Menopause is a natural process in every woman’s life (it is not a disease and should not be treated as such!) that marks the end of menstruation and the reproductive stage. Of course, when one door closes, another always opens. I perceive menopause as a vital stage in a woman’s life in which there is a change of priorities based on the wisdom gained from past experiences. When it goes well, a new woman is born, wiser, more self-confident, more empowered and with a unique feminine beauty, despite what society sometimes fails to portray!
Perimenopause, on the other hand, refers to the transition period towards menopause. It can last several years – between 2 and 10 – and is characterised by hormonal fluctuations and changes in the menstrual cycle. The hormonal dance in the perimenopause is much like menarche (but in mirror image) and is by no means linear. If one is prepared and adapts to the process correctly, it can be experienced as a challenge. On the other hand, if a woman enters perimenopause in poor physical and/or emotional health, she will almost certainly be confronted with symptoms that will force her to pay attention.
Typical symptoms that are reported and that significantly affect quality of life are hot flushes, sleep changes, vaginal dryness, weight gain, mood swings and loss of bone density. To these we have to add an even longer and less recognised list of consequences of this hormonal change: digestive problems, fatigue, anxiety, insomnia, mental fog, cardiovascular disease, insulin resistance, depression, loss of muscle mass, hair loss….
I find that the more a woman understands about her hormonal changes and what causes them, the healthier she will be during these stages. During the perimenopause, levels of oestrogen, testosterone and progesterone, the key sex hormones in women, begin to decline and fluctuate. The issue is that there are many factors that directly influence these changes such as:
stress
sleep quality
your diet
your nutritional status
your liver function
your detox status
your digestive and microbial balance ….
The good news is that there is somewhere to turn if you are having a bad time!
A failing health system Unfortunately, many women feel neglected by the health system during this stage. The symptoms of (peri-)menopause are often underestimated, misunderstood or considered an inevitable aspect of ageing that does not require treatment. However, understanding and attending to this transition is essential to ensure physical and emotional well-being.
5 habits to flourish at this stage
- Prioritise a balanced diet Incorporate plant-based foods rich in fibre and polyphenols to nourish your microbiota and facilitate intestinal transit and satiety. Cruciferous vegetables will help your liver to metabolise oestrogens in a ‘clean’ way (avoiding the most carcinogenic oestrogens). Ensure an adequate intake of protein-rich foods to prevent muscle loss, balance appetite and meet essential amino acid needs. Limit consumption of refined sugars, alcoholic beverages and ultra-processed foods, which can exacerbate symptoms such as hot flushes. If you want to know your personalised diet for this stage of your life, you know where to turn ;-)
- Regular and varied exercise Combine strength training, cardiovascular exercise and activities such as yoga or pilates. These not only help to maintain a healthy weight, but also improve bone health, prevent loss of muscle mass (key in menopause), balance mood and ensure quality sleep.
- Sleep care Sleep hygiene is essential. Establish regular routines, avoid caffeine, alcoholic drinks and screens before bedtime, and consider relaxation techniques such as meditation or deep breathing to combat insomnia associated with hormonal changes. Physical exercise and exposure to sunlight during the day have been shown to help with restful sleep. If this is not enough, there is natural supplementation designed for these cases.
- Emotional support and social connection Talking to other women going through this stage or seeking professional help can make a difference. Support networks help manage stress and emotional changes, promoting a higher quality of life. Find a circle of women or like-minded groups near you to join and share. This is medicine!
- Consultation with specialists Consider working with health professionals who understand this stage, such as gynaecologists, nutritionists or phsycho-neuo-endocrinologists who specialise in this issue. In some cases, therapies such as bioidentical hormone replacement therapy (BHRT) may be an option, always personalised and carefully evaluated. I work with 24-hour urine tests called DUTCH tests which allow you to see not only your hormone levels (much more reliably than in blood) but also how you are eliminating them (whether in the form of ‘clean’ hormone or in the form of more active hormone). This allows you to feel very calm about your BHRT and to further fine-tune it with natural supplementation to promote proper hormone elimination, once they have done their job in the body.
The (peri-)menopause doesn’t have to be a time of constant difficulty. With the right habits and support, you can turn it into a time of transformation and growth, fully enjoying the second half of your life and all that it has in store for you! ;-).