Annie Barry - Accredited Dietitian & Health Coach
As women, it feels like we are constantly navigating through different phases in our lives. We finally start to understand ourselves and our bodies and the goal posts shift again! Perimenopause is another one of these phases. A time when our bodies undergo significant changes, and we may find ourselves feeling lost and unsure of how to manage the transition. But instead of being fearful about what is to come, arm yourself with the knowledge that will allow you to tackle this next phase head on!
In this lifestyle guide, we'll explore ways to navigate the unknown territory of perimenopause, from diet and exercise to self-care and emotional wellness. We'll also discuss how to recognise the signs and symptoms of perimenopause, and the types of lifestyle changes you can make to maximise your health and wellbeing during this hormonal transition.
This guide will be useful whether you're just beginning to experience hormonal changes or are already deep into the menopause transition.
Understanding Perimenopause
Perimenopause marks the transition from the reproductive to the non-reproductive phase of a woman's life. It is the time when the ovaries begin to produce less estrogen, leading to a range of physical and emotional changes. The onset of perimenopause is usually between the ages of 45 and 55, but it can occur earlier or later than this. The duration of perimenopause can vary from woman to woman, with some experiencing it for only a few months, while others may experience it for several years. Approximately 75% of women will experience perimenopause related symptoms. These may include irregular periods, heavier or lighter flow, hot flushes, night sweats, mood swings, joint pain, gastrointestinal symptoms and vaginal dryness. These symptoms can be challenging to manage, but can be minimised with appropriate lifestyle changes and medical management. Perimenopause is a natural and normal phase of life, and it is important to remember that every woman's experience is unique. It is essential to listen to your body and seek guidance from your healthcare provider if you have any concerns.
Signs and Symptoms of Perimenopause
Perimenopause can be a challenging time for many women, as the body undergoes significant changes. Some of the most common signs and symptoms of perimenopause include: - Irregular periods
- Heavier or lighter flow
- Hot flushes and night sweats
- Mood swings
- Vaginal dryness
- Insomnia
- Fatigue
- Weight gain
- Loss of libido
Lifestyle Changes to Manage Perimenopause
Research supporting the use of lifestyle modifications for managing perimenopausal symptoms is mixed. However, given there is clear evidence of the benefit of diet and exercise on mood, mental health and feeling of wellbeing, it is logical to incorporate lifestyle measures into the management of perimenopause.
Diet and Nutrition for Perimenopause
No particular diet is recommended when it comes to perimenopause. Aim to focus on eating a balanced intake that is rich in whole foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats. Whilst there can be value moderating your carbohydrate intake, there is no requirement to follow a low carb or keto style diet. It is important to ensure you're including enough protein in order to protect against muscle loss as well as help with satiety. As per usual dietary guidelines, it is also important to limit ultra processed food and be mindful of alcohol intake as these can exacerbate symptoms.
Be mindful of getting enough calcium and vitamin D, which can help maintain bone health, as well as omega-3 fatty acids (found in oily fish such as salmon), which can reduce inflammation and improve heart health.
Exercise for Perimenopause
The benefits of exercise for general health and wellbeing are well researched. Exercise can have a positive impact on a range of factors including energy, cognition, mood and mental health, sleep, bone density, weight management and heart health. As such, it makes sense to incorporate exercise into your perimenopause management strategy.
The general recommendations suggest to aim for at least 30 minutes of moderate exercise, most days of the week. However, it is important to remember that any movement is good movement and if you're struggling with fatigue and struggling to talk yourself into doing a longer session, then just aim to do 10-15 minutes. There can be benefit in developing the habit of exercising regularly, even if the duration is short.
Throughout the menopause transition, declining estrogen levels can lead to reductions in muscle mass and strength. As such, strength training is essential in order to help reduce muscle loss as well as help maintain bone density and reduce the risk of osteoporosis. Strength training is also a useful strategy when it comes to weight management.
Mindfulness and Stress Management during Perimenopause
Perimenopause can be a stressful time and you may find yourself experiencing mood fluctuations and heightened anxiety. Whilst there is limited evidence regarding the use of mindfulness and stress management techniques for perimenopausal symptoms, it may be beneficial to incorporate some of these practices as a way of improving wellbeing as a whole. Practices such as yoga, meditation, and deep breathing exercises can promote reduced anxiety levels and improved muscle function and mobility.
Additionally, there is some research supporting the use of cognitive behavioural therapy (CBT) in perimenopause management.
Supplements for Perimenopause
Supplements are called supplements for a reason. They are designed to supplement a balanced diet rather than do the heavy lifting, so make sure you go with a food first approach before considering supplements.
Be wary of the range of supplements on the market that claim to "balance hormones." Aim to avoid 'mixed' supplements that are marketed as an all in one solution. More often than not, they contain only small amounts of the active ingredients, meaning you are unlikely to reach the therapeutic dosage required to see benefit.
There is actually limited evidence supporting the use of supplements for perimenopause symptoms in general. However, there may be supplements that have potential to assist specific symptoms or specific areas of health. For example, Omega 3's for reducing triglycerides, Creatine for muscle strength, Chasteberry for breast tenderness, Vitamin E for hot flushes, Ashwagandha for anxiety etc.
This why is it is extremely important to be selective and purposeful when it comes to choosing supplements, rather than taking everything and crossing your fingers hoping that something works.
What about HRT / MHT?
Menopausal Hormonal Therapy (MHT) was formerly known as HRT or hormone replacement therapy. MHT involves the use of hormones to treat perimenopause symptoms such as night sweats and hot flushes. MHT is one of the most effective ways of treating perimenopausal symptoms and may also be beneficial for heart health and bone density.
Despite what you may have heard, MHT is safe for most women to use. However, there are some cases where MHT may not be recommended, so it is best to discuss treatment options with your doctor and they will be able to provide personalised advice.
Shouldn't I be trying to get through menopause "naturally?"
Given the rise in the 'wellness' industry over the past few years, there is increasing pressure to tackle things naturally and pushing the narrative that natural = best. Reality is, symptoms of perimenopause can be debilitating and lead to severe health consequences. At present, research clearly demonstrates that MHT is the most effective way of alleviating symptoms as well as being a protective measure for bone and heart health. So if you are noticing changes and experiencing symptoms, there is no need to put up with it or 'push through', make an appointment with your doctor to discuss your options.
Talking to Your Doctor about Perimenopause
If you are experiencing symptoms or noticing changes to your menstrual cycle, that is an indicator that it is time to talk to your healthcare provider. They will be able to help you determine if you are in perimenopause and recommend treatments to manage your symptoms. It is important to discuss your medical history, including any medications you are taking, and any family history of illnesses including breast cancer or other reproductive cancers.
If you don't feel like you have received adequate support from your doctor, seek a second opinion. Consider going to a GP who specialises in womens' health or ask to be referred to a specialist.
Resources for Perimenopause
Perimenopause can be a challenging time, and it is important to have a support network to help you navigate the transition. Please be wary of misinformation online and on social media. There are some great (and credible) resources available including:
Conclusion
Perimenopause can be a challenging time, but you shouldn't have to just push on or battle through it alone. Medical management is an effective strategy for combatting perimenopausal symptoms and is not something to be ashamed of or doesn't mean you have 'failed' by not going through this transition 'naturally'. Seek support from your doctor if you are noticing changes or experiencing symptoms.
Lifestyle changes such as diet, exercise, supplements and stress management techniques can compliment your journey and help to promote improvements in weight management, mood, energy and overall wellbeing.
Remember, every woman's experience of perimenopause is unique, and it is essential to listen to your body and seek guidance from your doctor if you have any concerns.
Annie is a dietitian and health coach specialising in sustainable weight management for busy women. Annie has a special interest in perimenopause management and works to help women manage their weight and minimise symptoms.
If you would like to learn more about Annie's programs, book in for a free 20 minute kickstart call!
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