Supporting Menopausal Comfort and Healthy Aging: Expert Advice from an Integrative OBGYN


1. Symptoms of Menopause

2. What Is Going On During Menopause?

3. What Most Practitioners Miss When Supporting Menopause Symptoms

4. Four Steps to Supporting Menopause and Healthy Aging

5. Resources


Menopause is a natural part of life, but that does not mean it’s an easy one. In fact, 90% of women seek medical support during their menopause transition.1 Common but significant symptoms can include hot flashes, cold or night sweats, low energy, sleep disturbances, palpitations, weight gain, mood disturbances, inability to concentrate and vaginal dryness.

The loss of ovarian-produced estrogen and progesterone is predominantly responsible for the effects of menopause. Restoring these hormones to physiologic, premenopausal levels using conventional interventions is a common clinical objective. Unfortunately, recreating the exact ovarian function and hormonal rhythms of a healthy premenopausal woman is not currently possible, and for some women, these interventions may not be appropriate. For these reasons, additional modalities are often needed to support female health throughout the menopausal years.

Dr. Felice Gersh, M.D.,+ a board-certified OB/GYN and Integrative Medicine practitioner, says, “The unique health issues faced by women are often minimized and overlooked; the most egregious example is menopause. But no longer can we view menopause as simply the loss of fertility and periods. It is the beginning of a huge metabolic shift, which we must recognize and address to support the health and well-being of the woman for years to come.”


It is important to understand the physiological changes that drive symptoms in menopausal women. Instead of picturing menopause like a finish line women must cross, it is better to consider it as a process that is different for all who go through it.

Dr. Felice Gersh says, “Historically, they say [menopause] is when a woman has not had a spontaneous period for 12 consecutive months, which is arbitrary. There’s nothing special about 12 months. It’s a process. So, I want you to think differently … [Menopause] is a process of ovarian senescence, the aging and decline of ovarian production of estrogen and progesterone.”

Dr. Gersh points out the inversion of the hormones responsible for driving fertility cycles in women. Prior to the onset of menopause, estrogen is high and progesterone is low. As the process continues into the menopause transition, these hormones and others, including LH, FSH, and inhibin B, begin to invert, which triggers the symptoms listed above. As the process continues and the hormones stabilize, progesterone is elevated and estrogen remains low.2

The inverse relationship of hormone levels before, during and after menopause drives many practitioners to suggest hormone replacement therapy (HRT) to help restore balance. While HRT may work for some menopausal women, there are some contraindications to taking these pharmaceuticals, and even with perfect dosing, it will not be able to recreate the hormonal status of a healthy premenopausal woman.

Certain therapies, such as HRT, may be appropriate and should be used under the recommendation of a qualified healthcare professional for managing menopause symptoms. Dietary supplements are not intended to replace the use of such therapies or pharmaceuticals.

However, if looking for a way to potentially manage menopause symptoms, the following protocol and supplement recommendations mentioned later in the blog, may be appropriate.


Hormones take center stage when menopause support is initiated, and for good reason. Other hidden risks of menopause are often overlooked and must also be addressed.

Estrogen receptors are found all over the body and play vital roles in regulating countless physiological functions. The fluctuations of estrogen during menopause have additional health implications,3 including but not limited to:

  • Weight gain and increased visceral fat
  • Changes in metabolic health
  • Musculoskeletal effects
  • Cardiovascular health
  • Neurological health
  • Cellular health (breast, colon)
  • Autoimmunity
  • GI concerns like occasional heartburn, malabsorption and motility

Dr. Gersh points out, “There are receptors for estrogen on virtually every organ system in the body. So, when you lose ovarian-produced estrogen, you lose the optimal, healthy functioning of all the organ systems of the body, leading to these myriad problems.”

Two important health concerns to note are cardiometabolic concerns and bone health.

Cardiovascular health can become a risk factor for menopausal women, with postmenopausal women experiencing cardiovascular concerns 4 times the rate of premenopausal women.5

The menopause transition brings with it unfavorable shifts in body fat distribution, lipids and lipoproteins and alterations in the structural and functional measures of vascular health.6

The Study of Women’s Health Across the Nation (SWAN) study investigated chronological aging versus reproductive aging and the results showed changes in total cholesterol, LDL-C and apolipoprotein B levels during the menopausal transition. These changes were found to be independent of the effect of chronological aging alone. Additionally, the menopausal transition was independently associated with adverse changes in body composition and increases in visceral adipose tissue, both of which contribute to cardiometabolic function.7

Changes in bone metabolism are 4 times more likely to affect women than men, especially women over 50 years of age. Studies have shown that women can lose up to 20% of their bone density during the five to seven years following menopause.


It is important to support your patients through the menopausal transition and let them know that it does not have to be a difficult or negative experience.

Dr. Felice Gersh, in collaboration with Pure Encapsulations®, has co-developed a four-step protocol that connects lifestyle changes with targeted supplement protocols to help guide your patients through this stage of life.

To learn more about Dr. Gersh’s approach and the Pure Encapsulations® products designed to support menopausal women, explore the resources listed below.


Webinar: “A Woman’s Guide to Healthy Aging: Supporting Menopausal Comfort & Healthy Longevity” with Dr. Felice L. Gersh, M.D.

PureWoman Exclusive and PureWoman Brochure

Drug-Nutrient Interactions Checker: Offers scientifically supported, clinically relevant information and relevant product suggestions.

You can also explore Pure Encapsulations® to find more On-Demand Learning, Clinical Protocols and other resources developed with our medical and scientific advisors.


  1. Guthrie JR et al. Climacteric 2003; 6:112–117
  2. Davis, S., Lambrinoudaki, I., Lumsden, M., et al. Nat Rev Dis Primers 1, 15004 (2015).
  3. Adapted from Exper Rev Endocrinol Metab® 2011 Expert Reviews Ltd
  4. Centers for Disease Control and Prevention, National Center for Health Statistics. Accessed October 15, 2021.
  5. Davezac M et al. Front Aging. 2021 Sep 24;2:727380. doi: 10.3389/fragi.2021.727380. PMID: 35821994; PMCID: PMC9261451.
  6. El Khoudary SR et al. Circulation. 2020 Dec 22;142(25):e506-e532. doi: 10.1161/CIR.0000000000000912. Epub 2020 Nov 30. PMID: 33251828.)
  7. El Khoudary SR. Menopause. 2019;26(10):1213-1227
  8. National Osteoporosis Foundation. What Women Need to Know. Accessed June 2021.
  9. BHOF. Accessed on April 18, 2024.

+Dr. Felice Gersh, M.D. is a retained advisor for Pure Encapsulations®.