Perimenopause - The great rollercoaster

Did you know that the symptoms many media, doctors, and most women commonly refer to as ‘Menopause’ are in fact those of Perimenopause?  

So let’s get our terms straight.

Menopause is the life phase that happens 12 months after your last period, and is usually when symptoms such as night sweats and insomnia will settle down.  It’s a time of low oestrogen and you should expect to be symptom free and happy during this period.  The average age of menopause in Australia and New Zealand is 51

Perimenopause on the other hand is the 10 or more years leading up to menopause.  It’s this time of much change in a woman’s body and can bring on all sorts of unpleasant roller coaster rides.  Oestrogen is fluctuating wildly, soaring to double its previous levels, then plummeting to almost zero. It’s not the slow decline we’d expect or like it to be.

And what changes can we expect in Perimenopause?

Most women will experience at least 3 of the following symptoms

  • Night sweats and hot flushes (80% of women experience this Vaso Motor Symptoms)
  • Insomnia, sleep quality is less than normal
  • Heart palpitations
  • Breast pain, heavy periods, fluid retention and irritable mood
  • Anxiety, depression where it never occurred before
  • Poor attention and concentration, poor memory, recall and word finding
  • Weight gain without changes in diet or exercise – 72% of women gain weight
  • Changes in menstrual flow – usually much heavier, but can also be lighter
  • Shorter menstrual cycles
  • Increased menstrual cramping
  • New headaches, pain, frozen shoulder
  • Lower back, neck and hip pain
  • Abnormal skin sensation, crawling
  • Hair loss and thinning
  • Skin changes, acne, dryness
  • Vaginal dryness, increase in UTIs
  • Deficits in motor ability and processing speeds

Why does all this happen?

There are several biological alterations occurring at the same time, for example

  • Primary biological changes – a decrease in oestrogen, progesterone and testosterone, while at the same time and increase in FSH and LH
  • Secondary biological changes  – a decrease in melatonin, while at the same time an increase in Interleukin 1,6,18  and in TNF

The good is that you can stop Perimenopause from getting out of control.  There are many diet, lifestyle and nutritional changes that can easily made to efficiently address the symptoms and restore good mental and physical health. 

Can you test for Perimenopause?

There is  no specific test for perimenopause, but there are several tests that can be used by a practitioner to assist with the diagnosis.  Your health care practitioner should take a full history and depending on symptoms can conduct a tests, such as

  • FSH, estradiol, progesterone, DHEAS, oestrogen fractions
  • Thyroid Panel
  • Vitamin D
  • Cortisol serum
  • Metabolic panel, lipid panel, CRP
  • A1C, insulin sensitivity
  • Homocysteine
  • Mammograms, pap tests, vaginal culture swabs, DXA scan (generally >60)

Conventional treatment for perimenopause can include oral contraceptive pill, hormone replacement therapy or progesterone.

Natural Health treatments will begin with building an individual treatment plan. 

  1. Lifestyle variables
  • Considerable reduction in symptoms can be achieved by increasing exercise, especially movement and activity, even a 10 min stretch before bed will shift things 
  • Introduce meditation, yoga, tai chi, brisk walking

      2. Diet
  • Follow a Mediterranean style diet with generous amounts of Omega 3s - olive oil, oily fish (salmon, mackerel, herrings), flaxseed, walnuts, seeds 
  • Reduce or remove alcohol – there is a correlation between the amount of alcohol you consume in your life and the age of onset of menopause.
  • Eliminate smoking 
  • Add non-GMO soy (assuming thyroid condition has been ruled out), tempeh, miso

       3. Supplement your diet with targeted nutrients
  • Magnesium – decreases osteoporosis, CVD and artery calcification.  Improves bone mineral density, pain, hot flushes, triglyceride levels
  • Omega 3 – decreases blood triglycerides, blood pressure and can improve symptoms of depression.
  • B Complex – can influence mood, neurotransmitters (B6), energy and decrease homocysteine
  • Curcumin – lowers CVD risk, LDL, triglycerides and total cholesterol, addresses metabolic syndrome
  • Herbal remedies include ashwagandha, ziziphus, magnolia officinalis
  • Micronised progesterone – is a natural prescription only progesterone and is helpful for both perimenopausal insomnia and hot flushes. It improves sleep by supporting sleep centres of the brain and can relieve hot flushes by modulating the activity of the hypothalamus. 

If you are experiencing any of these annoying perimenopausal symptoms and need some nutritional support our friendly staff at Synergy Compounding Pharmacy can book a nutrition consultation at our Crows Nest store.