Perimenopause is a process, not a disease.

Let me say that again: Perimenopause is a natural process, a stage in the journey of a woman’s life. It is NOT a disease state that requires medical intervention.

Like puberty.
Like pregnancy.
Like labour & delivery.

In my practice, it shows up as

• the 40-year-old who can’t get pregnant;
• the woman who’s tried everything to lose the 20 lbs that showed up overnight and refuse to leave;
• the woman who can’t sleep at night, yet can hardly keep her eyes open all day;
• the confidant woman paralysed with anxiety;
• the woman who wants a new job and can’t stand the site of her husband…let alone have sex with him;
• the woman who walks into a room and…wait a sec, what was I saying?

She’s anywhere between 35 and 50, yet she feels like you may as well just buy her a flowered hat and sign her up for shuffleboard.

“Nobody talks about this,” my girlfriend complained the other day. And yet, we’re all (not so) silently suffering through its effects.

Is this all you have to look forward to?

Not at all.

Perimenopause is a transition. Depending on your attitude and willingness to work with the waves, it can be navigated smoothly, albeit not always gracefully.

As a holistic nutrition student, I learned that menopause is “simply” puberty in reverse.

Puberty:

1. Ovaries produce estrogen (boobs, pubic hair, curves + uterus develops + bleeding starts)
2. Progesterone kicks in (ovulation + body ready to maintain a pregnancy)

Perimenopause (= around menopause):

1. Progesterone production declines (ovulation stops)
2. Estrogen dwindles (stop bleeding = menopause after 1 year without a period)

But we aren’t simple creatures, as the men in our lives like to remind us: we’re complicated. (I prefer the word complex.)

First of all, puberty got rolling a good 3 years before you actually got your period and continued to fine-tune for a few years after. (Remember all those years of feeling more like a moody alien than a normal teenager?) The transition out of child-bearing mode takes its time as well, with just as many mood swings. About 10 years, and you might even start feeling the symptoms of hormonal shifts in your 30s.

The complexity comes from the fact that these processes involve much more than just your 2 female hormones.

All the glands of the endocrine system work in concert. (Skip the green box if you’re already familiar with this system.)

The Endocrine System – Click on the image for easier reading

If other aspects of your endocrine system’s out of whack, your sex hormones won’t be able to do their job properly. (Which impacts periods & pregnancy as well as perimenopause.)

When your sex hormone production begins to wane in your 40s, the other hormones change their tune to create a new harmony. Generally, that interplay happens most dramatically with the thyroid and adrenals. If those two musicians aren’t feeling their best: the perils of perimenopause.

The key players in this crazy dance:

Cortisol (from the adrenals) gets into action to keep you safe and able to cope during occasional times of strife. It keeps you alert to potential danger and ready to make a hasty retreat if necessary.

Unfortunately, we’ve set up our lifestyles in such a way as to keep that state of emergency going constantly. (To read more about this concept, click here.)

When stress gets the best of you, or you can’t get out of bed in the morning, that’s cortisol out of whack.

On the other hand, you know that elated mood you’re in about a week after your period, like someone lifted a veil? You know the peaceful, blissful state, like you’ve never looked or felt better than in your 2^nd trimester of pregnancy? That’s progesterone at work.

Progesterone calms the brain as part of its job to keep you zen & happy while pregnant.

Given the way that cortisol can dominate progesterone (see #3 in the green box), it’s not hard to see why so many women of this age suffer from anxiety.

Estrogen is like the Enjoli of the body. You remember the ad?

“I can bring home the bacon, fry it up in a pan, and never, ever let you forget you’re a man, ‘cause I’m a wo-o-oman.”

Ah yes, the epitome of the 70s women’s movement – elbowing in to take our place in the boardroom without giving up power in the bedroom, all while keeping up the housework.

The main peril of this life stage is estrogen dominance, the state in which estrogen is too high relative to progesterone.

It happens because of progesterone decline, progesterone resistance (see the green box), or because diet & lifestyle increase your exposure to xeno-estrogens & estrogen mimics from chemicals.

In terms of attitudes and ideals, it’s easy to see how this state has energetically become so prominent these days. Modern women focus most of the our energies into being sexy, successful, multi-tasking CEOs and push aside the instinct to make babies until much later, if at all.

Part of estrogen’s job is to enhance our female wiles to snag a mate, then give us the wherewithal to raise/maintain/hold together a family. One part of this particular super-power means that estrogen (along with her sister progesterone) makes us more, umm, let’s call it open to compromise.

I heard it best described in a conversation between Marc David and Dr. Sara Gottfried (during the Psychology of Eating Conference in July). One of them said something like, we spend childhood just being ourselves, go through the 1^st change to become accommodating for about 35 years and then go through the 2^nd change to be our (true) selves again.

Estrogen dominance also disrupts thyroid function (through iodine displacement as described in the green box).

Thyroxin modulates metabolism, that is, your energy levels and your ability to lose weight. The thyroid gland sits in your throat, the middle of the 5^th chakra, the emotional centre of expression and judgment. Your Voice.

It’s interesting to note that the hormone, which defines the first half of womanhood, also keeps the ability to speak your truth in check.

One thing for sure, once you get to the end of the fertile leg of the journey, once the estrogen levels off to a minimum, you no longer give a shit what others think. I see women in perimenopause all around me compelled to say what they have to say, do what they have to do, wear what they want to wear. It’s no wonder job and husband dissatisfaction are high on the perimenopausal complaint list.

(This by no means insinuates you have to change them – unless you do – but it means you need to reassess priorities and relationships. You may need to learn a few new dance steps with your sweetie, your colleagues, even your girlfriends.)

I could go on about all of this. In fact, as I wrote this, I realized that I could develop each sentence into a paragraph, each paragraph into a chapter…hmm, now there’s an idea… For now, I’ll keep it “simple”.

Is there a “simple” way to address the complexity?

You bet: reduce estrogen dominance.

HERE ARE 3 WAYS TO START:

1. Reduce exposure to xeno-estrogens.

Opt for household cleaners with natural ingredients (never anything chlorine based).
Pull out your grandmother’s old cleaning tricks.

2. Clear out/displace the excess.

Eat 7-10 servings of vegetables each day. Vary the types and colours; always include leafy greens, sea vegetables and (cooked) cruciferous.
Eat legumes (pulses) at least 3 times a week.
Eat good quality protein and fats (building blocks for all your hormones) at each meal.

Make it simple: vegetarian chili with sliced avocado

3. Reduce mental-emotional stress

Hang out with your girlfriends
Hang out in Nature (sunshine!).
Move in a way that you love, be it Zumba or running, surfing or dancing,…

Even simpler: Take a walk in the park with your BFF.

(For more detailed information about reducing estrogen dominance, click here.)

As I said, this is really just the tip of the iceberg, but let’s get this conversation happening. I’d love to hear about your experiences. Let’s support each other through this transition, to land softly grounded on the other side.

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