PERI-MENOPAUSE – Master the Transition

Naturopathic Doctor, Clinical Herbalist, Iridologist, Best-Selling Author

As you reach your thirties, it is not unusual to hear your friends talking about gaining weight suddenly, waking in the night in a hot sweat, and even experiencing episodes of feeling crazy. You may begin to wonder what perimenopause could look like for you. Will you put on weight? Will you get the horrid mood swings or wake up every night feeling like you are in a tropical heatwave, or will you be the lucky one to cruise through this transition with ease? To prevent becoming a victim of your hormones, it is important to understand what perimenopause is and what you can do naturally to breeze into menopause like a queen. 

Perimenopause is the transitional phase leading up to menopause, the point in life when our menstruation stops. It typically begins several years before menopause in the forties but can occur much earlier by starting in the thirties also. It is a time when the body’s hormones begin to shift as the ovaries gradually begin to make less estrogen and progesterone.

As your ovaries run lower on ripe eggs, progesterone levels begin to drop. Progesterone balances GABA receptors in the brain, an inhibitory neurotransmitter that induces a sense of calmness and relaxation, thereby aiding sleep. Fluctuating levels of progesterone and estrogen can also contribute to bloating, sore breasts, low libido and hot flashes.

Perimenopause can also trigger ‘thyropause’ in some women. This is a natural decline in thyroid function. Common signs of this include weight gain, crankiness, mood swings, dry skin, brittle hair or hair loss, temperature changes and bowel issues. A drop in thyroid function can throw the adrenals and pancreas out of whack, and suddenly, it becomes impossible to lose weight or find that vitality that used to be yours for the taking.

Common Signs of Peri-Menopause

Fluctuating levels of estrogen and progesterone levels can have a powerful impact on other hormones in the body resulting in unwanted symptoms that can last for many years. Symptoms may include:

• An irregular menstrual cycle – becoming more or less frequent or irregular

• Changes in bleeding – either heavy, scant or almost absent

• Cyclical or hormonal headaches

• Painful and swollen breasts

• Agitation, nervousness, teariness and other emotional swings

• Bloating, particularly in the belly or fluid retention

• Ovarian cysts, breast cysts, ovarian polyps and/or fibroids

• Waking at night or disrupted sleep

• Restless legs at night

• Crawling and itching skin

• Fatigue

• Low libido

• Brain fog

• Memory problems

• Cravings for food, alcohol, coffee, sugar and carbohydrates

• Hot flushes and night sweats

• Weight gain and more….

It is important to remember having these symptoms does not necessarily mean you are in perimenopause. There are many other factors that can cause similar symptoms, including hormone imbalance, thyroid problems, adrenal issues, and so much more. There are ways you can tell if you are in perimenopause, and one of the easiest is to have a complete hormone profile done via your urine. Urine or saliva hormone testing is much more accurate than blood testing. However, if you can only get a blood test, ask to include FSH, LH, Progesterone and Estrogen levels which can give you signs towards perimenopause.

Follicle Stimulating Hormone (FSH) is a hormone produced by the pituitary gland that stimulates the ovaries to make eggs. As you approach perimenopause the ovaries do not respond to FSH, leading to a rise in this. FSH increases to try to drive more estrogen production.

Leutenizing hormone (LH) is produced by the pituitary gland to regulate the cycle and ovulation. As you approach perimenopause, LH levels rise which can cause excessive body heat. 

Perimenopausal Weight Gain

One of the most frustrating changes many women experience during the transition is weight gain, even though diet and exercise remain unchanged. Several different hormonal shift cause this. A drop in estrogen increases visceral body fat, which is found primarily around the abdominal area. Drops in estrogen can also drive insulin resistance, furthermore decreasing a woman's ability to lose weight. One of estrogen's role is to deposit fat onto the hips, but as estrogen levels fluctuate, this signal weakens and shifts the fat deposition to the abdomen. This visceral fat is hormonally active, exacerbating existing hormonal imbalances and making the roller coaster ride of perimenopause even worse. If you are already and making the roller coaster ride of perimenopause even worse. If you are already starting to see this fat, use it as a warning signal and focus on balancing your reproductive hormones now. The easiest way to restore a healthy and balanced hormone ratio is with powerful herbs and natural adaptogenic compounds that support the endocrine glands. 

So why do some women breeze through this change?

Genetics, heavy metal and toxin exposure, diet and nutritional status and stress definitely have a big impact on whether your transition will be smooth or not. The most important thing to remember is that perimenopause will be a much easier transition if you nurture your body's endocrine system before you hit menopause. If a woman's adrenal glands are healthy and not burnt out, they will continue to produce estrogen via conversion from DHEA and other hormones. However, most women suffer from some kind of adrenal exhaustion, which can result in a total shutdown of estrogen and other sex hormones, creating some severe hormonal symptoms. When the ovaries run out of eggs, women rely on their adrenal glands, body fat and diet to help produce sex hormones to stay well, but if these little glands are worn out from years of stress, a poor diet and other factors, this transition will not be easy. Luckily, there are some incredible natural herbs and adaptogens found in nature to make these transition a breeze.  

Nutritional Support for Hormone Balance

A healthy and nutritionally balanced diet is one of the best ways to reduce peri-menopausal symptoms.  Adding phytoestrogenic foods into your diet can act as a natural estrogen substitute reducing symptoms of hot flashes, night sweats, mood swings and more. Phytoestrogens are plant-based foods that possess estrogen-like qualities. Some of these foods include: 

• Flaxseeds – rich in lignans – a phytoestrogen
• Sesame Seeds – rich in lignans
• Organic soy products – tofu, tempeh, edamame and soy milk – fermented is the best
• Legumes – chickpeas, lentils and beans – make sure they are soaked for 24 hours and preferably sprouted
• Wholegrains – oats, barley, rye and wheat – make sure they are organic – be careful if you are unable to eat gluten
• Alfalfa – contains phytoestrogenic compounds
• Red Clover tea
• Beer rich in hops – hops contains a phytoestrogen
• Strawberries, cranberries and apples
• Almonds, walnuts and cashews
• Organic Coffee (in moderation)
• Licorice root tea – also amazing for adrenal glands – don’t drink if you have high blood pressure
• Red clover tea
• Organic barley is very good

Natural Support to Transition through Peri-Menopause

One of the biggest concerns for women during this change is weight gain. When fat-burning hormones drop, it becomes harder to regulate insulin levels. Blood sugar tends to rise, and the stress of not sleeping and worrying about this can drive higher cortisol and, therefore, more weight gain. A diet composed of healthy low glycaemic vegetables, omega 3 oils and lean protein can help to balance this. Intermittent fasting can be highly beneficial for anyone going through perimenopause, as it encourages autophagy and detoxification of unused hormones.  I recommend a 16/8 protocol – sixteen hours of overnight fast with an eight-hour eating window.  Start with a much smaller window if you have adrenal or thyroid issues.

STRESS is one of the biggest hormone hijackers, and there is no quick-fix pill that is going to mend your symptoms if you are chronically stressed. The only way to change this is to learn to set healthy boundaries, adopt good stress-coping skills like meditation, yoga, deep breathing, practising gratitude, exercising, healthy sleep and rest and leave any toxic situations. Some great natural supplements to support the nervous system if you are going through lots of stress are magnesium, L-theanine, GABA, Passionflower, Skullcap, Lavender, Chamomile and Withania.  If you feel your adrenal glands are exhausted, try including great adaptogens like Withania, Rhodiola, Holy Basil and Ginseng

Berberine is one of my all-time favourite plant compounds that blocks several cancer pathways and can lower cholesterol and serum glucose and assist with weight loss. I recommend 500 mg 2 to 3 times daily to activate an enzyme called adenosine monophosphate-activated protein kinase or AMP. This is the metabolic master switch.

Alpha Lipoic Acid (ALA) is a powerful antioxidant that occurs in our mitochondria. It is brilliant at helping to remove heavy metals, acts as an anti-inflammatory and can reset blood sugar levels. It is 400 stronger in its antioxidant potential than Vitamin C and E and it can keep your cells sensitive to insulin so levels never rise. ALA can aid weight loss on a calorie-restricted diet. My other favourite blood sugar regulating nutrients for weight loss include bitter melon, fenugreek, cinnamon, gymnema, chromium and others.

Vitamin D protects against heart disease, weight gain, osteoporosis, cancer and other risk factors connected to peri-menopausal changes. It is important to check this regularly to ensure you have enough of it. Most women also need higher magnesium and zinc to absorb this.

If you are still experiencing an irregular cycle, I often recommend Chastetree or Vitex agnus castus.  It is brilliant at helping to boost progesterone levels, thereby regulating the cycle and reducing hormonal symptoms like breast pain, moodiness and irritability. Other herbs that help to increase progesterone include dandelion, parsley root, maca, don quai, black cohosh, red clover, wild yam, passionflower and peony.

If you are experiencing mood swings, particularly anxiety or depression, it is often helpful to add in St Johns Wort or Saffron.  It can also reduce hot flashes and improve sexual libido.  If testosterone is also low, reducing energy, worsening sleep and creating poor muscle tone and anxiety, consider adding some Tribulus or Horny Goat Weed.

Red Clover normalises estrogen-diminishing symptoms linked to estrogen imbalance, like hot flashes and night sweats. 

Ashwagandha balances hormones and acts as a natural adaptogenic herb and mood stabiliser to help with low libido, fatigue and mood swings.  

Passionflower contains monoamine oxidase inhibitors (MAOIs) which have anti-anxiety and antidepressant properties to help with anxiety, irritability and insomnia. 

Black Cohosh influences serotonin and balances estrogen to help with hot flashes, night sweats, mood swings and insomnia.

Don Quai can have a balancing effect on progesterone and estrogen balancing helping with hot flashes, night sweats, irritability, anxiety, heavy bleeding and mood swings

Getting the perfect formula, nutrients and lifestyle changes to bring you into balance can get a bit complicated as everyone is a unique individual, so if you are not seeing the results you want it is ideal to work with a trained herbalist or naturopath who can test your hormone and adrenal function via saliva and urine to make the most accurate recommendations.  

In love, health and happiness,