So apparently there’s a prequel to the end game that is the Menopause. And no, it mustn’t be mistaken for a Nando’s spice. Welcome ladies to, The Perimenopause. Now I’ve know for a long time that I’m not in Kansas anymore. Things are changing. Subtle things like I can’t eat an entire pack of Haribo like I used to unless I complete a half marathon to work the calories off (disclaimer here, I’ve never actually done a half marathon nor do I ever want to but it sounded apt and dramatic).
As I learn more about what’s to come, I realise the perimenopause is a transition phase and I want to use this time wisely to prepare my body for the next chapter. I’ll switch up those Haribo for Medjool dates licked with peanut butter and sprinkled with flax seeds right? I definitely need advice so I asked Francesca Liparoti, Registered Nutritional Therapist, to provide some insight into what the perimenopause is and some advice on how to prepare.
‘The first step to feeling great in your 40s is to understand what’s actually happening with your body so let’s take a closer look at what’s actually happening with your hormones during perimenopause.
Coming soon to a body like yours
For most women perimenopause starts in their late 30s where they may start to notice a change in their menstrual cycles and periods and perhaps new PMS symptoms and shifts particularly around sleep and mood. Then, as you progress into your 40s the shifts and changes can start to become more pronounced with the biggies being sleep and mood issues and hot flashes. Migraines and headaches are also more common now along with brain fog, and a lot less energy than you had in your 20s!
Perimenopause is a phase of hormonal changes that occurs in the 2 to 12 years before menopause. So, for some women this means they enter into perimenopause around age 38 (and even 35 for some women), but for most women it starts some time in their 40s and it’s definitely begun once they reach their mid-late 40s.
In a nutshell, it’s a time when your hormones are starting to change, as the communication between your brain and ovaries starts to change as your body starts its journey towards menopause. Oestrogen goes on a crazy roller coaster ride while progesterone gradually starts to decline. Some hormone experts call it the second puberty (!!) because oestrogen was erratic when your menstrual cycle first began, then it settled down during your 20s and 30s, and in perimenopause it becomes erratic again.
A happy hormonal picture for prevention or good management of the symptoms mentioned here is oestrogen that gently ebbs and flows throughout the month as per the natural menstrual cycle rhythm, ovulation occurring each month and subsequent progesterone production over the following couple of weeks (as a result of having ovulated). However, the hormonal picture during perimenopause is oestrogen rising to almost 3 times higher than ever before at some points in the month then crashing down to a really low level, like a rollercoaster ride, occurring month after month for the duration of perimenopause, while progesterone gradually starts to decline.
Symptoms of the high oestrogen points in this new oestrogen rollercoaster include breast pain, heavy periods, water retention (‘puffiness’), changes in mood and irritability whilst symptoms of DROPPING oestrogen include depression, weight gain (particularly around the middle), migraines, hot flashes, and night sweats.
During perimenopause cycles can still be regular and you are still fertile – although not as fertile as you were in your 20s and 30s – but your menstrual cycle is starting to change. For example, your cycles might be getting longer or shorter, longer or shorter periods, heavier or painful periods, spotting between periods and more and more non-ovulatory cycles.
The Importance of Progesterone
Why does progesterone production decline in perimenopause and what’s the significance of that?
This is due to you having more and more non-ovulatory cycles (cycles where you don’t ovulate), in perimenopause, which basically means you don’t ovulate some or many months. Ovulation was hard to achieve in your regular cycling years and becomes even harder in your 40s. You see, ovulation isn’t only important for fertility, it’s an essential part of a healthy menstrual cycle and hormone balance because it’s the ONLY way you make a good amount of progesterone each month and prevent a hormone imbalance where oestrogen is taking over the show.
Here are some of the wonderful things progesterone does which can help to explain in part why perimenopause brings the symptoms it brings:
- It’s your anti-anxiety, anti-irritability and calming hormone and it’s vital for your overall sense of wellbeing and good sleep and it increases your capacity to deal with stress.
- It shelters you from the effects of oestrogen’s ‘yang’ effects such as heavy or painful periods, painful periods and breast pain.
- It’s a natural diuretic so it prevents water-retention and ‘puffiness’ around the body.
- It boosts your metabolism & lean muscle mass, which are key for keeping your body fat in check and it supports a healthy thyroid.
The good news is that perimenopause symptoms are temporary and they respond really well to some simple diet and lifestyle interventions.
Rebalance and Thrive
One of the biggest blockers to ovulation is STRESS! So, you CAN support your body to have more ovulatory cycles during perimenopause by incorporating some simple stress management practices into your days and weeks, prioritising self-care, prioritising sleep and cultivating more joy and play!
Nourish your body & hormones now more than ever.
Perimenopause is NOT the time to restrict calories or follow any other restrictive diets. Now it’s more important than ever to support your body by ensuring it’s well-nourished each day with enough calories (energy), optimal amounts of quality protein, fibre & nutrient dense carbohydrates, plenty of different types of good fats especially omega 3 (in the form of DHA & EPA), as well as the smaller but all-important nutrients including but not limited to B12, B6, folate, magnesium, zinc, choline, vitamin A (as retinol), vitamin E and iron.’
Francesca’s Rebalance + Thrive programme starts on Monday 27th September. You can join here.