Managing Your Perimenopause Symptoms

Thursday, April 22, 2021


Perimenopause is a strange time in our lives. Menopause is clearly defined – 12 months after your last period, you’re in menopause. Blood tests can confirm this. Perimenopause, on the other hand, doesn’t have a set time frame, nor a definitive blood test. It includes changes to your menstrual cycle that can come and go, starts at different ages for different people and can last up to 10 years. Symptoms can include increased PMS, hot flushes, night sweats, insomnia, bloating, heavier periods and changes to cycle length. It may remind you of fluctuations during your first year or two of menstruation. You might even find yourself looking forward to menopause so you can just get on with life.

Here’s the thing though. Lara Briden’s book, The Hormone Repair Manual, (which I highly recommend) points out the benefits of a healthy menstrual cycle with regular ovulation, for as long as possible. When you ovulate, your body creates oestrogen and progesterone, both of which have lots of protective benefits, including bone and heart health. The longer you have a healthy menstrual cycle, the more you set yourself up for ongoing good health through menopause and beyond.

So, it’s in your interests to maintain a healthy period for as long as you can – whilst minimising the symptoms of perimenopause.

Let’s dive a little deeper into perimenopause. What’s actually happening?

Firstly, progesterone levels start to drop. Progesterone is the hormone released after ovulation; it helps thin uterine lining (so contributes to lighter periods), promotes sleep, has a calming effect on the brain so can help reduce anxiety, and offers some protection for bones.

Secondly, oestrogen levels increase, then start fluctuating. Oestrogen has many positives, such as building muscle and bone health, supporting our heart, helping prevent insulin resistance. But oestrogen also stimulates growth of uterine lining and breast tissue, so too much of it can lead to heavier periods and sore breasts. And high levels of oestrogen can also impact mood, leading to irritability and increased PMS.

During perimenopause, as progesterone drops and oestrogen fluctuates, you might have phases of heavier than usual periods, shorter cycles, increased PMS and other symptoms such as hot flushes, interspersed with phases of regular cycles and less symptoms.

How then to navigate perimenopause and reduce the less pleasant symptoms? As your bodies are re-calibrating to a new normal, your metabolism and nutritional needs are also gradually changing. Fortunately, for many people, a few small changes can have a big impact on reducing symptoms. Having spent the past few weeks listening to a wide range of talks from women’s health experts, here are some tips to help reduce perimenopause symptoms:

  • Support your gut and liver with lots of cruciferous veggies (broccoli, cauliflower, kale, brussels sprouts, bok choy, spinach). The liver is responsible for detoxifying excess oestrogen, which the gut then eliminates. If your liver isn’t healthy, the detoxifying process will be impacted; if your gut is sluggish (eg with constipation), oestrogen may not be eliminated effectively and may even recirculate through your body, contributing to perimenopause symptoms.
  • Make sure your main meals include a mix of healthy fats (oily fish, extra virgin olive oil, nuts, seeds, avocado), quality protein (lean meats, fish, legumes, nuts, seeds) and complex carbohydrates (vegetables, fruits, wholegrains such as brown and wild rice, wholemeal pasta, quinoa).
  • Reduce your intake of highly processed carbohydrates such as white bread, pasta, white rice, biscuits and cakes. These foods break down very quickly into glucose which is absorbed into your bloodstream; consistently high blood glucose can contribute to insulin resistance.
  • Choose healthy snack options such as nuts and fruit, wholegrain crackers and cheese, Greek yoghurt with berries, green smoothies, rather than sugary muesli bars or biscuits.
  • Reduce your alcohol and caffeine intake; excess of both can increase perimenopause symptoms.

Numerous lifestyle changes will also help reduce symptoms – addressing stress, self-care, resistance training, spending time in nature… we’ll delve into these in more detail in a future post.

Meanwhile, try thinking of perimenopause as a transition rather than a chore. Implement some changes to help reduce your symptoms, embrace ovulation for its numerous health benefits and keep banking those progesterone and oestrogen hormones as long as you can.

Develop a positive relationship with food