Good calcium intake, together with optimal vitamin D, has been shown to prevent possible bone loss. It’s thought that 1 in 2 post-menopausal women will have osteoporosis! Therefore, it’s important to start looking at your calcium intake during perimenopause.
After about the age of 35, the total amount of bone in the body begins to diminish. In women, the process begins fairly sharply with the onset of menopause, when estrogen levels drop dramatically.
Women can lose a whopping 10% of their bone when going through the menopausal transition. This is because the bone resorption rate increases, in response to a decrease in estrogen production.
The recommended calcium intake is around 1200 mg/day, together with sufficient vitamin D to ensure its absorption.
In addition, weight training and non-impact exercises such as balance are also important to prevent fractures.
Debunking Hormones
Progesterone & Estrogen
Progesterone and Estrogen shift rhythmically back and forth over the course of the menstrual cycle. Maintaining the delicate balance between the two hormones will keep you feeling vital. As we get older, the amount we make of each can fluctuate more widely, particularly when under stress.
Progesterone is produced primarily by the ovary after ovulation and by the placenta during pregnancy. It's also made in lesser amounts by the adrenal glands and the testes. Its main job is to prepare the body for pregnancy and regulate the menstrual cycle with estrogen. It also plays a role in mood and sleep. If there is no pregnancy, the corpus luteum breaks down, progesterone levels decrease which triggers menstruation.
Possible causes of low progesterone
Anovulatory cycle = no ovulation
PCOS
Hypothyroidism
Chronic stress
Low cholesterol levels
Hyperprolactinemia
Possible signs of low progesterone
PMS migraines
Lumby & sore breasts
Irregular/absent periods
Heavy periods
Painful periods
Spotting between periods
Disturbed sleep
Water retention
Estrogen
Estrogen is the queen hormone over the first half of your menstrual cycle, the follicular phase. This hormone stimulates the growth of the uterine lining and breasts, protects the brain, supports bone & cardiovascular health, and promotes vaginal lubrication. It can also make you feel great – you may feel energetic & more confident during the first part of the cycle.
We talk about one estrogen but there are others!
Estrone (E1) is a weaker estrogen and is predominant in menopause.
Estradiol (E2) is our primary estrogen & most abundant. It’s produced in the ovaries & plays a part in sexual development, brain, breast, bone & cardiovascular health.
Estriol (E3) rises during pregnancy and peaks just before birth.
Your estrogens need to be inactivated to maintain normal levels. They go through metabolism via different phases. Phase I (hydroxylation), Phase II (methylation, glucuronidation, and sulphation) and the final phase is removing the metabolites in the urine and stools.
Excess Estrogen Symptoms
Bloating / water retention, heavy bleeding, weight gain, breast tenderness, fibroids, endometriosis, painful periods, mood swings, PMS, anxiety, and weight gain. Quite a list!
Possible causes of excess estrogen
Body not breaking it down & getting rid of it, as it should.
High body fat. Fat tissue secretes estrogens.
Excess alcohol can increase estrogen levels and disturb its metabolization.
High stress can rock the balance of progesterone & estrogen.
Xenoestrogens. Bisphenol A (BPA), phthalates (both found in plastics), pesticides, cleaning & personal care, contain Xenoestrogens that act like estrogen when in our body.
During perimenopause our progesterone declines and estrogen can be as highest it’s ever been & fall drastically.
Maintaining this delicate balance between the two hormones is essential for your health.
5 Top Tips for Balanced Perimenopause
What is going on with my body & hormones?
This is a common question for women in 40s but also can occur in your 30s. Perimenopause refers to the time during which your body is starting the natural transition towards menopause. Your ovarian function is starting to decline and the circulating estrogen can fluctuate although you still menstruate. Your progesterone levels can decrease as you may ovulate less frequently. Fluctuating hormone levels can cause fluid retention, hot flashes, mood swings, heavy or irregular periods, insomnia and painful breasts.
According to Harvard Health, the average perimenopause is about 3-4 years, although this greatly varies. For some women their perimenopause last for a few months while for others much longer.
What can you do to support a healthier perimenopause?
Swap sugar & white grains to wholegrains, lean protein & fibre. These help to regulate your blood sugar. Dinner tip: roasted salmon with steamed broccoli & brown rice.
Eat plenty vegetables; spinach, broccoli, cauliflower, kale etc. Go for variety & rainbow colours - every day!
Eat healthy fats regularly; avocado, oily fish, olive oil, nuts and seeds. Breakfast tip: add 2 tbsp of ground linseeds to your breakfast.
Reduce alcohol. Too much alcohol can lower mood and induce poor sleep. Alcohol also depletes essential nutrients such as calcium and magnesium.
Stay active. Study showed that women over 40 lose about 1% of their lean body mass per year if they are inactive. Also physically active women who enter menopause are leaner and have a decreased risk of developing metabolic disease (Obset Gynecol Clin North Am. 2011)
Relief from Hot Flashes
You get that sudden intense feeling of heath, flushed or red face and sweating. Sound familiar? Although some women sail through menopause, research shows that almost many as 75% of women experience hot flashes during perimenopause and menopause. For many women hot flashes can be a real bother and can last for several years (North American Menopause Society).
Why do so many women experience these?
Hot flashes result from hormonal changes in the body and when heading to menopause our oestrogen levels decline which can trigger these. You may also experience other symptoms such as insomnia, mood swings, low libido, vaginal dryness and weight issues. Obesity, alcohol and poor diet could increase your risk of hot flashes.
Natural reliefs:
1. Reduce caffeine. Study found that excess caffeine intake exacerbates menopausal vasomotor symptoms (Menopause, 2015 https://www.ncbi.nlm.nih.gov/pubmed/25051286)
2. Stop smoking. Smokers were found to experience more severe and twice as more hot flashes than women who don’t smoke. (Pennsylvania Perelman School of Medicine, 2014 https://www.pennmedicine.org/news/news-releases/2014/february/penn-medicine-study-reveals-ge).
3. Take vitamin E. 2018 study found that 400IU of vitamin E can reduce the frequency and severity of hot flashes. https://www.ncbi.nlm.nih.gov/pubmed/17664882
4. Eat more phytoestrogens. Phytoestrogens such as isoflavones found in soybeans and lignans in flaxseeds, fruits, vegetables, legumes and wholegrains have a weak oestrogen-like properties. Phytoestrogens bind to oestrogen receptors and help modulate oestrogen activity and appear to have anti-estrogenic activity ( Journal of Steroid Biochemical Molecular Biology, 2015).