Thriving Through Perimenopause and Menopause with Deirdre Nazareth

Perimenopause and menopause are certainly hot topics right now, yet there is still a lot of confusion about what these terms actually mean. And it hasn’t been helped by the largely negative associations with which they have been portrayed and received in society. It’s no wonder many women are now so afraid of these normal life stages. Fortunately for us, knowledge in the field of reproductive ageing is increasing. By understanding the terminology and a bit of physiology, you can allay these fears and navigate these transitions with greater compassion, understanding, and more viable options for treating some of the more distressing symptoms.

With this viewpoint, the focus becomes: How can we best support ourselves from our mid to late 30s when hormonal shifts begin to impact our physical and mental flexibility, muscle and joint strength, weight gain, fatigue, brain fog, and mood changes? What small changes can we make on a daily basis that can give us the foundations to be even better and stronger than we were in our 20s? (Yes, it’s all possible).

What Causes Perimenopause to Occur?

This is the transitional time around menopause, the penultimate phase before the big finale, unique to women. It is not just a reproductive transition but also a neurological one involving many oestrogen-related systems. Oestrogen, our master regulator, has her hand in many “pies” or systems that include thermoregulation, circadian rhythm, sleep, and sensory processing. These systems also affect many areas of cognitive function.

Oestrogen functions through a network of oestrogen receptors to ensure that brain and energy (glucose regulation) metabolism work in a coordinated and rapid way. During perimenopause, this collaborative effort between the receptor network and energy system uncouples, resulting in both physical and mental symptoms along with imbalanced blood glucose levels. These imbalances can cause tell-tale signs like brain fog, anxiety, night sweats, waking at 3 or 4 a.m., skin and hair changes, and heart palpitations, etc.

The ovarian follicle is the main oestrogen producer, and menstrual cycles can change at the beginning of perimenopause. Little by little, your body’s natural ovulation process slows down, resulting in irregular periods — the most common first sign.

Perimenopause: Early Changes

The very early changes can be subtle but gradually increase over time through a period of 2-8 years (average 3-4 years), even a decade, depending on the person in hand. Furthermore, genetic and lifestyle factors, surgeries, and other kinds of trauma can accelerate or delay the onset of symptoms and phases. Symptoms can be mild, possibly not even noticeable in the early stages. In fact, many even tend to look back and realise they had perimenopausal symptoms. 

The symptoms of perimenopause can mirror the erratic ovulatory and hormonal fluctuations, namely oestrogen and progesterone, which usually start in the early to mid-40s and may include:

• Irregular or skipped periods of 7 days or more
• Heavy flooding from dropping progesterone levels; potential uterine pathologies such as endometriosis, fibroids, adenomyosis, polyps
• Shorter cycles
• Hot flashes
• Vaginal dryness
• Frequent urination
• Sleep disturbances
• Mood changes
• Weight gain

Perimenopause: Later Changes

Later transitional symptoms that typically present in the mid to late 40s include oestrogen and progesterone fluctuations that are greater, and cycle length typically extends due to the loss of regular ovulation. These are the symptoms which can be similar to those in the early transition, but are usually more marked with:

• Missed periods, with cycles extending to 60+ days
• More erratic oestrogen levels with loss of progesterone
• Skipped cycles with heavy bleeding at the next
• More marked cognitive issues such as brain fog, lack of focus or concentration
• Mood changes
• Fatigue
• Sleep disorders

As you can see, even the symptomatology is a big and broad arena in perimenopause, so I have compiled solutions from both a professional and personal standpoint to best support you, your mind, and your body to minimise the less desirable effects as you transition.

That begins with our mindset about perimenopause and menopause. Positive associations with these normal life stages increase overall confidence as we enter them.

These are simple but foundational strategies that should not be ignored. You don’t have to be super strict, but they need to be prioritised. Hormone replacement therapy (HRT) may still be necessary, but following these foundational strategies can help support added HRT.

1. Exercise

This is the time to focus on supporting your skeleton through resistance training rather than excessive cardio or too much HIIT. Overtraining and excessive cardio are energy and hormone-depleting. They increase cortisol production and further dysregulate an already dysregulated HPA axis. This can cause muscle loss, more mood changes, and drain energy.

Building bone and muscle is so important for the transitions because of the hormonal fluctuations and their impact on bone health. A full-body routine that focuses on progressive overloading gives all of your muscles a chance to rest and build strength to provide balance, flexibility, and support to your body and joints. Body-weight training is a good place to start, and there are many routines on YouTube or social media to follow.

2. Nutrition

Stay as close to whole and natural as possible and have a full range of macronutrients: protein, fat, and carbs. As we age and hormones fluctuate, our nutritional needs change. The most common macronutrient that is often too low is protein. We should have at least 1 gram per 1lb of body weight just to manage ourselves normally. These protein requirements change with hormone fluctuations, infections, and other types of stress. 

Understanding the role of each macronutrient and the basic principles of nutrition is never more important than as we transition through to menopause. To make hormones, we need fats (cholesterol) and protein (amino acids). It is important to make sure that whatever dietary strategy you follow, you are hitting your protein, fat, and carbohydrate requirements. Furthermore, eating enough of your macronutrients in the form of whole foods and both insoluble and soluble fibre choices helps to support a healthy gut microbiome, which is so crucially needed for oestrogen management.

3. Stress Management

It goes without saying that chronic or unmanaged stress is not helpful to anything, especially fluctuating hormones. Meditative and somatic practices that focus on diaphragmatic breathing are hugely beneficial here. Grounding practices, forest bathing, keeping your environment toxin and clutter-free, phone-free time, novel activities, and socially connecting in person are just some of the ways to help mitigate the impact of stress. 

Limiting alcohol intake can come under stress relief as a category because it is a stressor to the brain and body — and its impact is worse in perimenopause stages. But, if you do drink, ensure you stay optimally hydrated with foods/electrolytes and take supplements to help support liver and brain function (please see suggestions below). There are several meditation apps I suggest to you, such as Calm, Headspace, Healthy Minds Program, and Smiling Mind (the last two are free).

4. Sleep Hygiene

This can be difficult to maintain when the fluctuations of hormones can cause sleep disturbances, but it is really important to maintain a healthy circadian rhythm by going to bed and getting up at the same time. One of the reasons we don’t feel refreshed from sleep is our lymphatic system slows down as we age, so we need to manually stimulate it through diaphragmatic breathing.

This particular breathing action pumps our glymphatic system but also relaxes our nervous system so that we can breathe diaphragmatically. Additionally, breathing through our noses lessens the chances of sleep apnea, which can limit diaphragmatic breathing and create stress in the nervous system, encouraging jaw clenching or grinding that can further impede glymphatic flow. Wearable devices can really kickstart your sleep routine, such as Oura, Sensate, and Whoop. Manual lymphatic techniques such as dry skin brushing are also great ways to help improve overall circulation. I always have a herbal tea before bed, and Pukka makes a really great nighttime tea.

5. Supplementation

This alone can be a minefield with how many different options there are. It is a field that is sadly not well regulated, so it is really important to read your labels and stay aware. There are some key points to look out for when choosing a high-quality supplement. You have to consider the therapeutic effect, and this comes from the dosing amount in the bottle. Also, consider fillers and other potentially toxic compounds that can diminish the benefit of the supplement.

When it comes to perimenopause to menopause, you also want to consider what is included in the supplement to help manage the symptoms. Nutrients such as magnesium, vitamin D, omega fatty acids, and adaptogens are very important to have and perhaps best in a blend. Lastly, the delivery method is going to ensure you get those nutrients as quickly as possible. In this case, liposomal formulations (like Valerie’s liposomal product) really are the best to ensure quick absorption and assimilation or bioavailability.

• Valerie Daily Essential: Liposomal and highly bioavailable, this supplement contains adaptogens, vitamins, and minerals, along with its natural preservatives, sea buckthorn, which is high in antioxidants such as vitamin C and is anti-inflammatory, and rosemary extract, which is also anti-inflammatory and neuroprotective. 

• Heart and Soil: Her Package: Working well with Valerie’s Daily Essential, this product contains a blend of vital nutrients and peptides from grass-fed and finished ovary, uterus, fallopian tubes, liver, and kidney to support hormonal balance in perimenopause and menopause.

• Hifas Di Terra- Equilibrium: A potent extract blend of functional mushrooms to preserve balance for women with natural adaptogens, Reishi, Lion’s Mane, and Cordyceps. Also contains natural D2, vitamin C, and other bioactive compounds to improve bioavailability. Mushrooms tend to work very well in any supplement routine. But always check with a healthcare provider or natural health specialist if you are unsure.

Key Takeaways: Embrace the Journey

Remember, your journey through perimenopause and menopause is completely unique to you. If you embrace these natural transitions with a supportive mindset, and balanced lifestyle, these tools will love you back and help you to thrive every step of the way.

A special thanks to Deirdre

You can connect with Deirdre Nazareth and learn more at The Functional Osteopath and check her Instagram page: @thefunctionalosteopath.

We must all have at least one symptom that drives us up the wall — what’s yours? Did Deidre’s advice speak to you, or maybe you’ve got some wisdom of your own to share? In any case, we’re all ears! Drop us a DM — and let’s keep this conversation alight!

Time to take control

Put on your big girl boots. Diedre said it best, our winning formula has what it takes. 

Still wondering how Valerie’s Daily Essential Liposomal Shot can help kick some proverbials? Well, take a peek and find out!

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Keep your eyes peeled on our blog page.

Plenty more where that came from… We love to hear wise words from the professionals and our series is set to cover many vital topics around women’s health. With every newsbreak, rest assured — we’ll be there for you, separating fact from fiction. 

Learn more about symptoms, HRT, and what doctors think

‘Am I in perimenopause?’ — We’ve heard that one before.

Keen on understanding more about common symptoms of perimenopause? Check out our blog on Understanding Perimenopause with Dr. Linsey Leach, it’s well worth a read.