Perimenopause is an inevitable stage of life we will all go through as women. Let’s discuss how to know if you are experiencing perimenopause and what you can do early to make sure it is a smooth ride.

The first thing to know is that perimenopause is not a condition or illness but a stage of life. Technically it is not diagnosed by doctors through pathology testing or medical scans.

Perimenopause is unique for everyone – your symptoms, the order of symptoms, the age of onset and how long it will last will vary from one person to
another although there are strong links to your own mother’s experience of menopause.

The start of perimenopause symptoms can start as early as your mid-30s or as late as your mid-50s. During this transition, your ovaries begin producing fewer hormones, causing your menstrual cycle to become erratic or irregular. It typically starts with a loss of progesterone – your calming hormone.

Progesterone is needed for healthy periods, stress relief, reproduction, mood, sleep, brain health, building muscle, and much more. We only make progesterone IF we ovulate. After the age of 35, you may start to have anovulatory cycles, which means, you don’t ovulate regularly and don’t make
progesterone. When there is an imbalance of progesterone, you end up with “unopposed” estrogen and you may not feel your best.

Estrogen, on the other hand, starts to fluctuate as you go through perimenopause. Some days it could be high, other days it could be low. As a result, you may experience symptoms you have never experienced before or have more hormonal symptoms. While estrogen gets a bad rap, it is needed for reproduction, healthy periods, heart and brain health, improving muscle mass, supporting mood, creates vaginal lubrication, improves libido, and protects bones, and more.

Testosterone is another main hormone and while many think of it as more a male hormone influencing hair growth and the voice, it is also an important female hormone. It plays a role in women’s sexual desire and arousal, overall emotional wellbeing, and bone and muscle strength. Testosterone generally decreases gradually with age rather than dropping suddenly.

The chart below shows how progesterone (dotted line) starts to plummet around the age of 35, while estrogen (solid line) starts to fluctuate drastically. This stage of life is what we call “perimenopause”.

THE STAGES OF A FEMALE REPRODUCTIVE CYCLE

Perimenopause can be a much longer process than many realise. It can last for up to 10 years before you officially hit menopause. Menopause is declared when you have gone 12 months without a period.

HOW IS PERIMENOPAUSE DIAGNOSED?

The conventional medicine standard is:

“The basis of new onset vasomotor or other symptoms and a change in the pattern of menstrual bleeding”

So what this means is, it comes down to a symptom based assessment.

What are the most common perimenopausal symptoms:

  • Hot Flushes
  • Night sweats
  • Problems with falling asleep, staying asleep and sleep quality
  • Breast tenderness
  • Lack of energy
  • Trouble concentrating/brain fog
  • Irregular periods
  • Vaginal dryness
  • Loss of libido (sex drive)
  • Migraines
  • Mood swings – these may include feeling more teary and irritable or more severe symptoms of anxiety and mild depression may also occur
  • Weight gain despite no changes to diet and exercise (see next blog post)

What about Hormone Testing?

Some practitioners recommend either blood or saliva testing (such as the Dutch test), to check your hormone levels. These tests may be suitable in cases where you may be in perimenopause early or other conditions such as PCOS (Polycystic Ovary Syndrome) or Endometriosis. Please consult your health professional in this instance.

When you are in perimenopause, your hormones such as progesterone and estrogen can fluctuate from day to day, as a result, it can be difficult to obtain a baseline measure. While there are specific days of your cycle that practitioners use to test hormones, there are also other factors that should be considered which include:

  • The variation in your cycle from one month to the next (shorter or longer cycles)
  • Hormonal medications such as the pill and mirena

This makes it difficult to know where your hormones are at and as a result practitioners are best placed to take a detailed case history to uncover any perimenopause symptoms.

What else can you do?

If you have symptoms such as hair loss, brain fog, belly fat, sleep problems, hot flushes and so on, there is other powerful functional testing you can do, to uncover the root cause and get on top of these symptoms.

  1. GI Mapping Gut Testing

Hormonal health starts in the gut. Our hormones are made, processed, and eliminated in the gut. We need to address any gut issues before we look at our hormones. Secondly, our gut regulates inflammation. If you are inflamed (the GI Map test will give you a good indication), then your hormones are unable to talk properly. Lastly, our gut is where we absorb nutrients. If you have ‘leaky gut’, you are unable to absorb nutrients, even if your diet is perfect and you eat a whole food diet. The nutrients we absorb in the gut are our “spark plugs” and they help our hormones get along properly.

Unfortunately, due to modern living and our stress response, a lot of people have gut issues, and many people have a lot of work to do even though they don’t have gut symptoms such as bloating, indigestion, constipation or diarrhea or food intolerances.

For more information on the GI Map stool test:

https://racheldoherty.com.au/2022/10/the-gi-map-stool-test/ 

  1. HTMA (Hair Tissue Mineral Analysis)

It is a safe non-invasive test that provides information on more than 35 nutrients and toxic minerals, and over 25 important mineral ratios. Minerals are the LIFE BLOOD of hormonal health and everyone has imbalances/deficiencies in their minerals even if you eat a clean diet.

A HTMA test can show how your body:

  • Utilises nutrients – are you severely depleted in minerals or is your body lacking the ability to make them bioavailable?
  • Helps determine the effects that stress has on the body – are you burning through minerals under stress?
  • Gives an indication of how your diet is fueling your body
  • Looks at gut absorption. Do you have enough stomach acid to break down and digest food?
  • Indicates how well your thyroid and adrenals are performing
  • Indicates how strong your metabolism is (all systems in the body working together)
  • Indicates whether your body is compromised by heavy metals

 

For more information on HTMA (Hair Tissue Mineral Analysis):

https://racheldoherty.com.au/2022/09/why-we-love-htma/

Personally, I do at least one HTMA and one GI Map each year to be proactive with my health. Fortunately for me, I have not experienced any perimenopause or menopausal symptoms to date and I attribute this to the wonderful benefits of this functional testing and the lifestyle changes I have made over the years.

So what are some lifestyle and diet changes you can make now?

It is so important to tweak your daily habits to support your body through the changes of perimenopause and menopause.

  • Engage in daily physical activity.

It is recommended to have at least 30 minutes of physical activity every single day and the benefits increase when you incorporate strength training with low intensity cardio like walking, light jogging or bike riding. It also important to slow down. Yoga, breathwork and meditation are ideal for this phase of life.

  • Making healthy food choices

Familiarise yourself with balanced macronutrient (protein/carbohydrate/fats) recipes that support healthy hormone balance:

  • Lots of quality animal protein (at least 100g daily for most women, 30g per main meal). Animal protein is a must to build lean muscle, hormones, amino acids, and more. It will also support your blood sugar!
  • Eat a variety of vegetables and plant-based foods packed with nutrients and diversity for good gut health.
  • Caffeine and alcohol should be in moderation. Your liver has to work hard processing hormones and toxins from the body. Enjoy a glass a wine here or there but don’t overdo it. Swap for sparkling/mineral water or low-sugar mocktails if possible.
  • Prioritise sleep to at least 7 hours or more.

Sleep can be tricky as we start to lose our progesterone (our calming hormone). Create a relaxing nighttime routine, avoiding screens at night and getting to bed earlier.

  • Avoid saying “yes” when you want to say “no”.

Often at this stage of life, women are often caring for kids and/or elderly parents. Learn to set boundaries and being comfortable saying ‘no’ to demands of your time and energy. Learn to live a slower, more intentional way of life.

Is it time to get some answers about your hormonal health and be proactive. Are you ready to explore a large piece of your health puzzle?

Book your free discovery call today!