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Are We There Yet? Navigating the Road to Menopause

 

Emma Bardwell

Dealing with hormones can feel like your world’s being turned upside down. Emma Bardwell is here to help set it right. No matter what you’re going through, from seismic mood swings to bone crushing fatigue - and everything in between - Emma's got you covered. As a registered nutritional therapist and women’s health specialist, Emma offers offer evidence-based advice you can trust.

 

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Perimenopause—the time leading up to a woman’s last period—can leave you feeling disorientated, to say the least.

Although some cruise through without so much as a hot flash, it’s fair to say the majority of us (around 85%) are unprepared when perimenopause strikes: night sweats, burning mouth syndrome, palpitations, brain fog, aching joints, thinning hair, and headaches are just a few of the most common symptoms.

I know from personal experience how testing midlife can be. My own perimenopause symptoms crept up on me unannounced and although I didn’t experience the poster symptoms like hot flashes, I did suffer psychologically.

The anxiety, intense rage, and unbearable sense of emptiness really floored me. My memory also took a battering and, looking back, I can see I wasn’t functioning well. However, it’s not all doom and gloom! The key to powering through this hormonal journey—which can last up to twelve years—is to be prepared.

Here are a few pointers that I’ve picked up from my own journey as well as from my nutritional practice, to guide you along the way.

 

Be Kind to Your Mind

The psychological effects of perimenopause and menopause are not well documented, yet these are the symptoms that take most of my clients by surprise, often baffling them for months, if not years.

Very few women are prepared for the cognitive decline, the anxiety, and the low mood that so often appear around this time. For some women, it’s so severe they fear they’re experiencing early onset dementia. I’ve known a few women that have actually been put forward for brain scans by their doctor.

Many more have been offered antidepressants despite the fact that they’re not depressed, they simply have low levels of estrogen which is impacting their serotonin production.

Interestingly, if you’ve suffered from PND or PMS you may be more likely to experience mood change symptoms. Either way, it’s crucial you speak to a healthcare professional if you have any concerns about your mental health. Often speaking to someone or sharing your worries can lessen the burden.

You can also try guided meditation apps to settle a racing mind and help you focus, or alternatively schedule some ‘worry time’ each day to write down your anxieties in a journal so they don’t feel like they’re taking over your thoughts.

I find yoga to be incredibly calming and a great way to decompress at the end of a day. I’m also a sucker for a warm soak in the tub with a couple of generous handfuls of Epsom salts as the magnesium really helps to promote deeper sleep.

Speaking of sleep, it’s crucial to make sure you’re getting enough. Turn off all tech at least two hours before bed, dim the lights, keep your bedroom uncluttered and your temperature cool, and make sure you don’t eat too late. I advise leaving at least three hours between your last meal and the time that you go to sleep.

Additionally, be mindful of your alcohol intake as it affects both memory and mood and is notoriously harder to metabolize as we age. Aim for a minimum of three consecutive days drink-free every week.

Eat to Beat Your Symptoms

Many women find they put on weight as they hit their forties, particularly around their waists. There are a number of reasons: slowing metabolism, declining muscle mass, fatigue, reduced desire to exercise, and increased stress (cortisol) which causes the body to store fat around the middle.

Ever wondered why it’s so hard to shift extra pounds during midlife? It’s because fat cells produce small amounts of estrogen—the hormone that declines most rapidly in perimenopause—which your body wants to hang onto for dear life.

To help manage the fluctuations in your body, it’s important to eat a balanced diet that’s nutrient dense and rich in whole foods. You also want to keep your blood sugar levels consistent to counteract fatigue.

How, you ask? By making sure you’re including a palm sized source of protein with each meal and a small handful of protein with each snack. Good sources are fish, poultry, eggs, tofu, tempeh, edamame beans, peas, lentils, nuts, seeds, and chickpeas.

For me this means having a few almonds with an apple or adding some Greek yogurt and seeds to my morning oats.

As a general rule, I aim for eight to ten portions of fruits and vegetables a day and around thirty different plant sources each week, which I list on the Notes app on my phone as I go.

Herbs, spices, and all fresh produce count but you can only tally each one once. This ensures plenty of fiber, antioxidants, and variety, all of which are crucial for good gut health.

Don’t be afraid of healthy fats either, they’re needed for hormone production, as well as lustrous skin and hair. Look to oily fish, such as salmon and mackerel, nuts, seeds, avocados, and olive oil.

Healthy bones rely on calcium so it’s paramount you include this mineral in your diet. Osteoporosis, deemed the silent killer, affects half of menopausal women. The US recommended daily intake of calcium is 1000mg a day for women under fifty and 1200mg for women over fifty.

Food sources include dairy, sardines, cabbage, kale, broccoli, fortified milk, and tofu. Getting too much calcium from food is rare but is possible as a result of supplementation (and can lead to kidney stones), so I always advise caution!

One supplement worth considering, however, is vitamin D, especially if you live in the northern hemisphere. Vegan? Invest in a form of B12—tablet, spray, or capsule—to ensure you’re meeting your requirements and to help keep your energy levels tip-top.

Hot flashes are one of the most common perimenopause symptoms and can be incredibly debilitating. They’re often triggered by stress, caffeine, alcohol, and smoking.

To keep on top of them make sure you remain well hydrated and try eating phytoestrogen rich foods such as tofu, flaxseeds, alfalfa sprouts, and sesame seeds regularly.

Move Your Body

Daily weight bearing exercise is important for bone and muscle mass, both of which deplete as we get older. You should be aiming for anything that forces your feet to hit the ground, so running, skipping, and dancing count whereas swimming and cycling don't.

I’ve found as I’ve gotten older that my fitness regime requires adjustment. Running no longer works for me, so I now box and do a kettlebell class—much kinder to my joints! The benefits of low impact movement shouldn’t be underestimated.

A simple walk outside can be incredibly useful for shifting bouts of low mood and anxiety and many argue it’s a catalyst for problem solving and coming up with new ideas.

We all know exercise boosts mental health and self-esteem, but it can also help with vasomotor symptoms like night sweats and hot flashes. Research suggests active women have fewer and less severe perimenopausal symptoms.

My advice is to build movement into your normal day wherever you can: walk up escalators, run up stairs two at a time, stand on public transport, bust out some squats while brushing your teeth—it all adds up.

A Call to Action

Perimenopause is the perfect time to take stock of your current health and well-being, and make a concerted effort to tackle anything that could do with improvement.

Are you tracking your cycle via an app so you can build a bigger picture to see how your skin, mood, digestive health, and periods sync?

Have you had your cholesterol checked lately?

When was the last time you had a cervical pap test?

How much are you sleeping?

Is your weight creeping up?

Do you pee a little when you laugh, cough, or sneeze?

Make a checklist of everything that’s bothering you then split it into two: things you can solve yourself and things that require outside help. 

You’ve spent decades looking after others, now is the time to turn that attention on yourself. I advise my clients to make health and well-being their undivided focus for a few months and then to revisit it regularly.

Self-care isn’t selfish, it’s essential. Join forums, quiz friends, embark on research, make calls, listen to podcasts, scour social media. Knowledge is power!

This is a time of ascent. Most women will hopefully go on to live thirty or forty years post menopause and there’s absolutely no reason you shouldn’t feel strong, able, empowered, and relevant in the process.

If there’s one thing I’ve learned from my own journey it’s that perimenopause is a call to look within, be proactive and, above all, remain resolutely positive. Onwards and upwards.