Beyond The Hot Flashes

Oh perimenopause...the fear of all females 😂  Let me assure you though, it doesn't need to be like this. I believe what more women need is education around what's happening to their bodies, especially since it is very, very rare to hear a PCP discuss perimenopause or menopause with patients.

What Is Perimenopause?

Perimenopause can begin a good 10 years prior to menopause, so for most women that's somewhere in your 30's or 40's. During that time the level of estrogen rises and falls unevenly, menstrual cycles may lengthen or shorten, and you may begin having menstrual cycles in which your ovaries don't release an egg (ovulate). 

You may also experience some lovely menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. These are the classic symptoms. But, there are others that many women don't realize could be signs: sleep issues, memory problems, mood changes, fatigue, brain fog, and increased UTI's.

When it comes to perimenopause, many think that hormone levels just start to gradually decline. That's partially true. While both estrogen and progesterone do drop, many times it's not gradual and it's very erratic.

If you think about it, perimenopause is a time where we move from ovarian-centric, to adrenal-centric. So if you're stressed to the max, progesterone is barely being produced, meaning that oftentimes there's an estrogen dominant state (even if estrogen is quite low itself). This dynamic on it's own can create quite a bit of chaos in the body, especially in regard to sleep and mood. 

One of my mentors once said "menopause is just turning up the heat on imbalances that have already been at play." That means, the stronger the symptoms, the more you've been neglecting your body (ouch).

So for my ladies who are perhaps perimenopausal, or getting close, what can be done? I've got quite a few things for you:

1. Work on building out a toolbox of stress management techniques. Since progesterone is made in the adrenal glands (remember, going from ovaries to adrenals), we must ensure that we're nurturing the little bit that's there. My favorites are grounding in nature, meditation/prayer, hypnosis, and dance. You have to find the tools that work for you, and commit to implementing at least 1 of them daily.

2. Optimize your metabolic health. While I never want weight loss to be a top goal, this is also a time where it becomes easier to gain weight due to hormone fluctuations (including blood sugar). We want to optimize metabolism not just for weight loss, but for longevity, brain and gut health. That means I usually encourage my clients to aim for at least 25g of protein per meal (sometimes more), minimize snacking during the day, and lift heavy weights.

3. Support the gut. If you've not read my other gut health posts, scroll on back and read them, because there is a massive connection between the gut and hormones. So if you're dealing with gut flora imbalances or malabsorption, you're absolutely going to deal with stronger symptoms in perimenopause. If you don't know where to start, make sure to download my free ebook HERE. 

4. Minimize inflammatory foods. This is not the time to start drinking 3 cups of coffee per day, or having a bagel as a snack. Prioritize protein, veggies, and low sugar fruits, and minimize refined carbs, highly processed foods, sugar, and alcohol. Oh and for my coffee drinkers, that's not food ;) Food before coffee each morning.

5. Supplement wisely. I'm not a fan of throwing supplements at the body willy nilly, but I'm always asked "what supplement would you take for ___?", so here are supplements that I often recommend during this time (just note that this is NOT medical advice, please speak to your provider before starting anything new):  Vitex can help with progesterone and general hormone symptoms, maca root powder is great for hot flashes and night sweats (Femmenessence is the brand I trust), vitamin C can increase both progesterone and estrogen, and 2 TBS of ground flaxseeds daily can help with estrogen fluctuations.

6. Consider bio-identical hormones as needed. Look, I used to be adamantly opposed to these. But the further I dug into the literature and looked into longevity, the more I realized that these can be great for women. Not just to manage symptoms, but to get ahead (especially with brain and bone health). This is obviously a very personal decision, so only you can make that choice. Just make sure if you do opt for it, it's compounded (and I like to start with creams over anything else).

Remember, mid-life doesn't need to be an absolute nightmare. But you do need to prime the body. Symptoms that may have been minor before can become more pronounced. This is a time to nurture your body, listen to it's whispers, and optimize everything you have control over.