A Role of Adrenals in the Menopause Transition

Susan Blake, NTP, MS, CGP • May 01, 2019

Menopause is a significant change in a woman’s life as she transitions away from reproductive capacity. It opens the door to many opportunities for a woman – new roles in life, freedom, becoming more in tune with her own body, honoring and supporting change, and developing new passions. It should be beautiful, fulfilling and life-giving.



Unfortunately, women often don't feel supported and suffer through the menopause transition (MT) with many uncomfortable symptoms. This has given rise to MT being considered like a disease that needs treatment, particularly with hormone replacement therapy (HRT). While HRT may be necessary for some individuals and helpful for others, it has also been associated with an increased risk for breast cancer.1 HRT also doesn’t address the underlying reason why some women suffer while others do not. If it were a simple situation where having low hormones equated to having menopause symptoms, ALL women would have complaints and would improve with HRT. This does not happen. HRT doesn’t always work and women, particularly in non-western societies, often don’t experience negative symptoms.2 Fortunately, research is continuing to find other players and factors involved in the intricate balance of hormones involved in MT.

An often-overlooked factor is that the adrenal glands are intricately involved with sex hormone production. Before puberty, in both genders, the adrenal glands produce low levels of steroid hormones that can be converted to testosterone, progesterone and estrogens. In females during puberty, the ovaries take over production of progesterone and estrogens due to increased reproductive need. It is postulated during and after MT, with the decreased function of the ovaries, that the adrenals re-claim their role in the production of sex hormones.3

However, the ability of the adrenal glands to produce sufficient steroid precursors and hormones is dependent on the vitality and functioning of the adrenal glands.4 If the adrenal glands are fatigued, stressed or otherwise occupied from trying to keep up with the demands of cortisol and other stress hormones production, the ability to also produce sex hormones may be compromised or limited.5 Additional factors that complicate the situation included weight/obesity,6 levels of follicle stimulating hormone, epinephrine and norepinephrine,7 social expectations and culture,8 diet, anxiety, exercise and negative beliefs.9

While research has not yet found a simple solution, it suggests that increased levels of the adrenal androgens, Adiol, may be a factor associated with the differences in symptoms experienced during MT.10 Therefore, supporting the adrenal glands makes a lot of sense, as they are involved in many important functions in addition to steroid hormone production, including mineral and water balance, cortisone production and stress responses. By the time a woman gets to the age of the MT, her adrenals have worked pretty hard and could use some support.

Unfortunately, there is not one solution for supporting adrenals either. Modifiable factors include balancing the diet, stabilizing blood sugar, modifying stress response, getting good sleep, and finding the most beneficial type of exercise, activity and mindfulness practice. But more important than those is developing and trusting your innate wisdom. Healing comes from within and with a change in belief. Whatever you are doing right now, may not be the best solution for you, even if it follows culturally acceptable and touted recommendations. You may need to change your diet, activity level, habits or patterns. Maybe women just have to change our perceptions about our own bodies and roles in life as we age – gracefully accepting the changes and supporting ourselves with self-care, self-image, self-compassion and self-love.

Susan Blake, NTP, MS, CGP, is a nutritional therapist and focused on integrating mind, body, spirit and food. If you are ready to change your lifestyle and develop true health, contact The Whole Body Shop at sblake@thewholebodyshop.net, TheWholeBodyShop.net or 253.778.0684. A full list of references for this article can be found on our website.

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