Perimenopause ~ Menopause
All women who reach their 40s will begin to experience the transitional years of perimenopause.
It’s a time likened to a second puberty. This is because the transitional years of perimenopause are marked by a sequence of hormonal events and changes to a woman’s body and brain.
It can be an interesting time, to say the least! The ebb and flow of regular menstrual cycles begin to shift and often around this time (particularly later in this season) underlying health issues may also be revealed and/or amplified. This is why perimenopause is considered a ‘barometer of health’.
This season calls for some assessments, as the body and brain shift gear for the second half of life. I consider it a timely opportunity to take real stock of your health!
For many women, this can be a wake-up call. How we lived through our 20’s and 30’s becomes infeasible in the new landscape of the 40’s and beyond!
Perimenopause is a sequence of events. It’s marked by phases, each of which involves changes to progesterone and oestrogen, and how these changes affect the whole body. This is known as the metabolic impact of perimenopause.
The experience can be different (and forever evolving) from the first phase to the last. It’s a process that lasts on average, 4-6 years for women. Although some can experience the symptoms of perimenopause for 7-10 years prior to the menopause transition!
For most women, the loosely defined and often drawn-out season of perimenopause will bring noticeable changes.
These are due to the gradual decline of progesterone and the concurrent fluctuations of oestrogen. As shown below, the symptoms can vary, as can the severity.
Common symptoms of perimenopause / menopause
Irregular menstrual cycle
Heavy/painful periods
Fatigue
Poor sleep/insomnia
Anxiety, depression
Weight gain; particularly
around the middle
Headaches, migraines
Memory changes
Blood pressure/cholesterol changes
Brain fog/loss of concentration
Hot flushes/nights sweats
Fibroids, cysts, polyps
Reduced resilience to stress
Digestive issues
Development or worsening of
a thyroid condition
Bladder issues/UTI
Vaginal dryness
Insulin resistance
Anger/mood swings
Fluid retention/puffiness
Thinning hair
Low libido
Sore breasts
Heart palpitations
Skin issues (itch/rash)
Achy muscles/joints
Vertigo/dizziness
How can a Naturopath help?
Although this time is marked by hormonal ‘chaos’ the naturopathic approach does not aim to ‘balance or override’ these hormones. The aim is to support the body as it moves through this normal, physiological season.
Perimenopause calls (screams) for self-care, after what may have been years of caring for children, and/or aging parents and/or working.
I find it essential to educate women about what’s really going on with their hormones, what they may expect as they move through this time, and also when it would be of value to seek further guidance or support (e.g. testing or hormone therapy).
As a Naturopath (who has traversed the perimenopause landscape herself) I find it’s best to take a holistic and systematic approach, instead of trying to overhaul everything at once.
This includes:
Taking a whole-body approach to symptoms
Diving deeper into blood tests and/or functional testing to assess your situation and needs
Helping relieve your symptoms
Identifying and supporting any health issues that are amplified due to these hormonal changes
Reassessing dietary and lifestyle factors that may be working against you
Creating a long-term strategy for restorative care as you move closer to, and beyond menopause
Lifestyle, dietary, herbal, and nutritional therapies are often used to:
Support the body through the ‘hormonal rollercoaster’
Nourish the nervous system
Support sleep
Support mood
Support the adrenal glands
Support the thyroid gland
Support the gut and liver (eg. to encourage detoxification and excretion of oestrogens)
Support healthy blood sugar and insulin levels (to prevent or reverse insulin resistance)
Support a healthy body weight
Support the brain
Support the cardiovascular system and bone health ahead of menopause
Although every woman will experience this transition differently, it’s a common time when the body reveals underlying imbalances or issues that need addressing ie. things you can’t seem to get away with doing anymore.
Similar to pregnancy and postpartum, it’s a time of physiological flux which brings with it an increased vulnerability to the onset of new health conditions.
Areas that are often revealed include macro and micronutrient insufficiencies/deficiencies, digestive issues, poor liver function, poor blood sugar/insulin control, increased cardiovascular risk, poor thyroid health, development of autoimmune conditions (e.g. Hashimotos thyroid disease), chronic inflammation, the impact of stress impact and nervous system dysregulation. Yay, fun times (not).
There can also be an overlap of the perimenopause symptoms, thyroid disease and insulin resistance. In fact, the connection between perimenopause and thyroid disease is so strong that it’s referred to as ‘thyropause’. This presents as an underactive thyroid function associated with or triggered by a drop in ovarian hormones, particularly progesterone.
So, given the interconnected nature of our body and the intricacies of the metabolic impact of perimenopause, I find a whole-body approach leads to the best outcomes for women.
I also believe having the right support (or combination of support) with you, plus body literacy, is vital as you move through your perimenopause passage.
“Understanding what’s really happening to your body and your brain in perimenopause can be reassuring and empowering”.