Preparing for Menopause.....
When a friend and colleague asked me if I could do a blog on menopause, particularly preparing for menopause… I thought what a great idea, then I thought, far out that’s me, 47!! I cringed as I remembered that I am on that journey!! What a great idea…preparing for menopause…We kind of get that thought when we hit around 45 but let’s get clear of what perimenopause and menopause actually are and you can decide if you do need to start preparing for menopause.
Perimenopause may begin around the mid 40’s with the menstrual cycle shortening, interspersed with a few longer cycles. There can be some dysfunctional bleeding and the emergence of hot flushes. There can also be some insomnia and mood swings. Perimenopause clinically is characterised by a reduction of eggs in the ovaries, FSH (follicle stimulation hormone), will be elevated. Pregnancy is still achievable here.
You are in Menopause when there has been no menstrual period at all for 12 months. The ovaries are depleted of eggs so therefore no ovulation occurs. This can happen anywhere between ages 45 and 60, though the “mean” age is 51. The most common symptoms of menopause are, hot flushes, night sweats, insomnia, irritability, mood swings, depression, fatigue, muscle aches and pains, weight gain and low libido….something we really want to prepare for!! When the symptoms are severe, it is the body’s way of showing us the oestrogen levels are falling way too fast. Part of prevention, is slowing down the oestrogen loss. The biggest risks of oestrogen loss is bone loss, osteoporosis and an increased risk of heart disease. More good reasons to ensure we “hit” menopause in very good health.
So is there anything we can do to “prepare for menopause”, to lessen the effects and prevent going on HRT, which is what many women are afraid of and want to avoid? Absolutely!
I find that around the age of 40-45, I see women coming into clinic with a variety of similar symptoms such digestive problems, fatigue and PMT, which they didn’t have before. It is like they just cannot get away with what they got away with before. The effects of alcohol begin to be more apparent, there may be boating and digestive disturbances and a lot of irritability before the period. This is a sign of hormone imbalances and liver toxicity and I usually pop these 40 year olds on a good detox to sort their liver, digestive and hormonal problems out. This is the time to start to prepare.
The 2 main areas of the body to look after in ensuring a healthy menopause is the liver, to encourage a healthy clearance of hormones and to support the declining oestrogen levels, the adrenal glands as they take over from the ovaries to produce oestrogen as it declines in the ovaries. Another is protecting against osteoporosis and heart disease.
Look after your liver
The liver is the filter of all our toxins, including exotoxins, from our outside environment and endotoxins, from the inside of the body, including excess hormones. A good care plan will involve supporting the liver with an annual comprehensive detox, and also supporting the liver on a daily basis. Ways to do this include drinking a glass of water on rising with half a fresh squeezed lemon, including fresh bitter greens regularly in your diet including coriander which helps with heavy metal detox, staying away from processed food, and a moderate consumption of alcohol, which means 3-4 alcohol free days a week .
Protein is needed for liver detox so include plenty of lean sources of protein, not too much coffee and lots of water. Ensure you are eating a variety of brightly coloured fruit and vegetables every day and possibly with every meal. I often tell my patient to "eat a rainbow with every meal” to ensure a geed range of antioxidants in the diet. For example – scrambled eggs (yellow), with tomato(red), spinach(green), mushrooms, capsicum( orange), red onion (purple) for breakfast and then a big salad with lean protein for lunch, and then the same for dinner but a variety of vegetables this time.
Antioxidants provide co-factors for enzyme reactions and functions and mop up excess oxidative stress and free radicals which cause cell and aging in the body.
Cut the chemicals
Environmental toxins need to be considered also. We are exposed constantly from environmental toxins in the air we breathe, the water we drink, the food we eat and what we choose to put on our skin. Some general rules here include, filter your water, choose organic foods as much as possible and look at all the chemicals in your skin care, make up, deodorant and perfumes. . All those chemicals enter your blood stream and into your hepatic filter system, i.e., they all go through your liver. You can see how much the poor liver has to deal with! Over time…45 years perhaps and with age decline, the liver simply cannot cope and it slows down and now we are faced with our body’s not being able to cope anymore. We must look after our liver if we want a nice menopause!!!
Maintain a healthy weight
A small note here….often menopausal women have declining circulating levels of oestrogen and progesterone prompting their menopausal symptoms, but their serum levels can still be high as their fat cells become a major source of oestrogen biosynthesis. If very over weight, this can be a source of dangerous oestrogen metabolism and precursor to cancers. A healthy weight is optimal.
Take time for you
I have seen many menopausal women in clinic with very debilitating symptoms, who are very stressed out or whom have had a lot of stress in their lives. These women tend to have the worst menopausal symptoms. As the ovaries shrink and decline, the adrenal glands take over and can produce small amounts of oestrogen. If you go into menopause with adrenal fatigue and tired, you are likely to have worse symptoms. I always support the adrenal glands when I see a menopausal woman with severe hot flushes for example.
Hot flushes, or a loss of thermoregulation occurs when levels of our hormone DHEA decline with repeated stress and neurotransmitter imbalances, including depleted GABA and serotonin with increased noradrenalin. Further “stressing” the importance of stress management and adrenal support through peri and post-menopausal years.
We can support the adrenals by keeping our stress under control. How do we do that if life just keeps throwing us those stressful life events?? Take magnesium and B vitamins and keep blood sugar levels under control by eating small protein meals regularly.
Adaptogenic herbs such as Withania, Rhodiola, Schisandra and Korean Ginseng work to calm and restore a frazzled nervous system and over worked adrenal glands promoting sleep, energy and calm.
My favourite, make the time to meditate/relax/time for you daily. Enjoy down time and find the things in life that make you happy and bring you joy every day/week.
Keep your bones strong
To prevent osteoporosis, a bone disease where bone mineral density is reduced and the risk of fracture is increased, a multifaceted approach is required. Oestrogen is required for bone deposition and as oestrogen declines, so does bone health, but there is much we can do to prevent rapid bone loss.
Include calcium rich foods such as soy, tofu, tahini, sardines and salmon, (crush up the small bones in tinned salmon and sardines as these are rich in calcium), nuts, oranges, broccoli, lentil, spinach, parsley, prawns and dried apricots and figs are all good sources. I personally am not big on dairy products providing calcium as I see so many patients with intolerances to dairy and I think that dairy milk is only for baby cows, though I don’t mind hard cheeses, goat and sheep cheese alternatives.
Include good quality protein, oily fish, nuts and seeds and lots of fresh brightly coloured vegetables. Avoid carbonated fizzy drinks- high in phosphorus which leach calcium from bones. Smoking is a big risk factor for Osteoporosis.
Get your minerals in
There is a smart synergistic relationship in bone formation and calcium plays a minor part. Vitamin D, magnesium, boron vitamin K2 and zinc are all equally important nutrients and need to be in a balanced ratio.
Weight bearing exercises are important to maintain strong bones and a healthy weight.
For your peace of mind, if after preparing for menopause and if you it is too late to prepare and you are suffering with symptoms, natural therapies have many wonderful herbs and nutrients to help quell those hot flushes, mood swings and fatigue. The earlier you start preparing the better.
So to sum it all up, I think there are a few recurring themes here which go a long way to ensuring a healthy transition from peri to post menopause and maintaining general good health.
Maintain a healthy weight and enjoy moderate exercise including weight bearing such as yoga/Pilates/weights
Support your liver with daily and do an annual liver detox.
Consume a diet with good quality protein, antioxidant rich vegetables and fruit, oily fish, nuts and seeds.
Take time out, have a massage, walk in nature, meditate, manage your stress.
Filter your water and be mindful of environmental toxins. Choose organic where possible.
Look after your bones by quitting smoking, cutting out highly acidic processed food and carbonated drinks. Ensure adequate magnesium and good vitamin D levels.
And lastly, enjoy the process of leaving behind the insecurities of youth and middle age and embrace the wisdom and freedom of the latter years.