Perimenopause Support


Today’s “Ask the Nutrition Consultant” question comes from Ruth!

Q: Perimenopause symptoms are hitting me HARD – hot flashes and night sweats, moodiness, and an increase in belly fat. I know perimenopause can last for years (UGH!). Are there diet and lifestyle changes I can make to support my body to help make this transition easier? 

A: Thank you for your question Ruth. The symptoms you mentioned are very common and are due to the relative estrogen dominance we experience during perimenopause. Around the time women reach the age of 40 both estrogen and progesterone levels start declining. Progesterone starts dropping off a lot faster than estrogen does, creating an imbalance between the two hormones. This imbalance leads to estrogen dominance and the symptoms you mentioned above as well as: menstrual cycle changes (longer, shorter, lighter, heavier), breast tenderness, poor memory, loss of sex drive, vaginal dryness, difficulty sleeping, and PMS. 

The good news is that there are dietary and lifestyle modifications women can implement to support their hormones and reduce perimenopause symptoms. Ideally I would recommend all women follow this advice well before the age of 40, even in their 20’s and 30’s. This sets the stage for better hormone balance throughout your fertile years (less PMS, improved fertility) and an easier transition through perimenopause and menopause.

In order to support optimal hormone levels and address estrogen dominance we need to:

    • Support the: adrenals, thyroid, ovaries, digestion, liver detox, estrogen detox
    • Eliminate xenoestrogens
    • Limit toxins and chemicals
    • Eat a diet rich in vitamins, minerals, antioxidants, protein, and healthy fats
    • Reduce the consumption of refined grain and added sugars
    • Reduce or eliminate alcohol consumption
    • Manage stress
    • Exercise
    • Maintain a healthy weight 

Let’s Dig in a Little Deeper…

I mentioned a couple of endocrine (hormone) glands up above that need support – the adrenals, the thyroid, and the ovaries. All of these glands and hormones interact with and affect each other, and all must be supported in order to have balanced hormones. For example: high cortisol from the adrenal glands (stress) suppresses progesterone; thyroid hormone (T3) supports progesterone by increasing sensitivity of progesterone receptor sites; excess estrogen interferes with thyroid function and hormone production. As you can see from just those three examples there’s a whole lot of interaction going on between these three glands! We must support them all otherwise we risk throwing them all out of whack. 

Stress can contribute to estrogen dominance. As you learned above high stress raises cortisol levels which affects progesterone levels. High cortisol also raises blood glucose (blood sugar) levels and can increase the amount of abdominal fat we have. Most of us do not want increased belly fat, but this concern goes beyond aesthetics. Abdominal fat has the ability to synthesize estrogen from testosterone through a biochemical process called aromatization. This can further exacerbate estrogen dominance as we reach perimenopause. Learning stress management skills can be a game changer in your hormones, moods, and weight. 

Supporting the liver is also imperative for supporting hormonal balance. The liver metabolizes and breaks down estrogen so it can be excreted through our feces and urine. If the liver is busy detoxifying alcohol and other toxins it allows estrogen to continue circulating leading to (you guessed it!): estrogen dominance. To add to this, we need to be eliminating or having regular bowel movements (at least once per day) so that hormones and toxins are not reabsorbed in our colon. If you’re not eliminating daily we need to address this and get those waste products moving out easily and regularly. 

Dietary Support to Balance Hormones

We need adequate nutrients including healthy fats, proteins, vitamins, minerals, phytonutrients, and fiber to help with all of the processes mentioned above. We can help our body get the nutrients it needs for all of these functions by eating a plant based diet with lots of variety. Here are some general recommendations:

        • Consume 5 to 9 servings of vegetables and fruits per day.
        • Focus on cruciferous vegetables which support detoxification pathways in the liver.
        • Ensure essential fatty acid status. The ideal ratio of Omega-6 fatty acids to Omega-3 fatty acids is 3:1 or 1:1. The average American has a ratio of 25:1 which promotes inflammation.
        • Focus on hydration to support elimination.
        • Avoid or limit alcohol which raises estrogen levels and overburdens the liver. 
        • Eat fermented foods and fiber to support a healthy gut microbiome and elimination.
        • If consuming animal products, stick to animals that were fed a species appropriate diet (i.e. grass-fed beef and dairy; pasture raised chicken and eggs; wild caught fish). They will have more nutrients, a better Omega-6:Omega-3 fat ratio, and fewer hormones.

There are lots of herbs, supplements and teas on the market that claim to support healthy hormone levels and help relieve perimenopause symptoms. Some of them have scientific backing and are effective. These adaptogens will only be helpful if you are already doing all of the things listed above to support your hormones. They cannot replace a good diet or lifestyle changes. Before spending money on expensive supplements get everything else in order: improve your digestion and diet, manage your stress levels, get restful sleep, move your body, and reduce or eliminate alcohol. 

Lifestyle Support to Balance Hormones

A huge lifestyle change that can help with hormonal balance is switching to personal care and cleaning products that do not contain xenoestrogens and endocrine disrupting chemicals. Checking on the safety of your products is as easy as scanning the bar code in either the EWG’s “Healthy Living App” or an app called “Think Dirty.” As you use up products and need to replace them give them a scan, check the rating, and search for safer alternatives if necessary. 

Stress management is another area that often gets overlooked. High cortisol can wreak havoc on all of our hormones. Everyone tells us to “reduce our stress” but I feel that may be slightly unrealistic. There will always be stress, and we would be better served to learn how to better manage stress. Learning to manage stress may include seeking help from a therapist or counselor, starting up a meditation or yoga practice, or asking a spouse/partner/family member for help with household tasks. Exercise, which can be a great stress reducer, has the added benefit of improving insulin sensitivity, increasing muscle mass and bone density, and helping us burn excess body fat. 

Getting the Support You Deserve

Hopefully you have a better understanding of what causes perimenopause symptoms and some of the diet and lifestyle factors that can affect symptom severity. Women’s health concerns are finally starting to get the recognition and attention they deserve. No woman should have to suffer through PMS, fertility struggles, and awful perimenopause symptoms. It is possible to support our hormones through diet and lifestyle modifications and that is what I love to help women do! It can be hard to take an objective look at our habits and figure out where to make changes first. I’ve shared a lot of general info in this post, and they are great starting points. Start to implement one or all of them and see how you feel. If you’d like dietary and lifestyle recommendations specific to you, or if you feel like you may be a candidate to try some adaptogens or supplements for additional support call or e-mail me to set up a complimentary Nourish to Flourish Strategy Session. You can share your story with me and I’ll help you map out a road forward to optimal health. 

In Health, 

Amanda Watson, BCHN®

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