Peri / menopause
What’s the difference between perimenopause and menopause?
Perimenopause is the whole period of the menopausal transition, ranging from 2-6 years, including the 12 months after your period stops. Usually, between 40-50 years of age, it comes with hormonal & emotional fluctuations as well as menstrual irregularity. Begins with short cycles & heavy bleeding & ends with long cycles with light bleeding.
Menopause is 12 months after menstruation stops & often brings relief of symptoms due to hormonal stabilisation.
Changes in menstrual cycles (onset, length, and flow) can often be the first sign of Perimenopause, due to changes in hormone levels. Blood tests are quite unreliable in diagnosing this stage due to fluctuations.
Symptoms
It's the perimenopausal symptoms that can sometimes be uncomfortable. These can include:
Irregular periods
Hot flushes
Insomnia
Night sweats
Weight gain
Mood changes
Breast pain
Skin tingling,
Headaches
Joint pain
Closer to menopause more symptoms may appear including:
Vaginal dryness
Loss of libido
A decline in bladder control
More intense symptoms can occur with medically induced menopause, such as hysterectomy or drug-induced, mostly due to the sudden decrease in estrogen and progesterone.
Symptoms are Due to Fluctuating Hormones mainly estrogen & progesterone
Estrogen & progesterone levels start to decline & fluctuate during 40-50 years of age. A bit like a 2nd puberty.
Fluctuations (without progesterone to balance it) can also increase histamine release, often resulting in allergy-type reactions.
Meet the Sex Hormones: Estrogen, Progesterone & Testosterone.
Estrogen
builds muscle & bone; maintains a healthy metabolic rate; enhances insulin sensitivity; as well as maintains brain & heart health. In premenopausal women, the ovaries are the main producers of estrogen, post-menopausal, its the adrenals, with some coming from the peripheral tissues (skin, fat, gut & liver). This is why women of low body weight may actually be more symptomatic, as they are not getting potent estrogens from fatty tissues.
Progesterone
reduces inflammation; normalises immune function; builds bone; improves mood; & competes with the ‘masculinising’ testosterone. Another role is in the prevention of both cancerous and benign breast changes by balancing the effects of estrogen in the breast. Production occurs mainly in the ovaries (after ovulation) & in small amounts by the adrenals. Near menopause, progesterone levels are erratic due to ovulation occurring less. Sometimes, after menopause, symptoms can include increased facial hair due to the faster decrease in progesterone compared to testosterone, meaning that more testosterone is available to play a part in promoting hair growth.
Testosterone
not often talked about with women, but pretty important. 50% is produced in the ovaries, 10% in the adrenals, and 40% in the peripheral tissues. It declines gradually with age. Symptoms of declining testosterone near menopause include loss of libido, pesky fatigue, and lack of well-being.
A Natural Therapy Approach
Diet has a direct impact on menopausal symptoms & other concurring menopausal complications such as osteoporosis and coronary heart disease. Phytoestrogen foods (especially isoflavones) reduce symptoms like hot flushes, sweating & vaginal dryness between 20-50%. As the name suggests, they have an estrogen-type effect in the body & can also help in reducing LDL (bad) cholesterol while improving heart disease risk & bone density. What's not to like about that?
Foods that may help
Phytoestrogens
Richest sources are tempeh, tofu, miso, edamame and soy.
Other sources include legumes (lima beans, kidney beans, broad beans, black beans, chickpeas), whole grains, cabbage family, garlic, parsley, alfalfa, sesame seeds & pumpkin seeds.
Flaxseed is also a rich source with the added benefit of omega-3 for cardiovascular health, it needs to be freshly ground for optimal effect.
Fibre
Research shows that consuming high-fibre diets can regulate hormones in perimenopausal women and reduce perimenopausal symptoms. One human trial investigated the effects of fibre intake on sex hormone levels, insulin sensitivity, and cardiovascular disease risk factors in postmenopausal women. The study found that increasing fibre intake from 7g/day to 24g/day reduced blood concentrations of estradiol (a type of estrogen) by 25% and sex hormone-binding globulin (which binds estrogen) by 22%. These changes lowered the risk of breast cancer and cardiovascular disease.
Fibre also modulates insulin levels, which can be beneficial for women in perimenopause. One clinical trial examined the effects of a high-fibre diet on insulin secretion and sensitivity in postmenopausal women with type 2 diabetes. The study found that a high-fibre diet reduced blood glucose and insulin levels.
Read my fibre blog for more information on the different types of fibre and how they help.
Essential Fatty Acids (aka Omega-3)
Fatty Fish (salmon, trout, mackerel, sardines), nuts & seeds.
Antioxidant Foods
Eating an antioxidant-rich diet can counteract the oxidative stress & the drop of sex hormones that play a part in menopause, osteoporosis, & heart disease. Specific foods include all plant-based foods, especially those with vibrant colours (herbs, spices, broccoli, strawberries, blueberries, beetroot, sweet potato & kale to name a few).
Self-Care
Movement is crucial in perimenopause & menopause. Movement helps to reduce inflammation, improve insulin sensitivity & build muscle (& bone density). Resistance training is the best form for this. Here's a great 7-minute workout you can do at home.. https://www.webmd.com/fitness-exercise/a-z/seven-minute-workout
Stress & anxiety can impact your symptoms, sleep & mood. Women are social beings. Positive friendships & relationships are extremely important & can help alleviate symptoms. Improved quality of life scores along with fewer hot flushes, better sleep & reduced depressive symptoms have been attributed to both aerobic exercises, low-intensity exercise (yoga, Pilates) & social, self-care time. Find time for a massage, social catch-up, movie night, date night & perhaps exercising 2-3 times per week.
Other things you can do
To promote healthy estrogen/progesterone metabolism & insulin resistance reduce alcohol & sugar and incorporate foods to promote healthy digestion & gut health (hint: phytoestrogen foods).
For Breast Pain: Low histamine diets have shown promise (read more about histamine intolerance here). You can also try a dairy-free, high phytoestrogen diet. Having your iodine levels checked enables an even clearer picture of what is going on.
See your natural health practitioner, for a tailor-made treatment strategy, personalised to your individual needs.
