By Dr Shashi Prasad GP, BMS accredited Menopause Specialist and Women’s Integrative and Functional Medicine Doctor at the Marion Gluck Clinic.
The doctor just told me that I am perimenopausal. But what does that mean? How do I look after myself?
The menopause transition is a significant health milestone for all women. Some may be quite prepared for this, but for others, it can lead to a lot of uncertainty and be overwhelming. Let’s explore what perimenopause is and look at some top tips on how to navigate through it.
The average age of menopause is about 51 years in the UK. The ovaries cease to work, and the periods finally stop. It may be slightly earlier for some ethnic groups like South Asians and Black women. Every woman in the world will go through it, so why don’t we talk about it more?
Understanding Perimenopause
Perimenopause is the period before your final menstrual cycle, starting about 5-7 years prior to menopause. During this time, the ovaries, which produce essential hormones like Oestrogen, Progesterone, and Testosterone, start to function erratically. The ovulation and periods get irregular, hormone levels begin to drop, and many women start experiencing menopausal symptoms.
Common Perimenopausal Symptoms
Most women are familiar with common symptoms like hot flushes and night sweats. Sleep disturbances can be very troublesome – difficulty falling asleep, frequent waking up during the night, early morning waking, poor sleep quality, and waking up tired. Some symptoms, such as mood changes, fatigue, brain fog, joint pains, and loss of interest in sex, can be more subtle and confusing. Recognising these symptoms as part of hormonal changes is the first step towards managing them effectively.
So, can you do anything to improve your symptoms during Perimenopause and also improve your long-term health & wellbeing? Of course, you can.
Top Ten Tips for Improving Your Perimenopausal Health
1. Regular Exercise
Regular exercise offers immense benefits during perimenopause. It helps reduce the frequency and intensity of hot flushes and improves sleep quality. Exercise releases endorphins, which boost mood and energy levels. It also greatly improves cardio-metabolic status, helps maintain body weight, muscle mass, and bone density. Aim for 150-225 minutes of moderately strenuous exercise per week, including cardio, strength training, and stretching.
2. Practice Yoga
Yoga can significantly reduce menopausal symptoms by decreasing anxiety, improving muscle and core strength, and enhancing flexibility. Incorporating yoga into your routine can help ground you physically and mentally.
A recent study found that women who practiced yoga for 60 minutes twice weekly for 10 weeks showed significant improvement in physical, mental, and urogenital symptoms experienced during menopause.
3. Eat a Healthy Balanced diet
Adopting a well-balanced diet is crucial. Focus on consuming a variety of plants, vegetables, whole grains, oily fish, eggs, meats, dairy, and healthy fats. Reduce processed foods, sugars, and saturated fats. Aim for 30 grams of fibre daily to improve gut health and balance hormones. Ensure adequate protein intake (about 1g/kg body weight) and include phytoestrogen-rich foods like soy, legumes, and flaxseeds.
Keep hydrated and drink plenty of water throughout the day. Aim for 2-3 litres of water.
4. Prioritise Sleep
Perimenopause can disrupt sleep, making it essential to prioritise a good sleep routine. Maintain a regular sleep schedule, even on weekends, and have a relaxing bedtime routine like listening to soft music or taking warm Epsom baths. Keep your bedroom airy and cool. Avoid blue light at least two hours before bedtime; you can also try amber glasses 30 minutes before bed to reduce light exposure. Try not to plan your next day or think about things that worry you at bedtime.
5. Reduce Stress
Midlife can be a hugely stressful time. Many women are at the peaks of their careers, holding down stressful jobs, some may still have younger kids or need to look after older parents. Adding perimenopausal symptoms into this mix creates a perfect storm.
Stress can worsen many perimenopausal symptoms. It also causes cortisol imbalances that impact weight, immunity, memory, mental wellness, and emotional resilience.
Mindfulness-based stress reduction techniques like breathwork, yoga, meditation, and nature walks help reduce stress and cortisol levels. Cold water swimming is known to significantly improve anxiety, mood swings and low mood in menopausal women. Don’t hesitate to talk to a psychotherapist or CBT therapist if needed.
6. Consider Supplements
While a food-first approach is ideal, it can sometimes be challenging to get all the essential vitamins and nutrients. Consider adding B Vitamins, Magnesium, Vitamin D + K2, Omega 3, and Collagen to your diet. If you’re vegan, ensure you include Vitamin B12 and calcium supplements.
7. Minimise Environmental Toxin Exposure
Reduce exposure to endocrine disruptors like phthalates, BPA, PCBs, and parabens, which can worsen perimenopausal symptoms. Filter your drinking water, choose organic products, consume wild-caught fish and high-quality grass-fed meat, and carefully select cosmetics and personal care products.
8. Avoid Too Much Caffeine and Alcohol
During perimenopause, caffeine can trigger anxiety and cause palpitations, while alcohol can exacerbate hot flushes and night sweats and affect sleep quality. If this is the case for you, reduce or avoid these substances.
9. Look After Your Long-Term Health
Perimenopause is associated with various metabolic changes in the body. Women may develop metabolic syndrome, insulin resistance, high blood sugar, changes in cholesterol levels and blood pressure, or thyroid problems. Regular health checks with your doctor are essential. Quit smoking if you haven’t already.
10. Consult a Menopause or Hormone Specialist
Perimenopausal symptoms can sometimes be severe, significantly impacting a woman’s quality of life, work performance, and relationships. Mood changes like anxiety or depression can lead to unnecessary antidepressant prescriptions that don’t help.
Navigating perimenopause can be challenging, but with the right approach, you can manage your symptoms and improve your overall health and wellbeing. Incorporate regular exercise, a balanced diet, stress reduction techniques, and consider seeking professional advice if needed. Remember, perimenopause is a natural phase of life, and with these tips, you can sail through it more smoothly.
About the expert
Dr Shashi Prasad GP is a BMS accredited Menopause Specialist and Women’s Integrative and Functional Medicine Doctor at the Marion Gluck Clinic. The Marion Gluck Clinic is the UK’s leading medical clinic that pioneered the use of bioidentical hormones to treat menopause, perimenopause and other hormone related issues. Founded by Dr. Marion Gluck herself, the clinic uses her method of bioidentical hormonal treatment to rebalance hormones to improve wellbeing, quality of life and to slow down ageing. Find out more at www.mariongluckclinic.com
