Like many of you, I am becoming better and better acquainted with our mutual friend, Peri. Perimenopause. There has been a lot of mystery and a general lack of information around women’s health in the second half of our lives, so I want to share some insight that I have found very helpful.  The majority of the facts that I will share here come from The Hormone Repair Manual written by Lara Briden, ND.  As I dug into her research, I was excited to see that while some of the facts around perimenopause were new, the best practices to navigate it well were quite familiar.  

What is Perimenopause?

Perimenopause is the transition into Menopause.  For most women, it lasts between 4 and 8 years. It often begins around the age of 40, but many women notice symptoms as early as their mid-30’s. 

Progesterone, Where have you gone?!

The symptoms of perimenopause are largely driven by the loss of progesterone over time.  As progesterone decreases, estrogen often increases.  It is this fluctuation that can lead to symptoms like irritability, breast pain, heavy periods, anxiety, depression, night sweats, heart palpitations, brain fog and migraines. 

How do I know if I am in Perimenopause?

According to Briden, if you are experiencing three of the nine symptoms below, you are on your way:

• Increased cramping    
• Shorter menstrual cycles (25 days or less)
• Heavier or longer flow
• Lumpy or sore breasts
• Waking up in the middle of the night
• Premenstrual night sweats
• New or worsening migraines
• New or worsening premenstrual mood swings
• Weight gain without changes in exercise or eating

When does it end?!

Perimenopause officially ends when you have gone 12 months without a period.  Maybe you are thinking, “Great, then I am just in menopause!”  One of my favorite parts of the book is the optimism that Briden shared regarding menopause.  Most women experience relief from perimenopause symptoms, a return of their energy, stabilized mood, and report feeling well and happy during menopause. She also talks about the Grandmother Hypothesis which reinforces that older women provide a tremendous resource to their communities in how they care for their growing families and those around them. Not only are menopausal women contributors, they are KEY contributors to their communities. 

Perimenopause is an Inflection Point.

Now that we have a grasp on what perimenopause is, we can talk about how we navigate it and why it is critical to our health.  Briden refers to perimenopause as Second Puberty.  Similar to childhood, puberty, pregnancy and postpartum, our bodies are in a state of physiological flux.  Our immune system remodels itself which can be a tipping point for auto-immune diseases.  Cardiovascular health can be affected by increased insulin resistance.  Perimenopause is a time of neurological transition in our brains that can have a long term effect on our mental health.  Perimenopause and many of its symptoms are temporary, but how we care for our bodies during this critical time will lay the foundation for our future.

Calming your Nervous System

The parasympathetic nervous system reduces stress and recovery.  The book shares a lot more wonderful detail on this topic. Some recommendations to calm our parasympathetic nervous system include: walking in nature, building social connections, breath work, yoga, cold plunge and maintaining healthy gut bacteria.

HPA Axis Dysfunction is a reduced ability to deal with stress.  This dysfunction can come from chronic stress, undereating, poor sleep and illness.  It can be exacerbated by perimenopause.

Maintaining a Healthy Circadian Rhythm

Start your day with natural morning light by getting a walk outside.  Eat a sizable portion of protein before 10am. Limit or cut out alcohol.  Alcohol disrupts your circadian rhythm. Stop screen time 1-2 hours before bed. Maintain a regular sleep schedule and prioritize 7-9 hours of sleep. Here are some more tips on good Sleep Hygiene:

Sleep Hygiene

Keeping a Healthy Gut Biome

Here are a few things you can do to improve your gut health: Reduce alcohol as it damages the gut biome. Vegetables and healthy starches feed good bacteria. Manage stress. Exercise improves the health of the gut biome. Sleep is critical to a healthy biome. Limit processed foods and refined sugar.

Protect and Increase Muscle Mass

Eating enough protein and moving your body regularly will help protect your muscle mass.  Muscle mass decreases as we age.  When we lose muscle mass, our metabolism slows. Staying active by walking and exercising is critical.  Strength training has proven to yield tremendous benefits in building and protecting muscle.  If you don’t want to lift heavy weights, body weight exercises like lunges, squats, push ups and planks can all help you maintain muscle.

Protect Bone Health

Our peak bone health is around 30 years of age.  As we age, it naturally decreases.  The rate of bone loss is accelerated during the first 5 years of menopause. One of the best things you can do to protect your bones is to protect and increase the muscle that supports your bones.

Eat a Protein Rich Nutrient Dense Diet

If you have been around Stay Fit Mom for any length of time, you know that our goal is to provide you with the tools and support to build a foundation of sustainable nutrition that supports your health now and into the future.  Click here to learn more about macro and micronutrients:

Not Just Macros but Micros Too!

Briden’s book is rich in details and recommendations if you want to dive deeper into her recommendations on HRT, supplements, what to expect in menopause and much more.  

All of this information helps us better understand what is ahead and what to expect as we experience perimenopause. Not all women will have significant symptoms. Understanding the forecast of what is ahead helps us take the best steps to live the full, healthy lives we all desire.  If you are working with us at SFM, you are already on the path to eating a protein rich, nutrient dense diet.  You are already tracking your sleep, fiber, hydration, and steps!  This glimpse into perimenopause is a reminder that you are on the path for lifelong health and that your hard work matters. This journey will not always be an easy one, but we will do it together.