A lot of 40-something women tend to be caregivers and put ourselves far down on our list of priorities.
What is Perimenopause?
Perimenopause is the period in a woman’s reproductive life where her hormones begin to shift toward a menopausal state. Generally, perimenopause will happen eight to 10 years before menopause. For many women, that will be from age 40 to 44, but can begin when a woman is in her 30s.
During perimenopause, a woman’s hormones begin to shift. Generally, I will start to see a decline in progesterone before I will see a decline in estrogen in my perimenopausal patients. The decline in progesterone can make it seem like there’s too much estrogen in the body. Testosterone can sometimes shift downward in perimenopause as well. If a woman is under a lot of stress, as many of us are, this can disrupt her stress hormones, which, in turn, can disrupt estrogen and progesterone. Hormone balance can get complicated because of their interconnected nature, so it is important to address hormone balance with a wide lens and not focus solely on estrogen and/or progesterone. I often see patients who are just addressing estrogen and progesterone and continue to struggle with their perimenopausal symptoms.
What are the Symptoms?
When hormones are shifting and unbalanced during perimenopause, they can bring a whole host of uncomfortable symptoms! Some of these symptoms include:
- Heavy bleeding during menses
- Increased length of PMS moodiness (sometimes half of the month!)
- Increased breast tenderness
- Insomnia
- Hot flashes
- Irregular periods
- Low libido
- Interventions for Perimenopause
My preference as a practitioner is to address symptoms at a root cause level rather than cover up symptoms with medications, which is especially common especially during perimenopause. We need to recognize that you can’t out-medicate or out-supplement a poor diet and lifestyle. This absolutely holds true for perimenopausal women. A lot of 40-something women tend to be caregivers and put ourselves far down on our list of priorities. But we can’t do this and continue to be healthy enough to maintain our health and take care of others. Here are some interventions that can be undertaken to help balance hormones and maintain hormone health:
- Maintaining muscle mass. Weightlifting and maintaining healthy muscle mass is, perhaps, the best thing a woman can do to balance her hormones so that she can navigate perimenopause and head into menopause as healthy as possible.
- Eating a healthy diet. I am an advocate of eating unprocessed foods, ideally sourced from local farmers. Sugar and processed foods should be avoided and diets that promote intense restriction (vegan, keto, very low calorie, etc.) should not be undertaken for long periods of time without supervision.
- Avoiding alcohol. Alcohol has very little to offer in terms of health benefits and I can’t tell you how many times my perimenopausal women tell me that alcohol, especially red wine, creates or exacerbates their hormonal symptoms. Alcohol also is detrimental to sleep quality, which is another area where perimenopausal women struggle.
- Sleep. Establishing healthy sleep patterns can be tricky during perimenopause, but good sleep is essential to maintain healthy hormone balance. Our sleep hygiene and stress hormones can often be detrimental to sleep quality, so those are areas that can be evaluated to improve insomnia.
- Decreasing stress. Like sleep, this is a tricky area! Women in their 40s are often being hit with stress from many sides. One thing we can do is control our response to stress. Finding ways to respond to stress that help us maintain our calm can make a huge impact on our perimenopausal symptoms.
- Avoiding hormone disruptors. Did you know that the world is full of synthetic substances that contribute to hormone imbalance? Avoiding: fragrances in air fresheners, perfumes, detergents and everywhere else they are found (even in trash bags!); the many chemicals in plastics; triclosan in antibacterial products; lead; and many of the chemicals in hormone-disrupting personal care products and cosmetics can contribute to better natural hormone balance.
- Herbal medicine. Herbs can work with our body’s natural affinity to achieve proper hormone balance. Some of my favorite herbs to use during perimenopause are maca, chaste tree berry, black cohosh, ashwagandha, rhodiola, dong quai and wild yam. However, if my patient is eating a poor diet and has poor lifestyle habits, the herbs have less chance to work at their best.
- Hormone replacement therapy. Occasionally, I do have perimenopausal patients who benefit most from hormone replacement therapy. However, this is not my go-to because it can cover up symptoms like a Band-Aid rather than addressing them at their root cause. And, again, without good lifestyle and diet, hormone replacement doesn’t work as well.
Of course, there are many other modalities for hormone balance and healing and if you have found a healing modality that works for you, that’s great! If you’re a perimenopausal woman who is struggling with hormone balance, I’m here for you. Just be ready to make some changes and give me a call! FBN
By Amber Belt, ND
Amber Belt, N.D. is a naturopathic physician and co-owner of Aspen Integrative Medical Center where she helps patients get healthy from the inside out. She is also co-owner of Sage Sirona, which focuses on natural first aid and education. Dr. Belt has been practicing naturopathic medicine for more than 15 years and can be contacted via aspenmedcenter.com or sagesirona.com. You can also call her office at 928-213-5828.
