Knowledge is power during the third age of a woman's life. The more you know about menopause and how it can affect you, the less of an effect it has on your life, revealed the BodyLogic Survey in 2018. That's a pretty compelling reason to self-educate!
Tomorrow we celebrate World Menopause Day, so a perfect time to explore this natural change in female health and how we can manage the impact on our bodies. First up, some insights on peri-menopause. As a 47 year-old woman, I am in the thick of the peri-menopause, so I'm right there with you. Get yourself a cuppa and let's dig in!
So what is the peri-menopause?
Peri-menopause is the beginning stages of menopause. The years leading up to your final period, at which time your body stops ovulating. During the peri-menopause, your reproductive hormones start to fluctuate causing a variety of changes in your body, from irregular periods, through to hot flushes, mood swings and more.
Oestrogen and progesterone are the most well known reproductive hormones, which you may be familiar with. The changing balance between these hormones is what mainly governs the changes in how we feel. As you can imagine, it can be very different for each of us.
Progesterone, often referred to as the 'calming' hormone starts to fall in peri-menopause. Progesterone promotes sleep and has a calming influence on the brain, so in its absence, we may feel more anxious and out of sorts.
Oestrogen starts to decline during the peri-menopause, but can fluctuate, giving highs and lows of Oestrogen. As progesterone falls, oestrogen can become the dominant hormone in some women, leading to what's called 'oestrogen dominance.' This has been linked to some peri-menopausal changes. Helping to reduce the amount of oestrogen in the body can help to alleviate some of these issues.
Peri-menopause can last anything from 2-10 years, although the average is around 4 years. The median age of menopause is 51, so most women can expect to be in the peri-menopause for at least some of their 40s. As you enter menopause hormones continue to fall. Your menopause ends when you've had 12 months without a period. Eventually, post-menopause, both oestrogen and progesterone fall to very low levels.
How does my body change in peri-menopause?
Women experience the peri-menopause very differently. There are a wide number of changes that can accompany this natural process. Often, it can be accompanied by a feeling that you just don't feel yourself. You may experience:
Unsettled sleep or insomnia
Hot flushes and night sweats
Feeling more emotional, anxious or irritable
Low energy or fatigue
More sluggish digestion
Weight gain, especially around the middle
Is it me or my hormones...?
Whilst it's clear that hormonal changes are a key factor, we can't just blame our hormones. Hormone balance is disrupted by our diet and lifestyle. This includes our food choices, frequency of exercise and movement, lifestyle choices (smoking, too much alcohol), our exposure to stress and even our environment, through toxins we are exposed to.
Stress, for example, has a major influence on our reproductive hormone production. When the body is busy producing the stress hormone cortisol, the production of our reproductive hormones (oestrogen, progesterone) reduces, creating hormonal imbalances. Cortisol is also a driver of fat around our tummies, increasing appetite for sugary and fatty foods. If you are dieting and restricting calories, this can also elevate cortisol levels. Dieting has been shown to raise stress levels, because of the constant worry about what to eat, as research supports. In summary, getting a handle on stress and learning some techniques that work for you, can really support you during the peri-menopause.
Dietary choices are also a factor: When progesterone and oestrogen begin fluctuating, our bodies can become more prone to insulin resistance. Insulin is needed to absorb excess sugar from the bloodstream. If you are consuming a lot of refined sugar in your diet, your body is going to have a harder time dealing with this excess sugar, which is one of the reasons we can put on weight and find it harder to shift.
Supporting your body in peri-menopause
It can be daunting and stressful in itself to experience hormonal changes in our body, but there is much we CAN control. A good starting point to managing your peri-menopause is looking at your nutrition and lifestyle. Take a holistic approach and look at your 'whole health' rather than just looking at one area e.g. nutrition, sleep, stress, exercise - all these elements are interlinked and affect each other, so we need to look at the balance of each.
Here are some ideas to get you started:
1. Make YOU a priority: First things first, you need to make yourself a priority! It's time to take charge and create time to look after yourself. If you're here reading this, you've no doubt realised this. I know TIME is the number one barrier for so many of us. So yes, it does mean re-juggling some priorities and actively making time to dedicate to yourself in your day/week. If you are struggling with the peri-menopause, the rewards are so worth it though!
Making TIME to look after yourself now, will help you feel better in the peri-menopause and give you more energy to tackle life.
2. Reducing the stress load: Stress is a part of life that we can't always avoid, but we CAN embrace tools to helps us manage and build resilience to it. A personalised stress management plan is an excellent way to support you, encompassing elements such as restorative movement, breathing exercises, rest, dietary changes and other mindful exercises. Slowing down and prioritising more of the things that bring you joy is a great starting point.
2. Sleep quality and quantity: Sleep does not just recharge your body, it plays a major role in managing stress, supporting you to eat well and motivating you to move more. Unsettled sleep and insomnia can naturally cause low mood and irritability, which in turn may make it harder to stick to healthy habits. Reviewing your sleep routine and sleep hygiene is an important step to getting on top of any sleep issues. However, we need to think bigger than just night time routines. Your daily routine influences your sleep cycle too e.g the time of your last meal, alcohol, caffeine and other stimulants, blue-light exposure (from devices).
3. Look closely at your diet: The basic principles of a balanced diet will serve you well here, but look closely at the following.
Fill your plate (and snack box!) with whole foods: A combination of complex carbohydrates (that slowly release glucose into your bloodstream), alongside protein, healthy fats and fibre. These will satisfy your hunger and help prevent cravings for those convenience snacks.
Reduce your intake of refined sugars, which cause highs and lows in your blood sugar levels and thus your energy levels and mood. Sorry to say it, but yes that includes alcohol!
Think about your gut health: Our gut microbiota can be disrupted by hormonal changes, which can impact digestive health and mental health. There is a strong link between gut health and our mood - 90% of serotonin our happy hormone is made in the gut. Eating a wide variety of plants and fibre will help to manage your digestive and mental health, whilst also supporting your liver, which works hard to remove excess hormones we don't need.
4. Rethink your exercise routine: If you've been doing the same exercise for a while, it may well be time to have a rethink. Whilst restorative exercise is important, your body also needs cardio (getting out of breath) and resistance (strength) exercises. We need to increase intensity and build muscle mass in order to keep metabolism up, supporting our nervous system (managing stress) and brain health (mood, anxiety). You may have managed to avoid doing a lot of exercise in your 20s and 30s, but as your metabolism slows in our 40s, it really becomes a non-negotiable. There are so many health benefits from exercising, it affects every system in the body and will help you live a much healthier life.
5. Reduce exposure to environmental toxins: Many beauty and cleaning products contain oestrogen mimickers, that add more oestrogen into the body. If you are oestrogen dominant, you most definitely want to avoid this. I'll be covering this in another post as it's pretty detailed.
In summary, lifestyle choices can have a big impact on your hormones, influencing your menopausal experience. The better shape you are in, the better your experience should be. So let's empower ourselves to feel healthier, fitter and enjoy these midlife years.
Suzie Shore is a Certified Nutrition & Lifestyle Coach supporting women in their midlife to restore balance and achieve optimal health. Nutrition, movement, sleep and stress management are four of the key pillars I explore on my Well Woman Nutrition and Lifestyle Plans for clients.