Is this perimenopause?

Symptoms, signs & what to do

Common Perimenopause Symptoms

Hot Flashes

Hot flashes occur due to hormonal changes, particularly the decline of estrogen. These can be experienced as intense heat, sweating, dizziness, tingling extremities, chills, nausea, night sweats, head pressure, and or heart palpitations.

Why It Happens

  • Decline in estrogen: Most research points to a drop in estrogen causing the narrowing of the brains thermoregulator which disrupts temperature regulation.

What May Help

  1. Avoid spicy food and alcohol: Triggers like these can dilate blood vessels and raise body temperature, increasing the risk of hot flashes.

  2. Layer clothing: Wearing layers, and breathable clothes helps you adjust your body temperature quickly.

  3. Use a desk fan to keep cool: Using a desk fan can help keep you cool and less likely to have a hot flush.

  4. Deep breathing, yoga and meditation: These practices calm the nervous system and lower stress which may improve thermoregulation.

  5. Exercise and movement: Regular exercise supports overall hormonal balance and helps minimise flashes.

  6. Magnesium: Magnesium supports nervous system health and may play a role in temperature regulation and hormonal balance.

  7. Menopausal Hormone Therapy (MHT): MHT can help alleviate cognitive issues associated with menopause by restoring estrogen levels. However, it's important to discuss potential risks and benefits with a healthcare provider to determine if MHT is appropriate for you.

Memory Issues

During menopause the decline of estrogen and progesterone can impact brain function, leading to symptoms such as brain fog, memory loss or trouble concentrating.

Why It Happens

  • Decline in estrogen: Estrogen plays a crucial role in brain function influencing areas involved in memory, attention and processing speed.

What May Help

  1. Diet: Maintaining a balanced, healthy diet rich in nutrition supports brain health.

  2. Exercise: Engaging in moderate-to-vigorous physical activity has been shown to reduce brain fog and enhance cognitive function.

  3. Adequate sleep: Getting a good night’s sleep is essential for cognitive function.

  4. Supplements: Supplements such as magnesium and taurine are beneficial for brain health, and vitamin B12 deficiency can include fatigue and brain fog. Consult with a healthcare provider before starting any supplements.

  5. Menopausal Hormone Therapy (MHT): MHT can help alleviate cognitive issues associated with menopause by restoring estrogen levels. However, it's important to discuss potential risks and benefits with a healthcare provider to determine if MHT is appropriate for you.

Sleep Disturbance

Perimenopause and menopause can cause hormonal changes that interfere with a good night’s sleep. This can cause you to have trouble falling asleep, staying asleep, or waking early.

Why It Happens

  • Hot flashes and night sweats: Surges in body temperature can wake you multiple times, making it hard to stay asleep.

  • High histamine during high estrogen phase: High estrogen can increase histamine levels which may contribute to insomnia or anxiety.

  • Lower progesterone and melatonin: Falling and staying asleep can be more difficult because progesterone is calming and melatonin promotes sleep.

  • Disrupted circadian sleep rhythm due to low estrogen: Estrogen plays an important role in the sleep cycle which can be disrupted due to estrogen levels dropping.

What May Help

  1. Morning sunlight exposure: Getting sunlight in the morning helps to regulate your circadian rhythm and improve your sleep.

  2. Exercise and movement: Getting regular physical exercise can help to alleviate menopause symptoms and improve sleep.

  3. Deep breathing, yoga or mediation: Practices such as these can reduce anxiety, promote relaxation, improve mood and sleep.

  4. Limit technology and blue light exposure before bed: Blue light from screens can interfere with melatonin production disrupting sleep.

  5. Dim the lights at night: This signals to the brain that it’s time to relax, supporting melatonin production and a better sleep.

  6. Supplements such as magnesium, glycine, taurine, and melatonin: Certain supplements may support sleep. Consult with a healthcare provider before starting any supplements.

  7. Menopausal Hormone Therapy (MHT)

    MHT can assist menopausal symptoms such as hot flashes and night sweats, leading to improved sleep quality. However, it's important to discuss potential risks and benefits with a healthcare provider to determine if MHT is appropriate for you.

Mood Issues

Hormonal changes during menopause can impact mood. This can be experienced as depression, anxiety, overly tearful, total lack of motivation, fear, irritableness and even rage.

Why It Happens

  • Estrogen and progesterone fluctuations: The decline of estrogen and progesterone can significantly impact mood regulation.

  • Serotonin changes: Hormones such as estrogen influence the production of serotonin, which is a mood-regulating neurotransmitter.

  • Other menopause symptoms: Hot flashes, night sweats, weight gain and fatigue can all impact mood.

What May Help

  1. Lifestyle changes: Eating a healthy nutritious diet, getting regular exercise and practicing calming techniques such as yoga and meditation can all help improve mood.

  2. Morning sunlight: Exposure to natural light first thing in the morning helps boosts serotonin, a key neurotransmitter involved in mood balance.

  3. Time in nature: Spending time outdoors has been shown to reduce cortisol, improve mood and increase feelings of well-being.

  4. Self-care: Taking baths and getting regular massages can be great for the nervous system and enhance relaxation.

  5. Laughter: Laughing releases endorphins providing a natural lift in mood.

  6. Supplements: B Vitamins, Magnesium, Fish Oil

    • B Vitamins (especially B6, B12, and folate) support the nervous system and are essential for neurotransmitter production.

    • Magnesium helps regulate the HPA axis, which manages stress response.

    • Omega-3 Fatty Acids (from fish oil) support brain health and have been linked to reduced depression and anxiety.

Energy Loss / Fatigue

Hormonal fluctuations during perimenopause can lead to fatigue and energy loss. This period typically begins in a woman's 40s and can last several years, with symptoms varying widely among individuals.

Why It Happens

  • Hormonal changes: Declining levels of estrogen and progesterone during perimenopause can disrupt sleep patterns and mood, leading to increased tiredness and decreased energy levels.

  • Sleep disturbances: Night sweats and hot flashes are common during perimenopause and can significantly disrupt sleep, resulting in daytime fatigue.

  • Anemia: Heavy menstrual bleeding, a frequent occurrence during perimenopause, can lead to anemia, characterized by a decrease in red blood cells, which may cause fatigue.

  • Mood Didsorders: Increased susceptibility to mood disorders such as anxiety and depression during perimenopause can contribute to feelings of fatigue.

What May Help

  1. Regular exercise: Engaging in physical activity can improve sleep quality and boost energy levels.

  2. Balanced diet: Consuming a diet rich in iron, B vitamins, and magnesium can help combat fatigue.

  3. Adequate hydration: Staying well-hydrated is essential, as dehydration can exacerbate feelings of tiredness.

  4. Stress management: Practicing relaxation techniques such as mindfulness or meditation can help reduce stress and improve energy levels.

  5. Menopausal Hormone Therapy (MHT)

    MHT can assist menopausal symptoms which can assist better energy. However, it's important to discuss potential risks and benefits with a healthcare provider to determine if MHT is appropriate for you.

Weight Gain

As estrogen levels decline during perimenopause, the body may become more prone to storing fat, especially in the abdominal area.

Why It Happens

  • Loss of estrogen: The decline of estrogen can affect your bodies ability to turn fat into energy and insulin sensitivity, making it easier to gain weight even without changes in diet.

  • Muscle mass decline: A decrease in muscle mass, which naturally occurs with age, leads to a slower metabolism. This means fewer calories are burned at rest, contributing to weight gain if dietary habits remain unchanged.

  • Insulin sensitivity reduction: Fluctuating hormones can lead to changes in insulin sensitivity, making it easier for the body to store fat and harder to burn glucose, leading to weight gain even if diet and exercise habits haven't changed.

  • Stress and sleep disturbances: Elevated cortisol levels can increase appetite and fat storage, particularly around the midsection.

What May Help

  1. Regular exercise: Physical activity can help increase muscle mass, boost metabolism, and improve insulin sensitivity. Incorporate both aerobic exercises and strength training into your routine.

  2. Balanced diet: Focus on a diet rich in fruits, vegetables, lean proteins, and whole grains. Limiting processed foods and sugars can help manage weight.

  3. Stress management: Practice relaxation techniques such as mindfulness, meditation, or yoga to reduce stress and lower cortisol levels.

  4. Adequate sleep: Aim for 7–9 hours of quality sleep per night to regulate hormones and prevent weight gain.

Muscle and Joint Pain

Perimenopause often brings about muscle and joint pain, which can significantly impact daily life.

Why It Happens

  • Decline in estrogen: Estrogen plays a crucial role in maintaining joint health by reducing inflammation. The loss of estrogen can cause women to experience increased joint stiffness and pain.

  • Decline in progesterone: Progesterone also has anti-inflammatory properties and helps in maintaining muscle relaxation.

  • Increased Cortisol Levels: The hormonal changes during perimenopause can lead to elevated cortisol levels, the body's primary stress hormone. High cortisol levels can increase inflammation and exacerbate pain perception.

  • Fibromyalgia: Some women may experience fibromyalgia-like symptoms during perimenopause, characterized by widespread muscle and joint pain, fatigue, and sleep disturbances. These symptoms can be triggered or intensified by hormonal changes.

What May Help

  1. Exercising: Engaging in low-impact activities such as swimming, walking, or cycling can help maintain joint flexibility and muscle strength. Strength training exercises are also beneficial in preserving muscle mass.

  2. Stretching and Flexibility Exercises: Incorporating stretching routines, yoga, or Pilates can improve joint mobility and reduce muscle stiffness.

  3. Heat and Cold Therapy: Applying a hot compress can help relax tense muscles, while a cold compress can reduce inflammation and numb sharp pain.

  4. Stress Management: Practicing relaxation techniques such as meditation, deep breathing exercises, or mindfulness can help reduce stress and its associated impact on pain perception.

  5. Adequate Sleep: Ensuring sufficient and quality sleep is crucial, as poor sleep can exacerbate pain and reduce the body's ability to repair and recover.

  6. Magnesium supplements: Magnesium possesses anti-inflammatory properties that can help reduce inflammation in the joints.

  7. Menopausal Hormone Therapy (MHT): For some women, MHT can help alleviate menopausal symptoms, including muscle and joint pain, by replenishing estrogen levels. However, it's important to discuss potential risks and benefits with a healthcare provider to determine if MHT is appropriate for you.

Allergies

Perimenopause can be associated with the onset or worsening of allergy symptoms due to the loss of estrogen. This hormonal change can affect the immune system, making it more sensitive to allergens such as hayfever, eczema, hives and asthma.

Why It Happens

  • Hormonal Fluctuations and Immune Response: Estrogen and progesterone influence immune cell activity. As these hormones decline during menopause, the immune system may become more reactive to allergens, leading to stronger or newly developed allergic reactions.

  • Histamine Production: Falling estrogen levels can increase histamine production in the body. Histamine is a chemical involved in immune responses, and its increased levels can lead to allergy symptoms such as itching, sneezing, and congestion.

    What May Help

  • Identify and Avoid Triggers: Keep a symptom diary to track when and where your symptoms occur. Common triggers include pollen, dust mites, pet dander, mould, and certain foods. Once you know your triggers, avoid them as much as possible.

  • A low-histamine diet: By avoiding foods that contain high histamines, this may help reduce overall histamine release and relieve allergy-like symptoms.

  • Maintain a Clean Living Environment: Regularly clean your home to reduce exposure to allergens. Vacuum carpets and upholstery frequently, wash bedding and curtains regularly, and maintain low humidity to prevent mould growth.

  • Practice Stress Management: Stress can exacerbate allergy symptoms. Engaging in relaxation techniques such as meditation, deep breathing exercises, or yoga can help reduce stress and improve overall well-being.

  • Menopausal Hormone Therapy (MHT): MHT can help alleviate menopausal symptoms, including those related to allergies, by restoring estrogen levels. However, it's important to discuss potential risks and benefits with a healthcare provider to determine if MHT is appropriate for you.

Menstrual Changes

During perimenopause, women often experience significant changes in their menstrual cycles due to fluctuating hormone levels such as irregular periods, heavier or lighter bleeding, spotting between periods, longer or shorter cycles or missed periods.

Why It Happens

  • Estrogen and Progesterone Imbalance: As ovulation becomes less regular, the balance between estrogen and progesterone is disrupted, leading to changes in the menstrual cycle.

  • Irregular Ovulation: Inconsistent ovulation can result in missed periods or changes in cycle length.

  • Uterine Lining Changes: Hormonal fluctuations can cause the uterine lining to thicken and shed irregularly, leading to heavier or lighter bleeding.

What May Help

  1. Track your cycle: Keeping a menstrual diary or using an app helps identify patterns in your changing cycle and can be useful when discussing symptoms with your doctor.

  2. Lifestyle and nutrition: Getting regular exercise, eating am anti-inflammatory diet and limiting alcohol and caffeine can help regulate hormones.

  3. Menopausal Hormone Therapy (MHT): MHT can help regulate cycles and easy heavy bleeding. However, it's important to discuss potential risks and benefits with a healthcare provider to determine if MHT is appropriate for you.

Gut Health

The decline in estrogen can significantly impact gut health. These changes may lead to digestive issues such as bloating, gas,constipation, diarrhea, and increased sensitivity to certain foods.

Why It Happens

  1. Hormonal Fluctuations: Declining estrogen and progesterone can impact gut mobility and gut mircobiome balance.

    What May Help

  2. Eat more fibre: Fibre feeds healthy gut bacteria and supports regularity. Include whole grains (oats, quinoa), legumes, fruits, and vegetables.

  3. Probiotics and prebiotics: These support the gut microbiome by improving digestion and may reduce inflammation and estrogen imbalance.

  4. Drink good quality water: Water supports digestion and stool softness.

  5. Limit sugar and processed foods: These may promote harmful gut bacteria and worsen inflammation. Reducing refined sugar and ultra-processed foods supports a healthier gut environment.

  6. Stress management: Chronic stress activates the gut-brain axis and may worsen bloating or IBS symptoms.