Nutrition and the Menopause

In this post we’ll look at the changes that are occurring in your body during perimenopause, rather than menopause, as I think that this is an even less well understood period of hormonal transition than menopause.

In my next blog, I’ll cover the menopause – which officially starts 12 months after your last period. We’ll also look at HRT, what the science says about its safety, and other approaches that may help.

Perimenopause

So, let’s begin by exploring that transitional stage that usually begins a few years before your periods stop for good – perimenopause.   Perimenopause can feel like being on a hormonal roller coaster.  During perimenopause, instead of having consistently lowered oestrogen levels as in menopause, many women experience fluctuating peaks of very high oestrogen, due to the higher levels of follicle stimulating hormone (FSH) in the years leading up to menopause.  More FSH equals more oestrogen – it’s your body’s way of getting the most out of your last window of fertility – a kind of hormonal last hurrah!

Declining progesterone

In addition, during perimenopause often we may not ovulate every month – despite having what looks like a regular period.  This means that you will produce almost no progesterone to counteract these oestrogen ‘spikes’.

It is these sharp peaks and troughs characteristic of perimenopause that leads to symptoms – unlike in menopause where symptoms are caused by the body adjusting to a consistently lower level of  hormones.

Perimenopause can cause symptoms such as fatigue, memory problems, digestive issues, hot flushes, migraine headaches, unexplained anxiety, periods of insomnia and very low mood.

Dr Ghazala Aziz-Scott, Doctor at the Marion Gluck Clinic explains; “Many women who are going through perimenopause will actually have adequate levels of oestrogen, but progesterone is the first hormone to be depleted in this phase. The National Institute for Health and Care Excellence (NICE) currently states that blood tests are not necessary to diagnose perimenopause/menopause in women over 45 and that it’s not necessary to measure the levels of hormones in patients prior to prescribing HRT.  This means that a woman may be prescribed a blanket oestrogen/progesterone regimen when her oestrogen levels don’t need topping up”

So during perimenopause, rather than looking at HRT you may want to consider helping your body to metabolise higher than normal levels of oestrogen by increasing dietary fibre.  Fibre can help to lower circulating oestrogen levels and has been associated with a lower risk of breast cancer.  In addition, fibre is great for gut health.  Optimising our gut health is key to keeping our hormones in balance.

• try 2 dessertspoons of ground flax seeds either just mixed with water and drink if you are brave! OR sprinkled on cereal every day
• consider a supplement of diindolylmethane, or DIM. DIM promotes proper hormone metabolism in a number of ways.  It’s a natural component of cruciferous vegetables and has been shown to lower breast cancer risk in addition to helping to mitigate the symptoms of perimenopause.  DIM is best suited to those with signs of oestrogen dominance such as heavy periods (albeit irregular!), breast tenderness, insomnia, and weight gain.

Cortisol and insulin

In addition, during this time it’s important to look after our other hormones too, such as those produced by the adrenal glands, and your body’s response to the hormone insulin.  To this end, take extra care to manage your blood sugar levels.

There is an established link between increased severity of peri and menopausal symptoms and increased levels of ‘stress hormones’ such as cortisol and adrenaline (produced in the adrenal glands).  A high sugar diet and imbalanced blood sugar causes the body considerable stress – your body will produce the same stress hormones in response to a blood sugar crisis as it will to a highly stressful situation caused by external factors.

If you’d like to understand more about how to optimise hormone health, please get in touch.