Perimenopause…. No you’re not going crazy!
Menopause can be such a tricky time for women. One minute you're 30, full of energy and getting on with life and then next thing you know life has snuck up on you and you don't feel quite the same person you used to be. Maybe you get tired more easily. Weight that used to be so easy to lose when you wanted to doesn’t seem to shift so easily. And maybe you’re feeling a bit muddled in the head and forgetful. Can't be the menopause right?!? You're too young!
The menopause is actually the time after which you haven't had a period for an entire year. This typically is around the age of 50 or 51 on average but can vary greatly from woman to woman. Some may start to experience symptoms starting in their late 30s and some may go on late into their 50s. That run up to menopause is something we call perimenopause. It can take eight to 10 years before the actual menopause happens!
The obvious symptom is that your monthly cycle starts to go a little haywire, becoming longer or shorter, lighter or heavier, and more unpredictable. Some women also begin to experience hot flashes, night sweats, sleep problems, mood swings, forgetfulness, loss of bone density, increased cholesterol levels, or changes in sexual function. These are all down to the changes in hormone levels that we experience.
We women are complicated creatures, especially when it comes to hormones. We have four hormones that rise and fall during our regular cycle in an intricate dance with each other. These are oestrogen, progesterone, follicle stimulating hormone (FSH) and luteinising hormone (LH). And that rise and fall begins to be more pronounced during perimenopause and oestrogen production begins to decline overall.
If that's not enough to deal with, many women who are perimenopausal are also juggling a career, kids at home and maybe caring for elderly parents too. That’s a lot of stress and stress affects our adrenal glands which in turn affect both our thyroid gland and our female hormones too as well as insulin (blood sugar) control. Trust me when I say there’s a whole “science bit” going on there that I won’t torture you with just at the moment - but all of that going on can mean fatigue, irritability, depression, brain fog, and putting on a little extra weight around the middle.
So what can you do?
Self care!
“You can’t serve from an empty platter” is one of my favourite sayings, and women are infamous for looking after everyone else first and not looking after themselves. But make a little “me time” a priority for yourself every day - even if that’s just 5 minutes extra in the shower to clear your head and think of all the good things in your life.
Eat a healthy, blood sugar balancing diet.
That means:
Having three to five small meals a day with a little bit of protein at every meal or snack (meat and poultry, fish and seafood, tofu, eggs, beans, lentils, chickpeas, nuts and seeds – ideally nothing in batter or breadcrumbs).
Eat at least five servings of non-starchy vegetables every day.
Eat two portions of low glycaemic fruit per day, with meals (preferably berries of any kind, apples, pears, plums, tangerines or similar, lemon and lime, peaches and nectarines)
Don’t skip healthy fats… fat doesn’t make you fat, per se - that’s a whole other blog post really, but trust me on this. Fat is not just the thing that you store in awkward places, it’s also totally necessary for hormone production, nerve and brain function, and cell membrane structure. (Think olive oil, avocado, oily fish such as salmon or mackerel, and nuts and seeds.)
Staying hydrated. If you can’t do straight water, there are many creative ways to flavour it with fruit, veg or herbs. (what about cucumber and mint?)
Keep the sugar, caffeine and alcohol intake in check. I like a glass of red wine with the next of them, but the fact is those things directly affect your blood sugar, which in turn affects your insulin, which can then affect your adrenal and female hormones directly too, and the vicious cycle continues.
Look after your friendly bacteria
I’m sure you’ve heard a load in the media in recent years about your “friendly” bacteria in your digestive tract. The fact is we have more bacterial cells in and on our bodies, than we have our own human cells, and we have evolved to work together with them. But they need to be in a nice diverse balanced population. How do you do that? See the blood sugar balancing diet bit above first! Hydration and fibre (i.e. lots of veg, fruit, whole grains) favour a better balance of good bacteria. And once again excess sugar, caffeine and alcohol tend to favour “bad” bacteria. And the bacteria in our guts DIRECTLY impact our liver, our moods, our weight, and how we metabolise our female hormones - weird but true! Live unsweetened yogurt, kefir, kombucha, sauerkraut and kimchi are the kinds of fermented foods that can help encourage a nice healthy population of friendly bacteria.
Stress, antibiotics, and some other medications can also affect our gut bacteria population, so in addition to the foods mentioned, you may choose to us a good quality probiotic supplement.
Sleep
This is a bit of a “Catch 22” in perimenopause. Hormones can disrupt sleep especially if you are experiencing night sweats due to dropping levels of oestrogen and progesterone, but lack of sleep can also directly impact your hormone levels. Remember I said earlier about the adrenal hormones affecting all our other hormones? Not getting enough sleep, broadly speaking, often means that our adrenal (or stress) hormones are higher. Whether that’s from the mental stress of you worrying about that presentation tomorrow or the physical stress of running around doing household stuff or too much caffeine or alcohol before bedtime - the physical response is the same. Also, I think we all know from experience, that lack of sleep makes us tired, irritable, and less able to cope with stress. Now if it’s the night sweats getting to you, then we can talk about whether sage or black cohosh would be suitable for you and dietary changes mentioned above and possibly trying out something called seed cycling might help too. Warm Epsom Salt baths before bed can help sleep. Sticking to a regular bedtime routine, keeping your bedroom cool and dark and keeping screen time to a minimum just before bed can all help too.
Movement
I hesitate to use the “E” word because many people have bad memories of PE class or they associate exercise only with going to a gym and spending two hours on a treadmill. But the fact is our bodies are designed to move, and finding some kind of movement you can do, you WILL do, consistently several days a week, is essential. We start losing muscle and bone mass from about the age of 35 - that means the potential for a slower metabolism and osteoporosis later in life. Exercise is crucial to keep muscle and bone mass up to keep us healthy as we age. Fact. It also helps our mood, our heart, our sleep, our ability to deal with stress, and our blood sugar balance.
Experiencing perimenopause and menopause doesn’t have to be a nightmare. While there is no one single magic bullet thing you can do, you CAN look after yourself with good nutrition, sleep, movement, and stress management to help ease the transition. And ladies, even if you are only 35 or so right now, it’s never too late - the earlier you start taking care of your body and mind, the easier the transition will be.
By Sharon Strahan, BSc (hons) Dietetics, BSc Nutr Med.
mBANT, mIFM, rCNHC
Sharon has BScs in Dietetics and Nutritional Medicine and she is currently a candidate for certification with the Institute for Functional Medicine.
With a history of high blood pressure, stroke, cancer, heart disease, type 2 diabetes, and depression in her family, she knows what she's up against if she doesn't take her diet and lifestyle choices seriously. She likes to use her knowledge and experience to help others to stay healthy as they age.
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