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What Is The Perimenopause?

4 MIN READ • 31st March 2023

Are your hormones giving you hassle? Nutritionist Cassandra Barns looks at how to spot the signs of perimenopause and ease the symptoms

Although we all talk about the menopause, few of us are familiar with the term perimenopause.

In fact, the menopause itself occurs when a woman has gone 12 consecutive months without having a period. The perimenopause is the time leading up to that when hormonal changes start to occur and symptoms we associate with menopause begin to appear. Women usually notice changes during their 40s, although they can happen earlier.

One of the first signs of perimenopause can be a change in your menstrual cycle – periods may become less regular, or more heavy or light. Some women may not have any other symptoms until their periods stop. But many women can start to experience signs such as hot flushes and night sweats at this time, too. They may also suffer from:

• Vaginal dryness
• Low libido
• Fatigue
• Mood changes and irritability
• Weight gain
• Joint aches and pains
• Sleeping problems (not related to night sweats)

Here are six steps you can take to help naturally manage your hormones, reduce symptoms and ease the transition.

1. Eat to balance your blood sugar

Dips and peaks in your blood sugar (sometimes referred to as the ‘blood sugar rollercoaster’) can play havoc with your hormones and can directly trigger symptoms such as hot flushes.

The first step to balancing your levels is to eat more wholefoods, and avoid regularly consuming sugary snacks and drinks and refined carbohydrates. Whole foods are unprocessed foods in their natural state: they include vegetables, whole grains, beans and lentils, nuts and seeds, meat, fish, eggs, natural dairy products and whole fruits (not juices).They break down slowly and help to give a longer lasting supply of energy (sugars) to our body.

2. Focus on plant foods

Another important move is to get rid of excess hormones floating around your body. Fibre is essential for this because it binds to ‘used’ hormones in your gut and helps them to be removed efficiently from the body.

Getting more fibre doesn’t have to mean loading up on wheat bran and high-fibre cereals and breads. In fact, too much wheat fibre can cause digestive problems for many people. Instead, eat plenty of vegetables (five to seven servings a day of just veg is a great target) and other whole plant foods – beans, lentils and chickpeas, easy-to-digest whole grains such as oats and brown rice, and nuts and seeds.

For a double boost from your vegetables, include two servings a day of dark green leafy vegetables, such as kale, spinach, broccoli or watercress. As well as being high in fibre, these veggies are rich in the mineral magnesium, which helps break down ‘used’ hormones, supports energy levels to reduce fatigue, and can aid sleep and relaxation.

3. Try shatavari

Traditional herbs can be fantastic for supporting hormone balance in women. Shatavari is a renowned ‘women’s’ herb in Ayurveda, the traditional herbal medicine of India. It’s known as a tonic for the female reproductive system, helping to bring hormones back into balance, regulate the menstrual cycle (when still present) and reduce perimenopausal symptoms.

One study, which saw women take two capsules a day of Pukka’s Womankind Menopause, a herbal formula based on shatavari, for three months, discovered great benefits. The women reported an average 45 percent reduction in hot flushes, a 61 percent reduction in low mood, feeling tearful and mood swings, and a 57 percent reduction in vaginal dryness after the three months. And the number of women reporting that their symptoms had a moderate to severe impact on their lives reduced from 87 percent before the study to just 27 percent afterwards.

Herbalists recommend that shatavari is taken for a minimum of three months or three menstrual cycles to allow the benefits to appear.

4. Remember low fat is not all that

Did you know that hormones such as oestrogen and progesterone are made from fat? So, we need enough fat in our diet – of the right types, of course – to have balanced hormones. This is a time when a very low-fat diet may not be your best friend!

Omega 3 fats, such as those in oily fish, are top of the tree. As well as being good for the heart and brain, they have an anti-inflammatory action that can help manage aches and pains, including joint pain and painful periods. Aim to eat oily fish (salmon, mackerel, sardines, trout or herring) three times a week, or take a good-quality omega 3 fish oil supplement daily.

Avocados, olive oil, and unroasted nuts and seeds are other great sources of healthy fats. Avoid using vegetable cooking oils such as sunflower oil, margarines and vegetable oil spreads as these could have the opposite effect on your hormones.

5. Get a handle on stress

Stress seems to get the blame for many of our modern health problems! Disrupted hormone balance is certainly one of them and this is partly because the body’s resources that should be used for making sex hormones such as oestrogen are instead diverted away towards making stress hormones when we feel anxious. And to make things worse, a surge of adrenaline caused by stress can directly trigger some of the unpleasant symptoms of perimenopause, such as hot flushes and irritability.

So, finding ways to cope better with stress could be key to a smoother transition. Whether it’s delegating more at work, trying meditation, practising gentle exercise such as yoga, or setting aside an hour for ‘me time’ every day, every little step could help.

Another ‘herbal helper’ that can work particularly well here is ashwagandha. This much-loved ayurvedic herb is traditionally used for supporting energy while also helping to calm the nerves and lower levels of stress hormones. The result? As well as feeling calmer, your body will be able to make more oestrogen and progesterone if needed, helping to even out the hormonal ups and downs.

6. Know which types of exercise are best

Regular physical activity is crucial for managing some of the symptoms of perimenopause and for maintaining good health after menopause. Its benefits include preventing weight gain, lowering stress levels and improving mood.

Aerobic exercise, such as swimming, cycling or running, is recommended, as it’s great for heart health and weight management.

But strength training should be included too. It can boost your metabolism more than aerobic exercise, helping your body burn more calories even when you’re not exercising (muscle burns a lot of calories!). It’s also really effective in boosting bone strength, which starts to take a hit after the menopause. And it may even be good for a flagging libido, as some research suggests that levels of testosterone go up after strength training. While testosterone is considered a ‘male’ hormone, women’s bodies do make it in small amounts, and it’s vital for a healthy sex drive. Strength training can include weight training, strength-based exercise classes or specific bodyweight exercises, so there’s a form that can suit everyone.

Relaxing exercise, such as yoga or tai chi, are great for balancing hormones, too, as they’re brilliant stress-busters.


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