What’s the difference? Perimenopause normally starts between the ages of 35-45. It is your body’s two-year preparation time where it makes huge, tumultuous and unpredictable hormonal shifts before everything hopefully will settle down to a new balance in the menopause. Menopause occurs when menstruation finally finishes and is defined as the 12 months after your last cycle.
Now don’t too quickly heave a sigh of relief because perimenopause is actually where most of the real challenge lies. Research suggests women are three times more likely to suffer anxiety, depression and insomnia during five years before the menopause. Not only are the symptoms challenging but it can be a hugely vulnerable time in a woman’s life anyway. Often she has more responsibility than ever before – looking after children, balancing a career and supporting ageing parents.
This challenge, however, can be used to your advantage. Now is the time to make a whole life assessment and carve out positive change. Treat the perimenopause with the care and attention it deserves. By looking after your health, you can greatly improve the quality of those years of change and the rest of your life to come.
So what are these huge hormonal shifts taking place and creating havoc in your body? In perimenopause a woman’s ovaries (the main site of sex hormone production) are essentially going into a gradual retirement. The two hormones that regulate your cycle are called oestrogen and progesterone, and are produced during ovulation. Oestrogen is made as the follicles develop before ovulating and then declines as you move toward menstruation. Whilst progesterone is only made from the empty follicle left in the ovary called the corpus luteum. This is called the luteal phase and lasts the latter two weeks of your cycle.
Throughout perimenopause, there can be a huge change in your hormone production as the cycles become more unreliable and anovulatory (without ovulation). This of course in turn completely affects a woman’s ability to function, you could feel like you have permanent PMS, which is why you especially need extra support for this time.
The oestrogen roller coaster
Often, and particularly at the beginning of Perimenopause, rather than being on a slow, gradual decline, oestrogen behaves like it’s on a roller coaster ride; skyrocketing to high levels and only to crash down again. No wonder you can feel rough. In fact, the average oestrogen levels in perimenopausal women are higher than in younger women. This is because your FSH hormone is stimulating the ovaries to make more and more oestradiol (a form of oestrogen). Plus, if you already have any form of inflammation in the body, this may upset the normal detoxifying process and cause your body to accumulate more and more oestrogen.
To add even more fuel to the fire, progesterone (which help keep oestrogen in balance) is at an all-time low. This is commonly described as ‘progesterone deficiency.’ Your ovaries produce progesterone from the corpus luteum when you ovulate, but as these cycles decrease so does your production of this useful hormone. The symptoms of low progesterone are heavier, longer periods that become closer together due to too much oestrogen stimulating your uterine lining to thicken and grow. Normally, progesterone would counteract this build up in the uterus by thinning the lining. Swollen breasts and putting on weight are more common symptoms. This is because progesterone supports healthy thyroid function and you require a well-functioning thyroid for an optimal metabolism.
In addition, you could suffer from insomnia, rage and irritability mood changes (feeling like you have permanent PMS) this is due to your heavy ratio of oestrogen to progesterone. Progesterone is known as the ‘soothing hormone’ as it calms your nervous system and helps produce the relaxing neurotransmitter GABA. Without adequate sleep your body is missing key recovery time. There is no doubt that this can all add up to be detrimental to your personal life if there is no health intervention put in place.
Oestrogen gradually decreases
When the body is experiencing a slow gradual decline of oestrogen (most likely occurring nearer to actual menopause) your period becomes lighter and more spaced out as the cycles are reduced. This can be a relief short term. However, if your oestrogen levels are permanently too low it can be a cause for concern as oestrogen protects against degenerative conditions such as osteoporosis and heart disease in later life.
Oestrogen is a woman’s life force and with too much, she can feel hot-headed and without it she can become apathetic and retreating. A deficiency shows up as vaginal dryness (a red flag symptom) loss of bladder tone, increased UTIS, breast shrinkage, weeping bouts, hot flushes and night sweats. The infamous flushes can vary in length between 30 seconds and 30 minutes, you may have them anywhere between a few a days, or even to up to four an hour. Unstable blood sugar can also trigger hot flushes due to the surge in adrenaline it causes. This is why is it so important to make sure you have healthy levels of insulin (a hormone that helps your body use glucose for energy). Eating well throughout the day is crucial as your volatile blood sugar levels can cause further inflammation and this will only add to your hormonal imbalances.
Another stress hormone is cortisol. Like adrenalin it is made by the adrenal glands and when unbalanced often exists at either a constant high level or tends to be low in the morning and then soar up high at night, wreaking havoc with your sleep and consequently your energy levels. This is called ‘hypothalamic-pituitary-adrenal axis dysregulation’ (HPA axis dysregulation) and is otherwise known as ‘adrenal fatigue’.
During the perimenopause – when our ovaries are no longer producing progesterone and oestrogen – our adrenal glands are working extra hard. Our adrenal glands take over the responsibility to supply the progesterone and oestrogen we desperately require to keep hormonal balance. Moreover, if your adrenals do not supply adequate oestrogen, your body is much more likely to gain weight around the middle as fat cells can form to produce a form of oestrogen. It’s therefore vital you support these glands, through cutting down on stress, reducing inflammation and supplying your body with ample nutrients.
Throughout the perimenopause, it is of vital importance to your long-term physical, emotional health and stress resilience, to invest in your health by supplying your body with the correct nutrition it requires to function optimally. See below the list of ‘hormone heaven foods’ and ‘balancing lifestyle tips’ to help restore your hormones to a more harmonious equilibrium.
Hormone heaven foods
Getting good sources of fat in your diet is vital for hormonal balance. This makes sense as fats make up the cell membrane structure for every cell in our body. We need a healthy cell membrane for the rest of the cell to function. Omega 3 fats are particularly great because they improve fluidity within the cell membrane; reducing inflammation in the body. Here are some good sources: Monounsaturated fats – Avocadoes, Olive Oil, Coconut Oil and Nuts and Seeds. Omega 3 rich fats – Sardines, Mackerel, Salmon, Herring, Hemps seeds, Chia seeds. Good quality animal saturated fats- Organic Ghee and Butter.
Phytoestrogen foods are great for improving low oestrogen symptoms such as night sweats. They naturally and gently increase oestrogen levels and protect against estrogenic environmental toxins by binding to you your hormone receptors. Furthermore, they help protect osteoporosis developing (a risk factor for low oestrogen). Here are some good sources: Vegetables- Celery, Garlic, Carrots and Broccoli Herbs- Sage, Fennel and Cinnamon Legumes- Lentils, Chickpeas and Soy Grains- Oats, Rice and Rye Fruit- Apples, Plums and Cherries
Eating a healthy ratio of protein to fats and slow burning carbohydrates with each meal helps balance sugar levels. This consequently prevents an increase in perimenopausal symptoms such as increased irritability. Proteins are full of amino acids that help build and repair our muscles, bones, neurotransmitter and hormones. Here are some good sources: Animal – Chicken, Beef, Lamb, (make sure organic and grass fed), Fish and Eggs Plants – Lentils, Beans, Tempeh, Nuts and Seeds
Fibre is not a food in itself but it is a component of many foods. It helps with maintaining regular bowel movements which is important for your body to excrete oestrogen. In particular xenoestrogens (synthetic compounds that mimic oestrogen) and other substances that you do not want recirculating in your body. Fibre really helps sort this out. On average you want about 25-35 grams a day. Good sources are: Raw Carrot and Beetroot Apples Cruciferous vegetables; Cabbage, Broccoli and Kale Chia and Flax seeds
Dark Leafy Greens
Dark leafy greens are super for women during the Perimenopause. They stimulate liver function and are mineral rich in calcium, magnesium, potassium and vitamins A,C,E and K. Magnesium is particularly important. It helps with energy production (ATP), muscle relaxation, balancing blood sugar, soothing anxiety and is helpful for restoring healthy sleep patterns. Here are some good sources: Kale Spinach Swiss Chard Rocket Watercress Beet greens
Balancing lifestyle changes
- Reduce alcohol, caffeine, sugar and other inflammatory foods.
- Try to cut back on stress by setting healthy boundaries.
- Arrange relaxation and rejuvenation time in your week.
- Exercise smarter not harder – think strength training and regular movement rather than excessive cardio.
- Determine a consistent sleep hygiene routine.
- Make a life assessment. Prioritise what is actually important to you and plan how you can bring more of this into your future.