I’m interested in thriving as I age, not only barely surviving! Who’s with me?

So you’ve hit forty and all of a sudden you don’t recognize yourself in the mirror, can’t lose weight no matter how little you eat and how much you exercise, feel like you are losing your mind, are anxious and depressed and a good’s night sleep is a distant memory? If this sounds familiar, you are NOT alone! Welcome to perimenopause.

First the not so great news……

perimenopause ~ the period of a woman’s life shortly before the occurrence of the menopause. Symptoms include:

Hot flashes.
Breast tenderness.
Worse premenstrual syndrome.
Lower sex drive.
Fatigue.
Irregular periods.
Vaginal dryness; discomfort during sex.
Urine leakage when coughing or sneezing.

Great news……

IT DOESN’T ALL HAVE TO SUCK, if you know what you are in for.

The problem, and my motivation for writing this post, is that there is a huge lack of guidance and support when it comes to managing perimenopause. Women in their forties are way underserved. Going through perimenopause and menopause can be an extremely challenging and often isolating experience and we need to start talking about it and supporting each other more.

We aren’t prepared and we are not told what to expect. We aren’t aware of the power of our fluctuating hormones in terms of their effect on our body and on our mind. Especially when it comes to perimenopause, it just kind of sneaks up on you. The lack of awareness is dangerous as we don’t know what to look out for, and attribute our symptoms to the wrong thing which leads us to taking unnecessary prescription of drugs. In addition, you feel like you are going mad and that you are no longer in control of your body. Sound familiar?

I’ve been in and out of many doctors offices in the past 3 years, I’ve read many books on the subject and have helped myself successfully cope with my beautiful perimenopausal body. I wish I would have had access to this information 3 years ago. I am hear to tell you, that it doesn’t have to be horrible, you are not alone and yes, you are normal.

I’m passionate about women’s health and happiness and am interested in thriving! Here is how you can too.

Emotional and Physical Support Throughout Perimenopause

Part 1 – What is the problem? Dr Sara Gottfried summed it up beautifully in a recent article for “The Irish Examiner”:

“Part of the problem is that perimenopause, a time of intense hormonal upheaval, is not well understood either by women or their doctors”, says Dr Sara Gottfried MD, the three-time New York Times bestselling author of The Hormone Cure and The Hormone Reset Diet, and Younger. (Her latest book, Brain, Body Diet is out now.)

“The focus of discussion among women and the medical community is on menopause, which is the period of time that follows a woman’s final menstrual cycle. At least up until recently, no-one was talking about the years preceding menopause, namely perimenopause. Compared with menopause, when a woman’s sex hormones (oestrogen and progesterone) are low but stable, hormones in perimenopause fluctuate greatly from month to month.

Our hormones affect everything from our mood, to our energy levels to our metabolism, so you can imagine how wildly fluctuating hormones can make a woman feel like she is going crazy as she struggles to understand her sudden mood swings, flashes of rage, exhaustion and weight gain that seemed to appear overnight. On top of that, perimenopause can also severely affect a woman’s energy levels and concentration as well as her mood and libido.

During perimenopause, the ovaries start to sputter and are no longer manufacturing the same, predictable, and consistent levels of the sex hormones — oestrogen and progesterone — that they used to.

To make matters worse, the brain is less responsive to the hormones your ovaries still do produce. Scientifically, we’ve only recently discovered that the brain runs low on oestrogen first before the rest of the body in women over 40. This leads to low brain energy since oestrogen is involved in how your brain uses fuel.

One of the reasons behind mood changes in perimenopause is the sometimes precipitous drop in oestrogen, which fills your tank with serotonin, the feel-good transmitter. When oestrogen starts to fade in perimenopause, serotonin levels drop and can sometimes lead to depression. This is not well understood by mainstream doctors, which is why women may be handed a prescription for an anti-anxiety medication or an antidepressant by their well-meaning GP, instead of opting to run a full hormone panel. This happens to many women when they go to see their doctor, especially if they are still getting a period, albeit more irregular.

Low oestrogen also shows up as poor memory, emotional fragility, depression, anxiety or persistent mild depression (dysthymia), night sweats or hot flashes and vaginal dryness as well as low libido, among other things. Meanwhile, low progesterone often manifests as anxiety, sleep disruption, night sweats, and shortened menstrual cycles.

Thyroid hormones, which control how we burn calories and keep our metabolism from getting too sluggish, often get out of balance as we get older. This is a trend that has been labelled ‘thyropause.’ Your metabolism slows. Your weight climbs even if you eat less and exercise more. You start to feel depleted, and your mood becomes erratic.

Then the adrenal glands (where the stress hormone, cortisol is produced) get into the act. With all these hormonal changes, your stress response becomes heightened. You just can’t roll with the punches the way you used to. You can’t focus or concentrate.

It’s a good idea to have tests done to measure which hormones are out of balance. It may not necessarily be oestrogen that is the main problem. It could be your stress hormones or your thyroid or even low progesterone knocking everything else out of whack.

Part 2 – What is the solution?

Educating yourself about the symptoms and how you can support your body with a healthy diet, regular exercise, quality sleep, essential oils, rest and stress management.

Feeling empowered to make the right choices that work specifically for your body is a game changer. You have to feel like you are in control and allow yourself to experiment with diet and exercise choices that feel good in your body.

After age 40, and sometimes in the early 30’s, our hormone levels begin to change and fluctuate frequently. It’s really important to know your numbers so you know what you’re up against. Here is a list of recommended baseline tests:

Estradiol level, in blood or saliva, ideally performed on Day 3 or Day 21 if you’re still menstruating regularly, and performed anytime if you’re irregular or menopausal.

Fasting glucose level, drawn by lab personnel in a laboratory or measured with your own glucose meter and a finger stick.

Fasting leptin level, drawn by lab personnel in a laboratory.

Morning cortisol level, in blood or saliva.

Thyroid panel, including thyroid-stimulating hormone (TSH), free triiodothyronine (free T3 or FT3), and reverse triiodothyronine (reverse T3, or RT3).

Growth hormone level, typically measure in the blood as insulin-like growth factor 1 (IGF – 1).

Free testosterone level, in blood or saliva.

Dr Sara Gottfried has an excellent free resource online where you can find the optimal ranges for the lab tests above (as per functional medicine guidelines), a recommended reading list, overview of your metabolic hormones and recommended supplements. You can access it here:

http://hormonereset.com/bonus/

(For a list of functional medicine practitioners in your area, go to www.integrativemedicine.co.za in South Africa or www.ifm.org in the US).

Part 3 – Five things to focus on to help manage symptoms and thrive

Eat the right foods – If your ever increasing waist circumference is getting you down, you can support yourself in correcting your hormonal misfires with your fork. This certainly doesn’t entail restricting calories – we know that gets you nowhere. You have to be smarter about the kinds of foods that you nourish ourselves with. For a period of time avoid red meat, dairy, gluten, fruit (except for berries), alcohol and caffeine to reset your hormones and help balance your system. Eat lots of fresh veggies, clean protein such as eggs, chicken or fish, healthy fats, nuts & seeds and drink 2 litres of water a day. Send me a note if you are interested in learning more about my 4 week hormone reset protocol.

Move your body daily – Get moving and sit less! Go for progress, not perfection. This means you don’t have to do an hour of cardio every day. Efficient 20-30 minute HIIT workouts are perfect! Get creative….play games with your kids outdoors that involve lots of running, jump on the trampoline with them, go for a treasure hunt in the forrest. Chose something that makes you feel amazing and gets you moving every day for 30 minutes. Your mind and body will thank you!

Stress management – This one has been a biggie for me. Last year I was experiencing serious adrenal fatigue. Increased cortisol wreaks all kinds of havoc in your body and results in poor sleep and weight-loss resistance. Your body goes into the red zone (read my blogpost here) and thinks you are in permanent danger thus slows down weight-loss. A daily meditation practice and practicing yoga 3-4 times per week really make a difference. Being more mindful about how you approach your day and slowing down is key.

Get good sleep – Another area that I really struggle with! Having kids completely disrupted my sleep cycle and I’m still trying to recover from the sleep deprivation I experienced with both my kids. Good sleep hygiene includes sleeping in a dark and cool room, going to bed the same time every day, limit alcohol, don’t eat heavy meals late at night, turn off your devices one hour before bed and journal before turning off the light (this “brain dump” will help ease your racing mind throughout the night). In addition, my saviour is essential oils! These gifts from the earth have saved my sanity and I use them every night. If you want to know more about which oils to use for restful and restorative sleep, send me a note and I’ll give you a list of the best oils to use.

Be social, play and have fun – we are spending more and more time in front of our devices instead of truly connecting in person. Surround yourself with likeminded people and enjoy walks, meals and talks together, device free. Bring back the joy and allow yourself to be silly and let go of rigidity. Adulting is tough enough! Chill and connect, that’s my mantra for 2020!