Perimenopause can be a difficult time in life for a woman. The body is undergoing a transitional stage in which it is getting ready to shut down the reproductive system. Multiple system changes happen over this time, which can last anything from 4-13 years. [1]
The normal age of is between 40-45, although some women can start as early as 38. Menopause (when you have had 12 consecutive months of no menstration) is around the age of 52-55.
Perimenopause begins with the first onset of menstrual irregularity and ends after when 1 year of amenorrhea (no period) has occurred. There are two stages to the perimenopause or menopausal transition: the early transition, where cycles are mostly regular, with relatively few interruptions, and the late transition, where the lack of menstruation becomes more prolonged and lasts for at least 60 days. [1]
Today I am sharing 5 common struggles women have in perimenopause. Since I myself am in perimenopause for 5 years already, I can provide some added input and what I have found beneficial. Of course, one woman’s experience does not always equate to another. Genetic variants, diet, lifestyle, and many other factors need to be taken into consideration.
1. Weight Gain
This can result from any combination of factors:
- poor diet choices such as high saturated fats, sugar, refined carbohydrates and insufficient vegetables, fruit, fiber but also poor portion control in relation to energy expenditure
- Not enough protein (protein requirements increase during the menopause transition due to tissue protein breakdown)[3]
- insufficient exercise
- lack of strength training to build muscle and preserve lean body mass with reduced skeletal muscle mass and net bone resorption
- slowed metabolism[3]
- secondary causes like hypothyroidism
- and one not often talked about: Stress. A body that is in flight-and-fight mode will hang onto fat reserves as a security measure.
- excess alcohol consumption
- hormone imbalance
- It is not well known that while some women see more fat loss from diet alone, others will benefit more from exercise. This is covered in the DNA diet test.
Try:
- weight training 3x a week consistency is key! Give it 3 months.
- Balance your blood sugar (this means eating within one hour of waking, and eating 3 regular balanced meals a day with complex carbs, protein, fiber and healthy fats)
- Cold water immersion has been shown to increase brown fat and help for visceral fat reduction.
- Ditch the sugar, excess alcohol and refined carbs
- Up your protein to 1.2-1.6g per kg of body weight and then divide that into 3 meals
- Get the DNA Diet test which looks at how YOUR body metabolizes macronutrients and what kind of diet is best suited for you as well as how much exercise you should do for weight management.
2. Insulin Resistance
Insulin resistance begins with insulin sensitivity and can progress to type 2 diabetes. Bad habits like running on empty, fueling with coffee, eating on the go, favoring sugar and refined carbs over greens, fiber and protein is a recipe for emotional regulation, hormonal imbalance, mood swings and blood sugar imbalance.
Try this:
- slow down and be intentional about what you do
- sit down for meals and chew your food
- stop replacing food with caffeine and actually fuel your body with nutrients, regularly
- Eat regular meals
- Ditch sugar and refined carbohydrates
- Eat dinner before 6 and no snacking
- Walk 15 minutes after dinner
- Get the DNA Health test to find out your Insulin sensitivity risk.
3. Inflammation
You’re struggling with brain fog, joint pain, feeling 10 years older, puffy face, water retention, constipation, bloating and struggling to manage stress. Inflammation happens due to a variety of different reason. One of the biggest contributing factors is poor detoxification which leads to oxidative stress and in turn drives inflammation.
Try this:
- Increase your antioxidant intake : berries, vitamin C.
- Hydration: 8-10 glasses of water a day (more on the days you workout)
- Movement is key for detoxification
- Fiber 25-35g a day. Most people don’t eat enough fiber.
- Sufficient rest, getting outside and learning to say no are all part of it
- Get the DNA Health test which can provide information on how your body handles inflammation.
4. Hormone Imbalance
In Perimenopause some women are prone to declining estrogen and progesterone. Others are prone to excess estrogen and too little progesterone. We all metabolize hormones differently. Some women have genetic variants that are effective at breaking down estrogen, while other women have genetic variants that predispose them to poor estrogen detoxification that creates harmful estrogen metabolites involved in various estrogen related conditions like endometriosis, PCOS and cancers.
Try…
- Get the DNA hormone test to find out how YOUR body metabolizes progesterone and estrogen and other sex hormones and what your risks and predispositions are. Contact me for ordering your test. (available worldwide)
- Natural alternatives. Some women with Perimenopausal symptoms do well on Vitex. This supplement has been shown to reduce symptoms like hot flushes, night sweats, depression, and breast pain. [4,5,6]
- Supplements such as Calcium-D-Glucurate can also help to detox excess estrogen. DIM can also help to detox estrogen but can be contrindicated in those with certain genetic variants. Sulforophane is another supplement. Each person responds differently to these supplements depending on their hormone and liver metabolism and various genetic variants.
- Focus on improving detoxification.
Read: Estrogen dominance: risk for cancer
Low libido, estrogen dominance and high cholesterol
What you need to know about estrogen
Estrogen dominance in perimenopause – part 1
5. Digestive Issues
Your bloated, constipated, and feeling puffy. Genetically we all process nutrients differently. Gut health is very unique from person to person. Digestive issues differ in root cause, some being: absorption issues like celiac disease, bacterial overgrowth like SIBO, Virus like H. Pylori, insufficient fiber to feed microbes, low stomach acid, vitamin deficiencies, poor bile flow, poor diet, poor lifestyle, too much sugar and alcohol and so much more.
Try:
- Get the DNA GUT.
- Get your nutrient levels checked: important: B12, Iron, vitamin D, zinc, magnesium, calcium, folate
- Get tested for SIBO, H.Pylori, Celiac, stomach acid
In conclusion
There is no one-size-fits-all approach when it comes to perimenopause. But a very big part of your journey is knowing your genetic variants in nutrient metabolism, gut health, hormones, detoxification, oxidative stress and inflammation. Contact me to order your DNA tests or for feedback on your current results and guidance in personalized DNA based nutrition and coaching.
Related articles:
What you need to know about perimenopause
What you need to know about liver health
What you need to know about progesterone
references:
- Santoro N. Perimenopause: From Research to Practice. J Womens Health (Larchmt). 2016 Apr;25(4):332-9. doi: 10.1089/jwh.2015.5556. Epub 2015 Dec 10. PMID: 26653408; PMCID: PMC4834516.
- Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A. Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists. J Midlife Health. 2019 Oct-Dec;10(4):165-172. doi: 10.4103/jmh.JMH_155_19. PMID: 31942151; PMCID: PMC6947726.
- Simpson SJ, Raubenheimer D, Black KI, Conigrave AD. Weight gain during the menopause transition: Evidence for a mechanism dependent on protein leverage. BJOG. 2023 Jan;130(1):4-10. doi: 10.1111/1471-0528.17290. Epub 2022 Sep 25. PMID: 36073244; PMCID: PMC10952331.
- Rotem C, Kaplan B. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study. Gynecol Endocrinol. 2007 Feb;23(2):117-22. doi: 10.1080/09513590701200900. PMID: 17454163.
- Ooi SL, Watts S, McClean R, Pak SC. Vitex Agnus-Castus for the Treatment of Cyclic Mastalgia: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt). 2020 Feb;29(2):262-278. doi: 10.1089/jwh.2019.7770. Epub 2019 Aug 29. PMID: 31464546.
- Shaw S, Wyatt K, Campbell J, Ernst E, Thompson‐Coon J. Vitex agnus castus for premenstrual syndrome. Cochrane Database Syst Rev. 2018 Mar 2;2018(3):CD004632. doi: 10.1002/14651858.CD004632.pub2. PMCID: PMC6494412.