By Dr. Shawna Darou, ND
Perimenopause is a hot topic right now, and I’m so grateful that there is increasing awareness about women’s hormones, and especially the hormone changes we begin to experience in the 40’s and 50’s. The more we recognize that symptoms are hormonally connected, the more they can be treated and your overall health can be supported.
Perimenopause is the period of time before menopause, when hormones are changing. This can last from 2 years to 10 years, depending on the woman, and her sensitivity to hormone changes. You may not suspect that you’re experiencing perimenopause if your menstrual cycle is still coming regularly. In fact, many women begin to experience changes even when their periods are still coming regularly, meaning a period every 26-30 days each month.
Here are the more common symptoms of early perimenopause – you may experience only one, or maybe a lot of them:
- sleep disruption – especially waking up too early 3-4am
- night sweats in the 1-2 nights before your period comes
- more intense PMS – mood changes, breast tenderness, bloating, sleeplessness
- heavier periods, with more cramping and more clots
- more insulin resistance and blood sugar sensitivity
- easier weight gain – can be either central abdomen or lower abdomen / hips / thighs
- more migraines and headaches
- more difficulty with focus and concentration, and struggling with multi-tasking (many women are assessed for ADHD during perimenopause!)
- more stress sensitivity – feeling more overwhelmed with stress than previously
- hot flashes can even start while periods are regular and heavy
- heart palpitations
Many of these symptoms are related to more rapid fluctuations in your estrogen levels. Although you are still ovulating most months, and periods are coming strongly, the estrogen level is not as stable as before. Most women actually produce more estrogen in perimenopause, hence the term “estrogen storm”.
The good news is that there is lot of support for your hormones and overall wellness. Here are some of the things we would focus on:
- Eating balanced meals, focusing on stable blood sugar levels. This means including protein with each meal, minimizing sugar and emphasizing high-fibre foods. I don’t often recommend fasting during perimenopause – this really depends on blood sugar levels, stress hormones and how busy your life is.
- Exercising regularly, with a balance between daily activity (walking), strength training and aerobic exercise.
- Prioritizing sleep, and emphasizing good sleep hygiene.
- Lab testing to check for ovulation, estrogen levels, test for insulin resistance, thyroid function, stress hormones, and nutrient deficiencies. (Iron deficiency is extremely common in perimenopause due to heavy periods).
- Using vitamins and supplements to support regular ovulation, improve insulin sensitivity, reduce or support cortisol levels, correct deficiencies, and support hormone detox pathways. This could include Chaste tree, Aswaghanda, Relora, Berberine, DIM (Diindolylmethane), Iron, Vitamin D, Turmeric, or others depending on lab findings.
One caution however when you’re reviewing symptoms is to make sure you talk to someone, as there are other important conditions that can cause similar symptoms. For example hyperthyroidism can cause hot flashes, night sweats and more anxiety – we don’t want to mistake this for perimenopause.
Remember that once we can assess and diagnose where the imbalances are, there are things we can to to support your hormones so you feel more like yourself again. Perimenopause can be a very symptomatic transition for many women, and it is amplified by the stresses that many of us are under at this age.
If you suspect that some of the symptoms you are experience may be related to perimenopause, please book in to discuss further. We will talk about your menstrual cycles, and likely do some lab testing (bloodwork) to assess. There is so much you can do during this phase to feel better!