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Am I in Perimenopause?




Working in women’s health for nearly two decades now I’ve seen first-hand the tell-tale signs of perimenopause….the subtle drift into a state of un-ease, the adrenal exhaustion, the transition from being a great sleeper to a light sleeper, mid-body fat gain, flushed cheeks, dry eyes, headaches, irritability….


On their own each of them can usually be managed with some lifestyle changes, diet modifications, maybe medications. And to be honest, that's often what we do, treat them like ‘lifestyle symptoms’. Because discussions about menopausal symptoms may not have been common at the family dinner table, and because this is one aspect of a woman's life that doesn't gain public attention. It's become a very private experience. And because we aren't educated that well about what to expect in perimenopause often the tendency is to look at these symptoms as individual ‘conditions’. However, none of them operate in isolation, they’re all smaller parts of the larger perimenopause picture and it’s not until you can address the underlying cause that you can truly break free from these symptoms and regain control of your body (and mind).


In this article you’ll learn about perimenopause, what it is, what symptoms to look out for and how naturopathy can help you achieve a smoother transition to menopause while also improving your hormonal, cognitive, metabolic and cellular health. Take it from a naturopath nearing 50, there’s never been a better time to reframe your health story than in the lead up to menopause. You’re creating the foundations for optimal health for (on average) another three decades of life.


What is perimenopause?


You know that period of 8-12 years before your periods finally stop, where you notice changes in your skin, energy levels, appetite, sleep and perhaps some weight gain too? That’s perimenopause. It’s a natural phase for all women, regardless of where you were born, what job you hold, how many children you’ve had, or maybe you’ve had none...perimenopause will happen to all of us. Considering the time frame for perimenopause, don’t be surprised if you you start to see perimenopausal symptoms as soon as the late 30s or early 40s. It continues until menopause, which is marked retrospectively by the cessation of menstruation for 12 months.


What are the main perimenopause symptoms?


During the transition to menopause there’s a combination of hormonal fluctuations and inflammatory changes that can bring about a range of physical and emotional changes, often accompanied by uncomfortable symptoms. Fortunately, naturopathy offers a natural approach to alleviate perimenopausal symptoms and promote overall well-being. The right combination of herbs to calm excess hormones and build deficient ones along with the best diet protocol for you (diet should ideally be based on body types) may be all that you need to keep perimenopause symptoms from impacting you physically and psychologically.


Recently in a training webinar on perimenopause the presenter asks all of us naturopaths to vote on which symptoms of perimenopause and menopause our clients were most concerned about. Sleep, hot flashes and muscle and joint pain came up tops. If I think about my own experience in clinic with the women that come to see me it would be weight gain, hot flashes, bloating, sleep problems, anxiety and nervous tension, and then the joint pains, urinary problems, headaches and forgetfulness.


The hormonal shifts in perimenopause primarily involve estrogen and progesterone. These fluctuations can be unpredictable and vary from person to person, but they generally follow a pattern. At the beginning you might start having irregular menstrual cycles. Periods become shorter or longer and they also start varying in flow. There are other hormones that are starting to behave badly too, like leptin and ghrelin so you might end up feeling hungry all the time, always needing something sweet after a meal, or eating lots of carbs. And then there’s our old friend cortisol…I say old friend because this could be your most primitive hormone. It still puts you on alert when the roof creaks in the night because, well, it just might be a sabre toothed tiger on the prowl. You might be living in a state of the art steel frame dwelling but this hormone still thinks you live in a cave and chase woolly mammoths. Chronic stress, which is definitely a hallmark feature of the 40s for most women, will cause elevations in your cortisol.


Further down the track towards menopause many women experience sudden waves of heat and intense sweating, often during the night, which can disrupt sleep. If you’ve been on herbs you may not get this though, I find certain hormone regulating herbs get this under control quickly or prevent it altogether. There are some other key symptoms too. Hormonal imbalances can lead to mood swings, irritability, and even anxiety or depression. It’s not uncommon for women to despair about their lack of temper control during perimenopause. Again, it may not happen for all of us, but when it does it can feel like some other angry version of ourselves has hijacked our brains.


Reduced estrogen levels impacts women at a tissue level. It causes vaginal dryness, itching, and discomfort during intercourse which can be a sign of vaginal atrophy as the vaginal tissues tighten and lose elasticity. The decline in estrogen can also affect bone density, potentially increasing the risk of osteoporosis. Finally, sleep often becomes disrupted, leading to fatigue and irritability.


Perimenopause is a Journey


I really don’t want to give perimenopause a bad name though. I know it comes with a host of physiological and psychological changes that in my mind I’m saying a big fat ‘NO’ to! But on the other hand, this natural life phase has the potential to liberate us from societal views of women defined by sensuality and fertility. We’re embarking on a new version of ourselves without the constraints of having to please anybody except ourselves. One of the women leading the perimenopause revolution is Professor Jerrilynn Prior. In her paper “Perimenopause lost – reframing the end of menstruation” she states:


“many of us thus become menopausal without the unique, self-actualization experience that perimenopause has the potential to provide. Thus perimenopause—a valuable transition into knowing and standing up for ourselves—becomes lost.” (2006)


What she means is that confusing beliefs around the hormonal causes of perimenopausal symptoms which are distinct from the experience of menopause, have led to several ‘preconceptions’ or mis-interpretations of perimenopause. Beliefs that oestrogen deficiency is the cause, or that we can treat these symptoms with oestrogens, or the isolationist ideas around perimenopause in society. So we don’t want to think about perimenopause as a medical event, a hormonal event. It’s a LIFE event.


I’ve found the psychological journey that perimenopause takes you on can be scary, profound, empowering and heavy all at once. I’m in it myself, I know! There’s a deeper transformation occurring underneath the surface, as we leave behind an identity characterised by fertility, vigour, youth and all those other societal constructs that get thrown at women in their fertile years. We’re moving into the next phase of our lives to embrace a more evolved, individual, differentiated and proud woman.


How Naturopathy can help in Perimenopause


Naturopathy emphasizes dietary modifications, herbal medicines and lifestyle changes to ease the transition to menopause, focussing on balancing hormones, reducing inflammatory load, supporting mood and alleviating discomfort. My treatment protocols for perimenopause include a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support hormonal balance.


Naturopathic doctors often recommend phytoestrogen-rich foods like soy and flaxseed, which can mimic the effects of estrogen in the body. I use herbal medicines like Black Cohosh, Shatavari, Hops, Dong Quai, and Red Clover, which have been used for centuries to alleviate menopausal symptoms like hot flashes, mood swings, and sleep disturbances.


I use functional testing to assess hormonal status, stress response and metabolic health if there’s weight gain. Stress Management is an important aspect of treatment. Stress can exacerbate perimenopausal symptoms so I use herbs to help you manage emotional fluctuations and sleep more deeply. My treatments for perimenopause are highly individualized, to suit your unique needs and symptoms. This personalized approach brings more effective symptom relief.


Perimenopause is a natural and transformative phase in a woman's life, but its symptoms can be challenging to navigate. Naturopathy offers a holistic and patient-centred approach to managing your symptoms easily. If you are experiencing perimenopausal symptoms, get in touch and I can create a personalized treatment plan that suits your needs.


Head to my profile page or straight to my website and find a time in the calendar that suits you. By addressing the underlying hormonal imbalances and supporting overall health, I can help you embrace this life stage with greater comfort and well-being, giving you a smoother transition into menopause.


Thanks for reading and have a beautiful day, you deserve it!


xo Sulin

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