Common Symptoms of Perimenopause:

New onset heavy and/or longer menstrual flow
Increased menstrual cramps
Shorter menstrual cycles (<26 days), also irregular periods (long cycles and missing periods usually come later)
New sore, swollen or lumpy breasts
Weight gain without changes in exercise or eating
New onset of sleep trouble – particularly waking in the middle of the night
Premenstrual night sweats
New or worsening migraine headaches
New or increased premenstrual mood swings
Lower stress tolerance
More depression, mood swings (sometimes rage)
Cognitive issues – brain fog, trouble thinking and remembering
Increased joint pain - due to changes in connective tissue
Heart palpitations

If you are experiencing some of these symptoms, you could be in the phase of life called Perimenopause. Perimenopause is the process of hormonal and brain changes leading up to menopause when your periods will finally stop and your fertility ends. The process typically starts at some point in your 40’s and for some women as early as their late 30’s.

Perimenopause can last up to 10 years before you finally have your last period (Menopause). While it’s a completely normal transition, it can be tumultuous time for many women. It can be like puberty all over again and what woman wants that?!

Perimenopause involves a sequence of events. First, there is a decline in progesterone while estrogens climb and fluctuate greatly. It’s as if your estrogen is on a roller coaster. As you progress through the process, eventually estrogen levels will drop and remain consistently low. Towards the end of this process, there are changes in insulin metabolism – this partly explains why it’s so much harder to lose weight in your 40’s!

Most of the symptoms of perimenopause are due to the declining levels of progesterone, combined with the elevated and fluctuating levels of estrogen. Estrogen can spike up to 3 times higher than when you were younger. This big gap between high levels of estrogen and low progesterone is what causes many of the symptoms.

So, what can you do to stay feeling healthy and happy during this process?

Honor your body’s natural circadian rhythm – we need morning light and nighttime dark. Get sunlight every day, ideally morning light. A morning walk outside is great. Click here to learn more about circadian rhythm.
Prioritize sleep - maintain a consistent sleep schedule and sleep in total darkness. If you are unable to sleep on your own, magnesium, adrenal support and progesterone could help. Some people need to avoid caffeine all together. A healthy circadian rhythm is essential for sleep.
Get outside in nature daily – walking in nature increases your parasympathetic nervous system tone. This effect lasts after the activity and even hours later while you sleep.
Healthy social connection and community – studies are clear, having a community and social support makes positive changes in our physiology
Relaxing techniques – breathwork, yoga, Pilates etc. Choose something you love doing, that calms you and do this regularly.
Movement – be sure to include weights and resistance training, building muscle is key during perimenopause and menopause. Walking, outdoor activities and any movement you enjoy is good too!
Anti-inflammatory, Whole foods diet
- Diet that is high in plant foods and low in sugar, white refined grains, packaged foods and dairy. Think of dairy like a condiment.
- Eat 2-3 cups of cruciferous vegetables each day (cauliflower, kale, broccoli, cabbage, collard greens and Brussel sprouts).
- Ground flax seeds – 1 tbsp per day
- Focus on protein - include with each meal, 15-25 grams.
- Organic soy – tofu, tempeh, miso. Soy milk ½ cup per day for hot flashes
- Reduce or stop alcohol - drinking alcohol interferes with your body’s ability to metabolize and clear estrogens. Not what we want to have happen when estrogen levels are already too high! Unfortunately, alcohol never helps our hormones.
Identify and address blood sugar issues and high insulin levels.
Reduce inflammation - chronic inflammation in the body makes perimenopause and menopause harder and more symptomatic. Things that can cause inflammation are stress, diet, food intolerances, lack of sleep, underlying chronic infections, autoimmune diseases, diabetes, insulin resistance and digestive issues.