You wouldn’t believe how many women that come through my practice doors believe that hot flashes, weight gain, and a nonexistent libido are inevitable – even normal – things that happen as you age.
WHAT?!
Absolutely not normal.
You don’t need to fear perimenopause. But you do need to understand what your body is biologically programmed to do during perimenopause and how you can take care of yourself NOW to make this hormonal transition as seamless as possible.
Once you hit 35, your hormones can start getting a little wonky.
Estrogen, progesterone, testosterone, cortisol, thyroid, and insulin may go out of rhythm.
Key muscle-building hormones, including growth hormone and testosterone, can begin to decline.
All of these ebbs and flows can lead to muscle loss, which can slow your metabolism and lead to unexplained weight gain.
And this, my love, is your body transitioning to the next phase in your hormonal journey – perimenopause.
Perimenopause refers to the years of hormonal upheaval before your final menstrual period, and it can start as early as your mid-thirties. Or not until your mid-forties. It’s different for every woman.
In a nutshell, perimenopause is when a woman’s hormones begin to move from cycling like clockwork to more sporadic ovulation and cycle irregularities. This happens mostly because of the slow and steady rise of follicle stimulating hormone (FSH) and fluctuating estrogen levels.
Over time, these fluctuating hormone levels become waning hormone levels and they stop signaling the process of ovulation all together (menopause). Think of this as a kind of reverse-puberty.
As progesterone levels start to drop, you may experience a variety of symptoms such as anxiety, heavier and shortened periods, insomnia, bloating, and night sweats.
Declining estrogen may add mild depression to the mix, along with wrinkles, poor memory, hot flashes, night sweats, vaginal dryness, droopy boobs, achy joints, and more sun damage especially on the chest and shoulders.
Testosterone levels also start to decline one to two percent per year, starting in your thirties, leading to loss of muscle mass, a decreased confidence, feelings of helplessness, and low or no sex drive.
Changing hormones at this stage also affect our adrenal function. Often resulting in low cortisol during the day (which makes you feel exhausted) and high cortisol at night, which causes sleep disruptions and often results in unnecessary worry about everything.
At any time, a woman can experience low thyroid function, but it’s higher after age fifty. Symptoms include lethargy, weight gain, loss of the outer third of the eyebrows, dry skin, dry straw-like hair that tangles easily, thin/brittle fingernails, fluid retention, high cholesterol, constipation, decreased sweating, cold hands and feet, and cold sensitivity.
WHEW.
What a ride, amiright?
Perimenopause can be broken down into two phases:
This phase is when reproductive hormone production starts to shift and becomes less consistent. That said, if you’re in good hormonal health – you really shouldn’t feel these fluctuations. You should still be ovulating and menstruating regularly and have good muscle tone, skin quality, energy, and sex drive.
In other words, you should still be making enough hormones to feel vital and youthful.
If you are experiencing symptoms like difficulty with fertility, vaginal dryness, accelerated skin aging, mood changes, or dry hair (or all of the above), these are huge messages that your hormones need some love.
What makes matters worse – these are symptoms that women don’t expect to experience until much later. Dealing with them as young as your mid-30s can put a major dent in your quality of life and indicates you are aging biologically faster than your chronological years.
During this phase, FSH levels rise to the point where you no longer ovulate regularly (or at all). And while that sounds dramatic, this phase will be relatively smooth sailing if you’ve been taking care of your hormonal health.
However, many women let the symptoms they experience in Phase 1 go unaddressed which unfortunately majorly compounds symptoms in Phase 2.
Dr. Sara Gottfried has an amazing quiz in her book, The Hormone Cure, that might indicate you’re suffering from perimenopause, not that you’ve suddenly lost your mind.
Do you have, or have you experienced, in the past six months:
If you answered “Yes, most of the time!” to those questions and you’re ages thirty-five to fifty-five, welcome to perimenopause.
This means your ovaries have started to sputter and are no longer manufacturing the same, predictable, and consistent levels of the sex hormones—estrogen and progesterone—that they used to.
To make matters worse, your brain is less responsive to the hormones your ovaries still do produce and the happy brain chemicals such as serotonin may head south.
Some women sail through perimenopause without issue; others believe they are going crazy.
And both are a common reaction to the midlife hormonal flux.
This transition of hormonal shifts in the body is why taking care of our hormones BEFORE entering perimenopause and eventually menopause is so important. If your hormones are out of balance and causing difficult symptoms before you’re in perimenopause, the addition of the natural hormone fluctuations that occur during perimenopause will not make symptoms any better. In fact, your symptoms are likely to get way worse.
So what can you do right now to reclaim your hormonal health and transform perimenopause from a transition to be feared to a milestone that should be celebrated – and barely noticed, at least symptom-wise?
Choose organic. It’s not a gimmick. It’s serious and important and worth the extra money. Especially animal foods. If you eat animal foods, THEY ALL MUST BE ORGANIC! Purchase the highest quality animal products you can get your hands on. I love Butcher Box for sourcing clean animal foods from small, pasture-based farms, with quality I can totally trust. And they ship to my door. Which is ahhhmazing.
Focus on eating real, whole, fresh, organic food that you cook yourself. Your meals should include high-quality organic protein (animal and plant-based), clean and healthy fat sources, a variety of organic fruit and veg, lots of greens, and fermented foods like sauerkraut, kimchi, kombucha, properly fermented yogurt or kefir.
Eat enough healthy fat. Cholesterol is what our body uses to make our hormones. You need enough healthy fat in your diet to have enough cholesterol to support adequate hormone production. Your body naturally slows down hormone production at this stage, so it’s critical to make sure you have enough of this key building block.
In general – purchase the highest quality of food you can find and afford.
Drink at least ½ your bodyweight in ounces of clean, filtered water per day. Do not drink out of plastic water bottles, use glass or stainless steel refillable bottles.
Targeted supplements can be super beneficial, and can be total game-changers when it comes to optimizing our hormones and alleviating symptoms.
Vitamin D3: 1 capsule daily with a meal. Sufficient vitamin D intake is foundational for hormone balance, immune health and overall general wellness at every stage of life.
Omega 3s: 1 capsule, three times daily. Essential fatty acids are critical for mood support. They decrease anxiety and depression and improve skin, brain and joint health. Omega 3s also promote ovulation and overall improve the quality of the uterus by increasing blood flow to the reproductive organs. Low levels of omega 3s have been linked to depression and other mental health issues, and research shows the higher your essential fatty acid intake is, the less you suffer from PMS symptoms.
Magnesium: 2-3 capsules at bedtime. Magnesium is hands down the most important mineral for female hormone health. And honestly overall health. It promotes healthy estrogen clearance from the liver, improves progesterone levels, and reduces certain symptoms of PMS, including mood swings, anxiety, bloating, irritability and tension.
Adrenotone: 3 capsules/day. This is a blend of the most effective adaptogenic herbs and nutrients to support adrenal health! Adrenal Support is a comprehensive formula designed to balance stress hormones, support a healthy menstrual cycle, and optimize energy.
Evening Primrose Oil: 1 capsule, twice daily. This supplement is especially helpful in the second phase of perimenopause. Evening primrose oil is a source of gamma-linolenic acid (GLA), an essential fatty acid that influences prostaglandin synthesis and calms perimenopausal symptoms.
Zinc: 1 capsule daily. Zinc is critical for the production of testosterone production. Having enough testosterone eases the perimenopausal transition. Zinc is bountiful in beans and seeds. You can also supplement with 50mg a day.
Get rid of chemical-laden personal care products, cleaning products, yard fertilizers, etc.
Eliminate all plastic from your kitchen. Don’t drink out of plastic water bottles.
Avoid canned goods, only buy brands that specify “BPA-free”.
Handle paper receipts as little as possible and wash your hands afterwards.
Avoid using personal products that contain toxic chemicals and unnecessary added ingredients.
Look for cleaning and laundry products that are plant-based, fragrance-free, and phthalate-free.
Throw away all non-stick Teflon-type cookware. Cook only in cast iron, stainless steel, glass or ceramic.
Easier said than done, I know.
The truth is that there’s no way to eliminate stress from your life completely, but there are ways to manage it. The best method is to indulge in healthy activities that relax you and bring your unique soul pleasure.
Here are a few resources to help you dig a little deeper into finding a mind/body practice that works for you and your body.
Mind/Body Therapy Series: Meditation
Mind/Body Therapy Series: Yoga
Mind/Body Therapy Blog Series: Acupuncture
Mind/Body Therapy Blog Series: Emotional Freedom Technique (EFT)
Mind/Body Therapy Blog Series: Massage Therapy
Prepare your bedroom: remove all electronics, and use blackout curtains or an eye mask to eliminate all outside and artificial light. And keep your bedroom on the cool side to promote sleep.
Create a routine: adjust your routine so that it mimics natural light – rise with the sun and then wind down as the night falls. After the sun sets, dim the lights in your house, use candles, turn off the devices.
Develop a bedtime ritual: take a warm bath, meditate, drink herbal tea, or read a book (paperback or hardcover, no iPads or e-readers!) approximately an hour before ‘bedtime’. This will help reduce stress and promote relaxation.
Avoid caffeine and stimulants after 12:00pm: they’ll just keep you up at night! If you need a mid-afternoon boost, grab an apple with nut butter and a big glass of filtered water. Boring, yes. Does it work? Absolutely.
Exercise: get outside and choose a movement that makes you happy every single day. There is dual purpose in this – exercise will help tire your body, increase those feel good brain chemicals, and also gives you access to Vitamin D! Aim for 45 – 60 minutes of daily fully-body, functional movements.
You don’t need to fear perimenopause. But you do need to understand what your body is biologically programmed to do during perimenopause and how you can take care of yourself NOW to make this hormonal transition as seamless as possible.
This transition of hormonal shifts in the body is why placing a priority on good hormonal health BEFORE is so important. If your hormones are out of balance and causing difficult symptoms before you’re in perimenopause, the addition of the natural hormone fluctuations that occur during perimenopause will not make symptoms any better. In fact, your symptoms are likely to get way worse.
The good news is there are all kinds of natural ways to ensure your hormones are balanced before transitioning into perimenopause!
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Sarah Jane Sandy is a certified nutrition therapist, and a fertility and women’s health expert. She has helped hundreds of women increase their fertility naturally and go on to have healthy full-term pregnancies. She has been working with women and couples trying to get pregnant for over 16 years and over 90% of the women who work with her get pregnant and have healthy babies.
She also works with women trying to fix their hormone imbalances, as well as supporting women through pregnancy and the postpartum period. Learn more about her own fertility and hormone journey here. To send Sarah a message, complete her Contact Form.
Curious about your fertility health? Take this simple quiz to find out what factors may be harming your fertility, and learn what you can do about it!