Perimenopause and Menopause

Perimenopause and Menopause

Women’s health is a very important topic every day.

By far the majority of the clients I see at Braid Health are women and there is nearly always a hormonal overlay to optimising their health, whatever stage they are in their lives.

So what exactly is the menopause?

It’s the cessation of menstruation, the life phase that begins 1 year after the last period. The age of most women starting menopause is 45-55 years.

And have you heard about the perimenopause?

This can be a time between 2-12 years before menopause, when hormones and fluctuating like a rollercoaster. Symptoms can include heavy periods, hot flushes and insomnia and these can start from age 35. About 20% of women will experience the dramatic rollercoaster ride!

So what hormones are we talking about here?

Firstly oestrogen, a very important hormone that affects multiple areas in our bodies from brain to gut to breasts and of course our reproductive organs. It has multiple functions including:

  • Increase in metabolic rate
  • Improves insulin sensitivity
  • Regulates body temperature
  • Maintains muscles
  • Improves sleep
  • Anti-inflammatory

And secondly there is progesterone, which prepares and sustains a woman’s body for pregnancy. Generally as ovulation stops, the progesterone level drops more rapidly than oestrogen and it is this imbalance in hormones which causes symptoms.
Other functions of progesterone include:

  • Neuroprotective calming effect
  • Eases anxiety
  • Supports immune system
  • Smooths skin and improves hair growth

Have you come across the “Grandmother theory”?
We are genetically programmed to stop reproduction relatively young to dedicate time to dependants and their offspring. Other mammals are not programmed this way. Orca whales are the only other species to undergo menopause.

Some suggestions that may help with symptoms in the perimenopause include:

  • Managing stress. Aim for good sleep and self care routine
  • Reduce alcohol intake. Alcohol impairs healthy metabolism of oestrogen, and lowers progesterone and the calming action it has on the brain
  • Keep track of your cycles with a perimenopause diary. Here is one to try out: cemcor.ubc.ca
Reverse Puberty…..easing the transition

Reverse Puberty…..easing the transition

Have you come across the term Peri-Menopause?

It’s the time when a woman is transitioning from regular menstrual cycles to the menopause. It can be associated with a rollercoaster of body, mind and mood changes which is why it has been called Reverse Puberty (credit Dr Carrie Jones of the DUTCH test). The peri-menopause can occur during two to twelve years before menopause, and can start as early as 35 years. Cycles may still be regular but symptoms may start including hot flushes, heavy periods and insomnia. This can be due to hormone changes including making more oestrogen than ever before and also a lot less progesterone. In menopause (which starts the year after cycles completely stop), there is low oestrogen in the body.

So what are some of the changes of perimenopause?

  • new onset heavy and/or longer flow
  • shorter menstrual cycles
  • new sore, swollen or lumpy breasts
  • new mid-sleep waking
  • increased menstrual cramps
  • onset of night sweats, in particular premenstrually
  • new or markedly increased migraine headaches
  • weight gain without changes in exercise or eating

Having three or more of the above symptoms means a woman is likely in perimenopause, despite regular cycles.

So how can you ease your way through peri-menopause?
As with the approach to health with root cause medicine, by supporting our bodies with what they need and removing that which they don’t need, we can make the transition easier than it may otherwise be. I believe that as women are supported with fertility and pre-conception care, support through the time of peri-menopause is very worthwhile and can have a big impact on a woman’s life as well as those around her!

The main strategies are to support progesterone, metabolise oestrogen and reduce inflammation. So to start with rest and self-care is a high priority. Do you have a mindfulness practice you enjoy? Reduce alcohol as this impairs the healthy metabolism of oestrogen and lowers an already low level of progesterone (which has a calming action on the brain). Maintaining healthy gut bacteria is important as they escort oestrogen safely out of your body. There are some supplements shown to have benefit in peri-menopause which could be considered on an individualised basis.