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)

Functional Hormone Test - What's Going on With Your Hormones?

Have you ever wondered what your hormones are actually doing to your health?

Persistent belly fat, depression and mood swings, sleep issues, PMS, irregular periods, fatigue, brain fog and low motivation could indicate that your hormones are out of whack. But rather than guessing your hormone status, functional hormone test could help to identify what’s really going on with the hormones and what impact these could have on your health.

There are many hormone tests available, blood, saliva and urine.

Blood Test- Measures the hormones present in the serum. It does not measure bio-available hormones and the metabolites. It provides a snapshot view.  

Saliva - Easy to do and can be useful to test free cortisol (stress hormone) however doesn’t measure bound hormones. It also doesn’t measure metabolised cortisol or how much your body is actually making cortisol.

Dried Urine test – 24-hour urine test is one of the most reliable methods to evaluate the production of steroid hormones and their metabolites. Choose 24-hour urine test rather than one single urine test because the latter doesn’t measure individual differences in hormone secretion and only provides a snapshot view. 

I recently had my own hormones tested with DUTCH test and got some interesting results. Now it’s not a language test but stands for Dried Urine Test for Comprehensive Hormones. DUTCH test is a simple yet advanced which analyses 35 different hormones (sex and adrenal hormones and their metabolites), giving a comprehensive picture of your current hormonal health.

Benefits of the DUTCH test:

1.   For women who show signs of hormonal imbalance; do you suffer from irregular or painful periods, PMS, fatigue, mood swings, weight gain, chronic stress or going through perimenopause or menopause, the test is beneficial as it gives a full picture of your hormone levels and how your body is processing these.

2. Gives a comprehensive look at your cortisol and shows a detailed cortisol pattern; free cortisol, diurnal pattern and its metabolites. Cortisol is produced by the adrenal glands in response to stressors (emotional, mental and physical stressors). Chronically elevated cortisol can suppress immune system, increase anxiety, insomnia, contribute to weight gain around the belly, inflammation, skin issues and increases the risk of chronic disease.

3. It measures how you are processing oestrogen. The body has to eliminate its used oestrogen which is done primarily by liver via 2-hydroxylation and 4- and 16-hydroxylation pathways. 2-OH pathway metabolites were associated with reduced breast cancer risk (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313342/) while 4-OH metabolites have been associated with an increase risk of breast cancer.

I also use other functional tests at my practice to analyse - food intolerances, heavy metals, mineral & vitamin deficiencies and gut issues (stool analysis). 

Click here if you would like more information about the tests:

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).

3 Foods to Reduce Painful Periods

It is estimated that 90% of women experience some menstrual cramping and about 20% suffer from dysmenorrhea, painful periods (University of Birmingham, 2012 https://www.aafp.org/afp/2012/0215/p386.html). Painful cramps can be debilitating and interfere with daily activities.

What can cause painful periods?  

Naturally your womb contracts & relaxes on a regular basis throughout your cycle. During your periods, these contractions may become stronger because your uterus is expelling its lining.

Painful periods have been associated with excess production of prostaglandins, a hormone-like substances that our bodies produce. Too many prostaglandins can increase pain and inflammation. Women with painful periods have higher levels of prostaglandins. (ACOG https://www.acog.org/Patients/FAQs/Dysmenorrhea-Painful-Periods?IsMobileSet=false)  Menstrual cycle is natural but suffering from extreme period pain isn’t.  

Other conditions that can cause period pain are fibroids and endometriosis.

 3 Foods to Alleviate Period Pain

 1.    Eat more omega-3 rich foods; salmon, ground linseed, pumpkin seeds, green leafy vegetables. Study (Experimental Biology, 2004) showed that Omega-3 in fish may significantly diminish the production of prostaglandins and reduces inflammation https://www.sciencedaily.com/releases/2006/04/060404085719.htm

2.    Magnesium has been associated to relax and reduce pain through lowering prostaglandins in blood (British Medical Journal, 2006). Eat dark leafy greens, nuts, seeds, little dark chocolate. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624/

 3.    Zinc. A study showed that taking extra zinc could reduce or even prevent painful periods. https://www.ncbi.nlm.nih.gov/pubmed/17289285. Eat zinc-rich foods; chicken, pumpkin seeds, seafood.

 Top tip: High caffeine intake, saturated fats (dairy, red meat) and sugar can increase period cramps & inflammation.

How to Reduce Hormonal Migraines

Migraines affect over 30 million people in the US and it is suspected that almost 1 billion people suffer migraines worldwide. Women suffer from migraines three times more than men and research associates this with fluctuating hormonal levels.

Hormonal migraines are linked to falling levels of oestrogen usually at the end of menstruation cycle. Other common triggers for migraines can be stress, blood sugar issues, fatigue and food sensitives. It’s a good idea to keep a food diary and note down what you ate & drank 1-2 days before the migraine.

 My Top Tips to reduce migraines

• Eat magnesium-rich foods; green leafy veg (kale, spinach, watercress), nuts, beans, chickpeas and bananas. Magnesium works by calming the nervous system, reduces pain and inflammation (Pain Physician, 2016).

• Ditch the sugary snacks & drinks and snack on fruit and nuts and drink plenty water.

• Eat anti-inflammatory foods before periods such as avocados, salmon, nuts, seeds and plenty green vegetables.  

• Certain foods could trigger migraines such as chocolate, citrus fruits, red wine, aged cheese, artificial sweeteners, excess caffeine and gluten (Journal of Headache Pain, 2014).