Kate Oliver is a functional health and nutrition coach specialising in gut, hormone and nervous system imbalances. She is the founder of Kate Oliver Coaching which provides one to one support and online learning programmes, helping people to resolve the root causes of their health issues, for lasting wellness.
There is no sudden ‘switch’ to menopause. We don’t wake up one day, no longer in our fertile window, having gone through ‘The Change’, as my grandmother used to call it. There is a long window of time – a multi-year transition – ahead of menopause, called perimenopause.
Because girls and women are taught shockingly little about how their bodies work, many of us have no idea what’s happening to us when we start to experience the symptoms of perimenopause. We may be especially unaware that it can start as early as 35.
Common perimenopause symptoms
If you are somewhere in your mid-30s to mid-40s, you might be noticing that life feels more exhausting than before. You might also be unable to revive yourself with a good, deep sleep. Maybe it’s monkey brain preventing you from dropping off, maybe it’s early morning wake-ups, maybe it’s hot flashes leaving you dripping with sweat in bed.
You may have noticed that you can’t remember things the way you used to, your brain is foggy and less sharp than before. Perhaps you’ve even let a few balls drop at work, which isn’t like you.
Maybe you’ve been feeling quite low and weepy, maybe it’s anxious thoughts which seemingly come from nowhere. Right now sex is probably at the very bottom of your list, because after you’ve done your day’s work, cooked dinner and done what’s needed at home, you’re too wiped.
Lately, your menstrual cycles have become heavier and a little more erratic. You’ve noticed that premenstrual syndrome is getting worse, or perhaps you’ve never had it before, but you think you understand what people have been going on about now.
The thing about these perimenopause symptoms is that it’s really easy to normalise them in the modern world. We pass them off as natural consequences of a busy lifestyle, a stressful job or home life, especially as we get older. However, if you are suffering from a number of these symptoms and life is feeling quite hard, it is time to do something about it.
Perimenopause symptoms are not meant to be ignored and endured
The hard truth is that these symptoms are signals from your body to accept and adapt to the fact, that in this phase of a woman’s life, nature intended for her to slow down.
If we think about this from an evolutionary perspective, the busiest time of a woman’s life (raising her children) is supposed to be over and now her role is transitioning to one of support for her children raising their children, and support for her wider community. Human beings have particularly helpless young, so the ‘Grandmother’ role was an important one, based on imparting wisdom and providing an emotional holding to help mothers ensure the survival of their young.
As a working woman who has recently become a mother at 38, I am acutely aware that this is not how we live today. My generation of women has been brought up to believe they can fulfil multiple roles in their lifetime beyond motherhood, so most of the women I know at this age are juggling a busy career, home and social life, and they have no intention of changing the way they live their lives.
But we cannot escape the fact that our hormonal system has not evolved at the same pace as our environment or our understanding of a woman’s role in society. If we are hoping for a comfortable experience of perimenopause and menopause, we simply have to find a way to slow down. Perhaps it is at this time in a woman’s life when Oprah Winfrey’s famous saying becomes profoundly true: “You can have it all, just not all at once”.
Hormone replacement, doesn’t it fix everything?
We are led to believe that hormone replacement will make us feel normal again when we go through menopause. There is no doubt that HRT can be a lifeline, and I for one feel privileged to live in an age when it is available. But a woman’s body changes in ways that no amount of HRT can reverse, and in my opinion, we must try to respect this change.
Through perimenopause, the adrenal glands take over from the ovaries in making oestrogen, but they also make cortisol (our major stress hormone), so if we live a stressful life, these glands will prioritise cortisol over sex hormones. HRT or not, we have to work harder to manage stress than we have ever had to before. So if you feel like the balls are harder to juggle these days, it’s because they are, it’s not in your head.
A woman’s hormones in perimenopause are erratic. They don’t descend in a tidy, clean line, they are all over the place. Contrary to what we are told, symptoms like night sweats are not necessarily from low oestrogen, they are often from erratic oestrogen and this means we have to think carefully about how we might support or supplement these hormones.
Progesterone usually begins to decrease 5-10 years before menopause, while oestrogen is 1-2 years prior. So we can end up with low progesterone, which leads to its symptoms, as well as a condition called oestrogen dominance if oestrogen is normal or high at the same time as low progesterone. This dynamic will be worsened by oestrogen hormone replacement.
Symptoms of low progesterone
Short luteal phase of menstrual cycle
Spotting before your period
Prolonged period bleeding
Heavy periods
PMS
New or worsening migraines
Decreased fertility & miscarriages
Trouble sleeping especially in the luteal phase
Decreased resilience to stress
Symptoms of oestrogen dominance
Breast tenderness, pain or fibrocystic breasts
PMS
Irritability or mood swings
Acne breakouts
Hot flashes
Weight gain around hips & stomach
Fatigue
Decreased sex drive
Depression or anxiety
Decreased fertility
Joint pain
What can we do to ease perimenopause symptoms?
Balance stress
As I have discussed, we cannot escape the shift towards higher stress hormones, and this means we need to find ways to slow down and look after ourselves. Maybe that means taking a hard look at your work-life balance, maybe it means building in small periods of time each day to do something for you, or maybe it means shifting away from your usual high-intensity exercise to something slower, stronger & more grounding.
Get tested
Find out what is going on, with blood testing at a minimum and if you have the funds to do so, consider functional testing as well, as it looks at the downstream metabolites of your hormones to understand the picture much more clearly. Worryingly, I know of women who have been prescribed HRT without their hormones being tested and remember, it is possible to make symptoms worse if the balance of hormones in your unique body is not well understood.
Don’t avoid fat
Fat is an essential component of hormones; we simply cannot make them without it. So even if you are struggling with weight gain, try not to get caught up in the calorie rhetoric of the diet industry. High-calorie, nutrient-dense foods do not make us gain weight if they are part of a balanced, whole-food diet. Highly refined, sugary foods are much more likely to contribute to weight gain. Ultimately though, most people need to address the underlying hormone imbalance before they see the weight come off.
Support your liver
Your liver needs to be working optimally to process excess hormones and keep them in balance. Every glass of wine or caffeinated drink diverts the liver’s attention away from dealing with hormones. Refined, sugary foods and toxin exposure can make the liver ‘fatty’ and slow it down. Focus on whole, unprocessed, low-sugar foods. Drink lots of water and try to choose low or chemical-free products for use on your skin and in your home.
Consider targeted supplementation
There are many supplements such as DIM, Vitex and Calcium D Glucarate, which can help to rebalance hormones and support your liver and stress axis. But first, test don’t guess! Anything we supplement (drugs, hormones, herbs, minerals) has the potential to make things worse, so work with someone who can devise the right plan for you.
For more information on hormone balance, perimenopause and menopause, please get in touch by clicking here.
Read more from Kate Oliver
Kate Oliver, Functional Health and Nutrition Coach
Kate Oliver is a functional health and nutrition coach specialising in gut, hormone and nervous system imbalances. After suffering her own health crisis for which she struggled to find answers, Kate teaches people about what is happening in their body so they can take control, advocate for themselves and develop the lifelong practices which will enable them to thrive. Kate holds a bachelor’s degree in chemistry from the University of Sheffield, a certificate of health coaching from the Institute of Integrated Nutrition and is a functional medicine practitioner with the School of Applied Functional Medicine.
References:
https://ndnr.com/womens-health/the-relationship-between-adrenal-function-and-menopausal-symptoms-2/
A. https://my.clevelandclinic.org/health/diseases/21608-perimenopause\
B. Hormone Balance Made Simple, Dr John Lee & Virginia Hopkins
