Perimenopause: Practical Tips to Ease Symptoms and Feel More Like Yourself

Perimenopause, meaning ‘around menopause’, is the stage during which your body is preparing to enter menopause. Often referred to as the menopause transition, the production of estrogen and progesterone incrementally declines during perimenopause to prepare for the end of the reproductive stage of life.

Menopause is reached only when you have not menstruated for 12 consecutive months. Before that, women typically experience their own unique journey through perimenopause for a period of 4-10 years.

Below, we explain how declining hormone levels during perimenopause impact various aspects of the body. We also outline what you can do to manage your symptoms and improve your quality of life during this transitional phase.

What Causes Perimenopause Symptoms?

Once you hit puberty, estrogen and progesterone (and testosterone, to a lesser extent) naturally rise and fall to support your development, menstruation, reproduction, childbirth, and even breastfeeding.

During the mid to late 40s - it can occur later or earlier for some - hormone production tends to slow down as the end of the reproductive stage of life approaches. 

Although declining progesterone can affect moods, sleep, and libido to a certain extent, estrogen is the main culprit behind most perimenopause symptoms. While primarily known for supporting the female reproductive system, estrogen also passes through almost every organ, muscle, bone, and body tissue.

Therefore, when estrogen levels begin to diminish during perimenopause, what few understand is that it can also impact the brain, heart, bones, nervous system, muscles, joints, skin, and vaginal health.

So, along with irregular menstruation, lower estrogen levels can also cause brain fog, memory loss, anxiety, depression, hot flashes, heart palpitations, headaches, loss of bone density, less muscle mass, slower metabolism, itchy skin, vaginal dryness, and even a weaker pelvic floor.

Why Do Perimenopause Symptoms Come and Go?

Although estrogen and progesterone levels are dropping during perimenopause, the decline tends to occur erratically rather than uniformly. This hormone fluctuation generally means that perimenopause symptoms arise and ease off randomly without any warning or recognizable pattern.

 Certain lifestyle factors, such as stress, excessive alcohol consumption, ultra-processed food, and smoking can also increase the intensity of perimenopause symptoms. On the other hand, healthy life choices can significantly ease the journey through perimenopause.     

Therefore, when women feel their symptoms in a more pronounced way, it often correlates with a further drop in hormone levels. Or a lack of nutritional, physical, and mental support for your changing body.

How to Manage Your Perimenopause Symptoms?

Recent research has largely debunked the risks previously linked to menopause hormone therapy (MHT), and it is now more widely recognized than ever as one of the most effective ways to treat perimenopause symptoms. However, the benefits and risks of MHT are dependent on receiving the right type of hormone therapy for you, and not all types and doses of MHT are suitable for every woman.

So, if you're considering hormone therapy to treat perimenopause symptoms, consider scheduling a consultation with a Menopause Coach or Gynecologist to understand what will suit you and your symptoms, your overall health, and your medical history.

That being said, whether you choose MHT or the natural route through menopause, the following lifestyle changes have also been proven to help ease several perimenopause symptoms.  

Eating The Right Food to Manage Perimenopause Symptoms

Nutrition is incredibly important throughout life, but even more so during perimenopause, because it can support the body through the decline in hormone production.

In addition to supporting your physical and mental well-being throughout the menopause transition, the right nutrients can also help with perimenopausal weight gain, mood, sleep, and hot flashes.

For instance:

• Protein and fiber boost muscle and bone health

• Calcium keeps the bones strong and prevents osteoporosis later in life

• Magnesium can improve sleep and help the absorption of calcium to keep the bones strong

• Omega-3 fatty acids help boost the immune system, lower blood pressure, and support cardiovascular health to prevent heart disease later in life. 

Nutritionists, dieticians, and menopause coaches understand that each woman experiences perimenopause differently, in addition to favoring certain eating habits. It can, therefore, be helpful to schedule a consultation with either to create a nutritious eating plan that suits your tastes and help manage your symptoms.

Reducing Hot Flashes & Night Sweats with Lifestyle Changes

Declining estrogen levels during perimenopause often affect the body's thermostat (hypothalamus) and render it far more sensitive to internal temperature changes. This typically means that when the perimenopausal hypothalamus senses an increase in body temperature, whether true or not, it will cool the body down.

This process is known to us as a ‘hot flash’ and typically causes a sudden feeling of heat in the chest, neck, and face. Red blotchy skin, upper-body perspiration, increased heartbeat, and a cooling sensation as the hot flash subsides are also common.

Hot flashes that occur during the night are known as ‘night sweats’ and they are sometimes the cause of broken sleep during perimenopause.

Although MHT is often prescribed to ease hot flashes, the following lifestyle adjustments also help manage them.

• Drink cold water throughout the day to stay cool and hydrated

• Regular exercise and a well-balanced nutrition

• Cutting back on alcohol, smoking, and spicy food. All three can trigger and intensify hot flashes

• Wearing clothes made from natural materials like cotton and hemp to keep the body cool

• Dress in layers that can be easily removed and put back on as body temperature changes

• A cold shower before bed helps prevent night sweats and sleep disruptions

• Cotton or linen sheets keep the body cooler at night than sheets made from synthetic materials

• A fan or air conditioning in the bedroom

• Carrying a hand fan in your bag to use anytime you feel a hot flash starting

How Maintaining a Healthy Weight Can Ease Perimenopause Symptoms

Hormone imbalances can adversely affect muscle tone, bone strength, metabolism, and our desire to exercise due to less sleep and energy. Combined, these changes can contribute to weight gain in midlife, particularly around the midsection.

We all understand how weight gain can lower a woman's confidence in her appearance, and when anxiety, brain fog, or mild depression arise as perimenopause symptoms, mental health can suffer.

Furthermore, scientific evidence suggests that perimenopausal weight gain can increase the severity of other symptoms like hot flashes, joint pain, and the risk of osteoporosis in later life.

On the other hand, maintaining a healthy weight by eating well and exercising regularly throughout the perimenopause transition reduces the intensity of many of the associated symptoms.

How to Naturally Relieve Anxiety, Sadness, or Mild Depression During Perimenopause

You’re getting older, your body is changing, and your kids might be leaving home. On top of that, declining estrogen levels may be playing havoc with your moods, libido, and sleep patterns. All of these life changes can enhance feelings of anxiety, sadness, depression, distance, or pessimism during perimenopause and negatively affect your quality of life.

First of all, it helps to understand that these emotions, just like other perimenopause symptoms, will not last forever. And being mindful that you are in a transitional phase of life can help you find a more balanced and accepting outlook.

That sort of acceptance can help release anxious, sad, or depressing thoughts. In fact, research has shown that women who have a positive mindset about menopause tend to experience less intense perimenopause symptoms than those with a negative outlook.

Use mindful practices like meditation and yoga to help build acceptance for your changing body and gratitude for everything it has done for you thus far in life. Learn to be more open and welcoming of your elder years and wisdom, rather than grieving your youth.

And meet regularly with friends who are going through the same life phase. Sharing experiences can be beautifully therapeutic, remind you that you are not alone, make you laugh, and empower you to understand that perimenopause symptoms will not last forever.

If you’d like support to understand and manage your perimenopause symptoms, get in touch to arrange a coaching session.

Namaste,

Karen

References

British Nutrition Foundation – Managing Menopause with Diet - https://www.nutrition.org.uk/nutrition-for/women/menopause/managing-menopause-symptoms-with-nutrition-and-diet/

National Library of Medicine - Physical Activity and Health During the Menopausal Transition - https://pmc.ncbi.nlm.nih.gov/articles/PMC3270074/

Mayo Clinic – Hot Flashes - https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790

Taylor and Francis Online Medical Journals – Understanding Weight Gain During Menopause - https://www.tandfonline.com/doi/full/10.3109/13697137.2012.707385

Balance Menopause - Pelvic floor health during the menopause Factsheet - https://www.balance-menopause.com/menopause-library/pelvic-floor-health-during-the-menopause/

National Library of Medicine - Reducing Menopausal Symptoms With Mindfulness-Based Meditation - https://pubmed.ncbi.nlm.nih.gov/38363970/