Perimenopause can be a stressful period of adjustment for women as their rhythmic flow of oestrogen progesterone and testosterone levels starts to fluctuate before periods stop altogether. Some symptoms such as hot flashes and mood swings can be difficult to recognise or dismissed as stress induced. Others, such as erratic periods and weight gain are a lot more obvious and can be challenging to deal with. You have several routes to take to alleviate symptoms which include perimenopause supplements, hormone replacement therapy and diet tweaks.
Let's take a look at the common symptoms and what you can do!
Firstly, what is the average age of perimenopause?
The average age of perimenopause is 46, although it can happen much earlier. A woman is still having periods and is still able to get pregnant although it is much harder
What is happening during perimenopause?
During perimenopause there is a slow down in egg production and ovarian function. It is a transitional period between fertile years and menopause. Progesterone is usually the first hormone to start waning and affects a woman's psychological function. This includes how she use her senses, feelings, intuition and thinking to interpret everyday life. Symptoms include low mood and erratic moods, loss of confidence, anxiety and heightened PMS. Uncontrollable rage for no good reason..yeah thats progesterone related.
What is happening during perimenopause?
Hormonal changes aren't predictable during perimenopause, hormone fluctuations have no pattern. Oestrogen levels can surge one day and drop the next but overall there is a downward slide of both oestrogen and progesterone.
What are perimenopause supplements?
Perimenopause supplements help to reduce perimenopause symptoms experienced when hormone levels fall. They can include real food, meal replacement shakes, active botanicals or pills with essential vitamins.
What to look for in a perimenopause supplement
It's best tool for a perimenopause supplement which has a combination of the core vitamins and minerals to support overall health. Vitamins and minerals work together to support the body and a supplement which is based on an individual nutrient can tip your body's balance and work against other nutrients, blocking absorption. Unless you're under medical supervision, a balanced supplement is the way forward.
Read the supplement labels and do not exceed recommended daily intake. Too much of a good thing can have adverse affects. If you're on any medication you need to take advice from your doctor. Herbal supplements and active botanicals can be quite powerful and interfere with medication
Herbal supplements for perimenopause symptoms
The most common herb based supplements for perimenopause include Red Clover, Ginkgo Biloba, Siberian Ginseng, Ashwagandha KSM 66, Evening Primrose Oil and Sage and St Johns Wort.
A health nutritious diet can also alleviate perimenopause symptoms
A good, nutritious diet rich in key vitamins and minerals can help to alleviate your symptoms. A Mediterranean diet with moderate protein, rich in fresh vegetables, oily fish, fruit, legumes, seeds, nuts, whole grains and health fats like avocado and olive oil has been shown to support hormone regulation.
What are the most common symptoms and what supplements can help?
The most common symptoms of perimenopause include mood changes, impaired cognitive function, missed or heavier periods. As perimenopause progresses sleep problems, weight gain, fatigue, joint pain and headaches can emerge.
Disrupted periods and heavy bleeding
Periods can become erratic during perimenopause. Women can experience lighter periods, missed periods, bleeding between periods. They can also experience very heavy periods ( super soaking events - yes as horrific as it sounds) and prolonged bleeding which, unless iron levels are monitored, can result in anaemia.
Consider Hormone replacement therapy, iron rich foods or supplements
The Mirena, an IUD is often prescribed for heavy bleeding and is effective in 9 out of ten women. It can have adverse side effects such as low mood so talk to your doctor about the risks. Menstruating women need at least 14.8mg from iron per day. You should be able to get most of this from a healthy diet. Iron comes from both animal based foods such as red meat, fish and eggs and plant based foods like spinach, kale, beans and pulses.
Iron supplements can support the body through heavy periods but first levels need to be checked with a blood test to confirm more iron supplementation is needed.
Mood Swings, Anxiety and Stress
Oestrogen stimulates mood boosting serotonin and feel good endorphins. This can contribute to low mood, frequent mood changes and more severe PMT during perimenopause. Mood swings shouldn't be confused with depression which is a more serious condition, where very low mood is more constant for longer periods of time. When progesterone drops cortisol and adrenaline are released which bring with it anxiety and irritability.
Adaptogens, Vitamins, Amino acids and Healthy Fats
Stress and low levels of neurotransmitters such as serotonin affect mood. Herbal adaptogens like Ashwagandha helps to lower the stress response. Fenugreek and Red Clover can help to calm mood. Quality protein contains amino acids which support serotonin production. The brain is made mostly of fat, Omega 3 can help to support brain function and mood. Stress depletes B vitamins, Vitamin C, Zinc and Magnesium so a multi-vitamin based supplement can help.
Sleep issues affect around 50% of women in perimenopause and menopause. Oestrogen and progesterone are involved in sleep as are other hormones such as cortisol and melatonin. Sleep plays a crucial role in overall health, allowing the body and brain to relax and repair.
Oestrogen helps to support REM sleep which is key to memory and learning, helps you to fall asleep faster and keeps you asleep longer. It helps to regulate body temperature when you're asleep and regulates serotonin which is your feel good hormone.
Progesterone is a natural sedative and stimulates GABA ( gamma-aminobutyric acid) which helps the body and brain to relax and regulates breathing patterns.Melatonin, known as the sleep hormone, drops as we with age but significantly during menopause.Cortisol, a stress hormone, can be stimulated by night sweats and increase at night causing unrest and anxiety.
Magnesium, Melatonin and Whole grains
Magnesium and Melatonin can help to support sleep. Magnesium helps to lower blood pressure and relax muscles. Melatonin helps to improve sleep onset and sleep quality. Whole grains are good for balancing blood sugar which keeps cortisol levels in check to aid sleep.
Brain Fog - memory and focus
Cognitive health is affected in perimenopause and menopause as oestrogen and testosterone levels fall which can affect memory and focus, you may notice you're losing words and find it difficult to keep your train of thought.
Amino Acids, B Vitamins, Choline, Omega 3
Essential vitamins for supporting your mental health in perimenopause.The brain needs amino acids to produce neurotransmitters to support brain function. Vitamin B1, B3, B12 and Folate support memory and concentration. Choline is a nutrient related to B vitamins which supports the communication processes in the brain. It is found in eggs and shellfish. Salmon, mackerel and sardines contain high levels of omega 3 fatty acids.
While weight gain isn't a symptom of perimenopause, weight gain can be attributed to the symptoms caused by the drop in hormone levels. Fatigue can make it difficult to become motivated, sleep disruption and lower oestrogen can affect blood sugar levels. Fat storage changes midlife as well as body composition. You carry less lean muscle which can affect how many calories you burn.
Diet and regular exercise
NICE guidelines are recommending your waist circumference should be less than half of your height. People are being encouraged to keep their waist measurement to less than half their height to reduce the risk of potential health problems.
Being overweight is associated with an increased risk of type 2 diabetes, high blood pressure, high cholesterol and heart disease. Perimenopause symptoms can affect your mood and energy levels which can make you less active.
Find out what your 'healthy weight' should be using waist circumference, height and BMI. If you're overweight set a goal to get to a healthier weight with a diet and exercise plan.
The NHS recommends the MINIMUM exercise you need to be doing each week, spread over 4 or 5 days is 150 minutes of moderate intensity activity a week OR 75 minutes of vigorous intensity activity a week
Low energy levels
Fatigue, lethargy and low energy happens because your body's attempt to manage the fluctuations in hormones can be quite draining. Paired with sleep deprivation the result is you can feel super tired. Fatigue manifests as feelings of weakness, energy dips, apathy, reduced memory, irritability and lack of stamina.
Thiamin, Riboflavin, Niacin, Thiamin, Pantothenic Acid, Vitamin B6
Thiamin is particularly crucial for turning carbs into energy. Riboflavin also helps the body to make energy. Niacin transforms food into energy and is needed to thyroid hormones. too. Pantothenic Acid converts food into energy and involved in making hormones that help you respond to stress. B6 Vitamin B6 helps the body to access and use energy derived from food and stored.
Night sweats and Hot Flashes
Lower levels of oestrogen causes problems all over the body including the brain. The hypothalamus is your internal thermometer and helps to regulate body temperature. You can become a lot more sensitive to slight changes in temperature. This prompts your blood vessels to dilate to release the excess heat from the body, triggering the characteristic heat in the chest, face and neck.
Vitamin E, herbal remedies, phytoestrogens
There is clinical research to suggest that Vitamin E supplements can help to relieve mild hot flushes. Herbal remedies include agnus castus , liquorice root and mace root, sage as well as red clover. Red clover isn't recommended for women who have had cancer or are at risk of cancer. Caffeine and alcohol are associated with an increase in hot flashes. Phytoestrogens can be found in flaxseeds, broccoli and soya beans.
Joint pain and bone health
Oestrogen helps to keep joints protected, regulates fluid levels in the body and reduces inflammation. When oestrogen levels drop, inflammation can increase and fluid levels drop drying out cartilage and making joints stiff. The risk of osteoporosis and osteoarthritis can increase in perimenopause.
Vitamin D, Calcium, Magnesium, Omega 3 Fatty Acids
Calcium and Vitamin D are the dynamic duo when it comes to keeping bones strong. You need optimum levels of Vitamin D in order to absorb bone strengthening calcium. Supplementation of vitamin D is recommended in winter as you can't get enough from food. In summer you can create your own vitamin D from sunlight. Magnesium is also good for relieving joint stiffness. Oil fish, nuts ad seeds will increase your intake of Omega 3 naturally, you can also use supplements.
The bottom line
There is no doubt that perimenopause can be a very challenging period for a lot of women. Weight gain is common which can increase your risk of chronic disease, bone health and cognitive health can deteriorate. A healthy diet and regular exercise can play a big part in helping to relieve symptoms.
If you know your diet needs to be better you can use specialised nutritional products like meal replacement shakes or vitamins to supplement your needs. Consider using products which have a range of nutrients which can work together to support symptoms. Consult with your doctor before taking higher does of specific vitamins or herbs as they can have an adverse effect on medication and nutrition absorption.