Restoring Endocrine Function in Menopause with Specific Maca Phenotypes: A Functional Medicine Approach

Menopause is the talk in all walks of life. As part of this inevitable journey that women are on toward the declining function of the endocrine system, maintaining hormonal reserve for as long as possible is pivotal in helping to weather the perimenopausal storm of symptoms. After all, as research from Lisa Mosconi, PhD, and others would suggest, lower levels of hormones are often the primary crux for menopausal symptoms, whether brain fog, poor sleep, changes in cardiovascular markers, reduced bone mineral density, or even altered skin texture and hair quality. Estradiol, progesterone, testosterone, melatonin, cortisol, and many other hormones all play a powerful role in all these body systems, and when they decline due to the decreasing function of the entire endocrine system, it can take a toll. 

What is a functional medicine or root-cause-based approach to menopause?

One of the best places to start with maintaining hormone reserve, as discussed in functional medicine, is for a woman to address the fundamentals at this time of life if they haven’t already by (1) eating a nutrient-dense, diverse diet; (2) getting the right amount and type of physical activity and sleep; and (3) bolstering everyday life with some iron-clad stress management practices like meditation, bouts of relaxation, and being in nature. These foundations lay the groundwork for a healthy gut microbiome, liver detoxification, immune health, and better stress response.

As we know, sometimes, additional laboratory testing and staple dietary supplements like omega-3s, probiotics, vitamin D, and others will need to be included to help with the heightened inflammation and increased nutrient needs of a menopausal woman, which will be different than what was required during her premenopausal years. For some women who need therapeutic relief once they’ve got the basics covered, they may need to consider a hormone-targeted intervention to help meet their health needs. 

What about HRT?

In one study¹, 77 percent of symptomatic women surveyed were reluctant to take HRT. Outstanding questions about HRT remain:

1. Does HRT by itself address all the hormone issues women experience?
2. Do women want to take many different hormones at the same time, and what is the right combination for each woman?
3. How are those exogenous hormones monitored and measured clinically to modify the dose?
4. Is there any clinical follow-up on the gut microbiome and detoxification processes as a result?
5. How late after menopause can a woman truly begin HRT without any risk?

However, realistically speaking, there is a threshold for what a healthy diet, lifestyle, and exercise can do, especially in a short time period. Furthermore, while most herbal supplements can provide menopausal symptom relief, there is limited evidence that they have statistically significant effects on hormones, especially during the postmenopausal period, which can ultimately impact heart, bone, and mental health.

What is another option to HRT?

Instead of introducing exogenous hormones into the body, there is a specific combination of maca phenotypes tested in clinical trials referred to as Maca-GO^2-4. Maca-GO is an organic, standardized, highly bioavailable combination of phenotypes from yellow, red, black, and purple maca that has been shown to be beneficial for increasing hormones in both perimenopausal and early postmenopausal women.

Meissner et al. have shown that different maca phenotypes differ in the ways they modulate the hypothalamic-pituitary-ovarian axis via their influence on estradiol, progesterone, follicle-stimulating hormone, and luteinizing hormone. In other words, Maca-GO naturally supports the endocrine axis in restoring some extent of physiological hormone production. 

Can any type of maca be used?

Most of the maca powders on the market are not defined according to phenotype or marker compounds, so it is unknown as to the effects they may have on the body, particularly in relationship to hormones. In fact, some of these preparations, while they may provide an initial bump in energy, may not perform as well to support other, more specific health applications. They may even cause an adverse result, leading to acne and hair loss if from particular phenotypes known to stimulate androgens. When it comes to hormones, the choice of phenotype really does matter. 

Can Maca-GO be used with HRT?

Maca-GO supports the body’s production of hormones by supporting the endocrine system. Therefore, it offers a unique first step in which it supports the hypothalamic-pituitary-thyroidal-adrenal-ovarian (HPTAO) axis and the body’s production of hormones such as estradiol, progesterone, and follicle-stimulating hormone. This mechanism of action, in conjunction with the other Functional Medicine approaches leveraging diet, lifestyle, environment, exercise, and other modalities, sets the body up for optimal health across the board. 

For those women who, through all those steps and therapeutic supplementation with Maca-GO, don’t get to the levels they want for their health, the next option is to introduce hormone replacement therapy (HRT). With the added support of Maca-GO, it may potentially require fewer hormones and in much lower doses than what would have been needed without Maca-GO. This safe and effective approach and ability to support the body’s hormone production also reduces the clinical concern over introducing hormones later in life. Instead, the body is naturally stimulated to optimize its production first and foremost. 

Final words

Menopause doesn’t need to be a biohacking drug intervention for all women for the rest of their lives. Nor does it need to be an uncomfortable, sometimes miserable decline in physical, emotional, and mental health. Rather, it can be an opportunity for the fullest expression of a woman to emerge at this transformative time of life when she is supported from within, at a physical level, through her hormones. There can be a ripple effect on her mindset and emotional well-being. She might feel inspired to write her memoir, start a new business, champion a social cause, or even give herself the luxurious self-care she has longed for over the decades of overwork and fatigue. With the support of diet, lifestyle, and high-quality dietary supplements like Maca-GO to optimize her hormones and endocrine system, she can effectively navigate this transition, going from the physical phase of fertility into the more expansive phase of nourishing the wisdom and power within.

About the Author

Deanna Minich, MS, PhD, CNS, IFMCP, is a nutrition scientist, international lecturer, teacher, and author with over twenty years of experience in academia and in the food and dietary supplement industries. She is the author of six consumer books on wellness topics, four book chapters, and fifty scientific publications. Her academic background is in nutrition science, including a Master of Science in Human Nutrition and Dietetics and a Doctorate in Medical Sciences. For a decade, she was part of the research team led by the "father of Functional Medicine," Jeffrey Bland, PhD, and has served on the Nutrition Advisory Board for The Institute of Functional Medicine. Dr. Minich is Chief Science Officer at Symphony Natural Health.

References

1. Lu J, Li K, Zheng X, Liu R, Chen M, Xian J, Tu S, Xie L. Prevalence of menopausal symptoms and attitudes towards menopausal hormone therapy in women aged 40-60 years: a cross-sectional study. BMC Womens Health. 2023 Sep 4;23(1):472. doi: 10.1186/s12905-023-02621-8. PMID: 37667324; PMCID: PMC10476428.
2. Meissner HO, Mscisz A, Reich-Bilinska H, Kapczynski W, Mrozikiewicz P, Bobkiewicz-Kozlowska T, Kedzia B, Lowicka A, Barchia I. Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (II) Physiological and Symptomatic Responses of Early-Postmenopausal Women to Standardized doses of Maca in Double Blind, Randomized, Placebo-Controlled, Multi-Centre Clinical Study. Int J Biomed Sci. 2006 Dec;2(4):360-74. PMID: 23675005; PMCID: PMC3614647.
3. Meissner HO, Mscisz A, Reich-Bilinska H, Mrozikiewicz P, Bobkiewicz-Kozlowska T, Kedzia B, Lowicka A, Barchia I. Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (III) Clinical responses of early-postmenopausal women to maca in double blind, randomized, Placebo-controlled, crossover configuration, outpatient study. Int J Biomed Sci. 2006 Dec;2(4):375-94. PMID: 23675006; PMCID: PMC3614644.
4. Meissner HO, Reich-Bilinska H, Mscisz A, Kedzia B. Therapeutic Effects of Pre-Gelatinized Maca (Lepidium Peruvianum Chacon) used as a Non-Hormonal Alternative to HRT in Perimenopausal Women - Clinical Pilot Study. Int J Biomed Sci. 2006 Jun;2(2):143-59. PMID: 23674976; PMCID: PMC3614596.
5. Meissner HO, Kapczynski W, Mscisz A, Lutomski J. Use of gelatinized maca (lepidium peruvianum) in early postmenopausal women. Int J Biomed Sci. 2005 Jun;1(1):33-45. PMID: 23674952; PMCID: PMC3614576.