. Women who fit this profile have severe menopausal symptoms (extreme night sweats and hot flashes, mood swings, etc) and may also have a bad case of osteoporosis. This accounts for approximately 25-30 % of all menopausal women we see in our clinic. The real decision comes down to whether to use "natural" or "synthetic" hormones.

In general, it makes sense to use hormones that are identical to those you find in the human body (as opposed to the synthetic hormones found in common HRT therapies), so we tend to favor "natural" hormones over synthetic ones. You won't hear much about natural hormones from the pharmaceutical companies as they are unpatentable (and much less profitable). However, they are available and can work with your doctor to implement them into your menopause therapy. There are also many complementary herbal and nutritional therapies that can help relieve symptoms even for women taking hormone therapy. Women who are Menotype C can take supplements such as ginseng for energy, St. John's Wort for depression, and Vitamin C to strengthen the immune system, as well as many others.

The key to a pleasant menopause is to maintain a positive attitude and seek an individualized approach. The use of diet, supplements, and natural hormones provides the ability to relieve menopausal symptoms safely and effectively. By discovering your "menotype" you can immediately begin a natural program that creates healthy hormone balance and smoothens your menopausal transition. Work with your doctor to benefit from a tailored program that safely and effectively relieves your menopausal symptoms.

Doctors Angela and Mark Stengler have worked together to co-author a comprehensive book on menopause entitled "Your Menopause, Your Menotype" (Avery/Penguin, 2003). Both are naturopathic doctors who practice in La Jolla, California. They can be contacted through their website at