June 1, 2021 by Megan Dahlman
(Peri)Menopause - Everything You Need To Know
The hormonal shut-down process… dun, dun, dun. I know the word menopause sounds scary and like “the beginning of the end”, but it doesn’t have to be. I think one of the reasons that menopause and Peri-menopause is scary is because it’s so darn confusing. (Sidenote: We go through so many confusing seasons with our bodies, right?) It feels like every decade is a whole new experience with something new to learn about, wrestle with, accept, and finally love. All of these phases and transitions in our bodies have been designed by God for a reason.
So, on today’s episode I’m going to bring you a LOT more clarity to this season of life. You’re going to find out what’s actually happening in your body, all the typical symptoms of this hormonal change, and specific tips for your exercise and your nutrition during this phase. Consider this your one-stop-shop for all things menopause. Are you ready?
Why does this word have to sound so ugly? The moment the subject of menopause is breached in our minds, we have a feeling of doom, a sense of failure, and the idea that “this is the beginning of the end”.
In our 20’s and 30’s, we tend to undergo a sort of grieving process for what our pre-baby body was like and have to face the reality of a postpartum body. (Which, of course, we soon realize is still quite amazing.) As soon as we learn to accept and love our postpartum bodies, a whole new curveball gets thrown at us in our 40’s and 50’s… menopause.
As women, our bodies simply don’t stay the same for very long, especially if we have babies. Every decade is a new experience with something new to learn about, wrestle with, accept, and finally love. None of this is accidental or “not-fair”, even though it feels like it at times. Each phase and transition has a phenomenal purpose, a design that God specifically intended for a reason.
(I don’t know about you, but I think it’s pretty thoughtful that God put a natural end to our child birthing years. Thank you, Lord!)
What is Menopause?
Menopause is technically when the ovaries stop releasing eggs and menstruation comes to a complete end, determined as 365 days since your last period. The timing of menopause is different for every woman, but in the U.S., 85% of women will have entered menopause by the age of 51.
The hormonal shutdown process may take years leading up to this. This transition phase leading up to and then one year after actual menopause is called perimenopause and may last for 4 to 8 years. Many factors can determine age of menopause including lifestyle, diet, genetics, reproductive history, cultural factors, ethnicity and social factors.
In general, it's somewhat difficult to determine if someone is transitioning into menopause, or is in perimenopause. Irregular periods may be your first sign. If you also experience some of the symptoms of menopause like hot flashes, difficulty sleeping and/or mood swings, this could be another indicator. Because our hormone levels naturally fluctuate so much throughout our cycles, it's difficult to say you're transitioning to menopause based on blood hormone levels, so doing a blood test may not be helpful.
However, if you're younger than 40 and are suspicious about your symptoms, your doctor may choose to test your hormone levels.
What is actually happening?
As we age, our hormone production slowly decreases. Our brains normally produce a large enough dose of FSH (follicle stimulating hormone) and LH (luteinizing hormone), which in turn send a signal to our ovaries to produce estrogen and progesterone in a well-balanced cycle that builds up our uterine wall, releases an egg, sheds the uterine wall, and does it all over again. This is our menstrual cycle.
But with less and less hormone production, the signals become smaller and smaller…almost like someone whispering to you from the other side of a football field, “Hey, release an egg.” Yeah, no. Not gonna happen…I heard none of that.
Another factor in play is that we store and release a significant amount of these sex hormones (estrogen and progesterone) in body fat, which is normally not a big deal. But as our ovary production declines, having excess body fat can really tip the hormone scales in the wrong direction, making our body really confused, possibly intensifying the symptoms of menopause. This is another reason to make sure our body fat percentage is in a healthy range during this stage of life (18-22% body fat).
In general, the hormone progesterone takes a nosedive a lot more than estrogen. Between the ages of 35 and 50, progesterone will have declined by about 75%, whereas estrogen will have only declined by about 35%. Around the age of 50, you have a significantly higher amount of estrogen compared to progesterone. As you continue to age (60+), estrogen will continue to decline and eventually be more relative to progesterone again, albeit with both hormones at a very low level.
The imbalance of progesterone to estrogen is a huge cause of menopausal symptoms. Many women, with their doctor’s recommendation, will opt for some form of hormone replacement therapy, usually progesterone. This seems to ease the symptoms of such a steep decline in natural progesterone production.
There are three types of the hormone estrogen: estriol (produced during pregnancy), estradiol (produced by the ovaries and is the most common), and estrone (the most dominant during menopause). Estradiol is the most potent type of estrogen.
Estrogens are powerful little hormones, which makes many of the issues that women face during menopause much more understandable. Estrogens (specifically estradiol) strongly influence how much and where body fat is deposited; they influence muscle mass; they have properties that protect the cardiovascular system; and they stimulate bone formation and inhibit bone breakdown.
Oh and guess what?! There's more. Estradiol is a natural appetite suppressant, it helps regulate body temperature, it’s associated with decreased fat storing enzymes, and it helps you use fat as a fuel source during exercise more readily. So, when estradiol tanks…well, you get the picture.
In fact, lower levels of estrogen in comparison with testosterone are related to more intra-abdominal fat, or fat that is stored around the midsection. Yep.
Now you can see why in the absence of estrogen, all of these things suddenly become an issue. It’s all starting to make sense.
So, no you're not going crazy if you suddenly have a huge appetite, your body temperature is all over the place, and you begin storing more fat around your midsection. You can blame your waning estrogen levels.
Typical Menopause Symptoms
Each woman experiences menopause a little differently, although there are some consistent symptoms, which I’m sure you are well aware of:
- Hot flashes
- Mood swings and depression
- Osteoporosis risk
- Cardiovascular disease risk
- Vaginal dryness
- Changes in sex drive
- Changes in breast tissue
- Digestion issues
- Bloating (from new digestion issues)
- Brain fog
- Difficulty losing fat
- Feeling jittery
- Hair loss
- And so much more! (Yay!)
While one woman may experience a certain set of symptoms very strongly, another woman could experience a whole other group of symptoms. There’s no telling how exactly you’re going to experience perimenopause and menopause. But as you’ve seen from the previous section, when your progesterone and estrogen levels plummet, nearly every system in your body is affected in one way or another.
Fortunately, there are specific things that you can actively do to manage the symptoms and feel a little more “even keel” during perimenopause and beyond.
What You Can Do About It
There is no cure for menopause.
Yes, that statement sounds ridiculous, because, duh!, we all know that there's no cure. It's going to happen no matter what. Fortunately, though, there are action steps that you can take to ease the transition and to relieve the symptoms you may experience.
To come out the other side of all this feeling no worse for wear, the most important things you can do are to be very physically active and eat as healthy as possible. The effects of having poor eating habits and being sedentary are dramatically increased during menopause. If you used to have a little “wiggle room” before with your habits, your wiggle room is probably gone.
Imagine trying to run up a steep hill with a flood of water rushing down on you at the same time…the descending flood being your hormones. It’s not impossible to get up that hill, but it is much more difficult than when the flood of rushing water isn’t there. It's going to require more discipline, consistency, and intention than ever before.
Tips for Exercise
For menopausal women and exercise, these three things are the most important:
- Building and maintaining muscle mass
- Stimulating bone density
- Improving metabolic output (your metabolism)
Fortunately, there is one style of training that can do all three of these things at once: Strength/Resistance Training.
MUSCLE MASS: When you lift weights and move your body against a resistance (and it can even be a well-designed bodyweight program), your muscles are challenged and stimulated to create more muscle tissue.
Creating muscle tissue is very difficult to do without resistance. You must push, pull or lift something heavy! Having adequate muscle mass is key as you navigate through menopause and beyond.
BONE DENSITY: Your muscles are attached to your bones along the full length of them. When your muscles contract against a heavy resistance, this pulls on the bones. (We know this, because in turn, your limb moves.) When your bones are repeatedly exposed to this type of muscle pull, they will stimulate more bone cell production. Therefore, denser bones! And the heavier the resistance, the more your bones are stimulated.
Walking and other impact style exercises also work to create denser bone structure, but for many menopausal women, walking/jogging is not an option and downright uncomfortable. Fortunately, resistance training actually has an edge over other weight bearing activities for its effectiveness at improving/maintaining bone density.
METABOLISM: The more muscle mass you have on your body, the higher your metabolism. Period. Most women assume that their metabolism declines as they age, and there’s nothing they can do about it. Actually, it’s more likely that their declining metabolism is largely due to declining muscle mass.
If you can preserve and build as much muscle mass as possible through strength/resistance training, your metabolic output will be much higher, and you’ll have an easier time running up that metaphorical hill mentioned earlier (remember, the one with the rushing flood of hormones?). Keep this in mind: faster metabolism equals less body fat storage.
To make sure that you are getting adequate amounts of physical activity, it’s good to aim for a total of 5 hours of exercise per week. Wow, that's a lot! This certainly doesn’t need to be 5 hour-long hard workout sessions. This could be 3 or 4 resistance training workouts plus a couple hours total of walking, jogging, swimming, cycling or other types of purposeful activity. I know many menopausal women that particularly enjoy doing yoga in addition to their weight lifting sessions for improved balance and flexibility...because yes, balance and flexibility decline as we age, too!
This 5-hour goal could seem so far beyond where you’re currently at, but you can certainly build up to that over the course of a year or two. Perhaps, start with just two beginner strength training workouts per week with some extra walking, and then every two or three months introduce some more.
Fortunately, the benefits of regular exercise extend beyond bones and muscles. Physical activity improves your mood, helps you sleep better, and has been shown to have a positive impact on hot flashes.
Tips for Nutrition
The most important thing with your nutrition during menopause is that you’re working from a foundation of healthy eating habits. Many women in their 40’s, 50’s, and 60’s have a long history of yo-yo dieting and emotional eating tendencies. It’s crucial to break these cycles and create a consistent pattern of eating clean and healthy food. No more dieting!
Here are some very basic guidelines to help you consistently choose healthy foods:
- Make sure you’re eating meals at regular intervals throughout the day. If you skip meals, you're missing nutrient and metabolism-boosting opportunities!
- Every time you eat, choose lean protein (for those muscles and metabolism!) and plenty of fresh produce. (Just think "eat your PRO's!"
- Avoid processed and packaged foods as much as possible. Aim for fresh, real food.
If you can follow through with these habits day-in and day-out, you will be in a much better place to handle the majority of the menopausal symptoms.
More Menopause Food Specifics
Now, here are some more specific things to consider with your nutrition during this season:
FOODS THAT SEEM TO EASE SYMPTOMS:
In general, aim to eat a lot of plant foods including vegetables, fruits, beans, whole grains, nuts and seeds.
Green leafy veggies, nuts and seeds, and legumes are particularly high in calcium to help with bone density.
Bell peppers, broccoli, citrus fruits, potatoes and yams are high in Vitamin C, which will help improve your mood and help your muscles grow better.
Wild rice, brown rice, quinoa, buckwheat and green leafy veggies are high in Vitamin B and serotonin, which also help to improve your mood and overall energy.
For hot flashes, you can try eating flax meal daily, and consider including one serving of whole soy foods daily, like edamame, tofu or tempeh.
It’s also important to take fish or algae oil supplements, which will improve your sleep quality, may help reduce mild depression, and manage your cardiovascular disease risks.
For more help with sleep, try avoiding protein, sugar, fat, and beans right before sleeping, as these take a lot of work to digest. You may find that a small (make sure it’s small) serving of starchier carbs in the evening helps, as it stimulates the release of serotonin. Having a banana or a piece of whole grain toast should do the trick. (Don’t run off the deep end with that suggestion, please!) Melatonin or Unisom may be helpful, but there are side effects with any sleep aid. Be sure to create a good bed time routine with a very predictable sleep schedule, which is the most helpful thing for improving sleep quality.
Drinking plenty of water and decaffeinated tea is important for alleviating symptoms, too.
FOODS THAT SEEM TO AGGRAVATE SYMPTOMS:
Your menopausal symptoms will most likely be magnified when you eat processed foods , especially processed carbohydrates like chips, crackers, and refined grain breads and pastas. You may also notice that processed carbs do a number on your digestive system, as well.
Refined sugars will also make your symptoms far worse, so limit the amount of candy, sweets and sugary beverages that you consume. Make sure to deliberately save these for very special occasions.
Pay attention to how you feel when you eat large amounts of meat and dairy products. Sometimes these foods, especially processed varieties, may leave you feeling pretty uncomfortable.
Caffeine and alcohol consumption will impact your sleep quality as well as other menopausal symptoms (weight gain!). Caffeine has also been shown to trigger hot flashes, so you may feel best limiting your caffeine consumption. Spicy foods, citrus foods, and large meals in general seem to aggravate hot flashes, too.
It might feel like it wasn't that long ago that you could enjoy a dessert with a cup of coffee in the evening, but now it seems to wreak havoc on your entire body! Try to get in the habit of opting for decaffeinated beverage options and passing on the sugary treats, choosing fruit or high cacao percentage chocolate instead. You will probably feel immensely better.
Whew! Ok, that was a lot of information.
Let's just simplify all of these eating recommendations and aim to...
- avoid processed foods, added sugar, and caffeine,
- aim for eating a really wide variety of plants and lean proteins,
- consider eating a small amount of soy-based foods and/or flax meal daily,
- drink water and tea,
- and consider taking a fish or algae oil supplement.
Not Scary At All
Menopause does not need to be so scary. While it's true that "there's no cure", and enduring a hormonal shutdown process is inevitable, there are plenty of things you can do to mitigate the negative side effects.
Right now is the best time to make your health a major priority. Remember, because of the hormonal environment during menopause, you no longer have the freedom or "wiggle room" to be flippant with your choices.
But being disciplined and intentional with your exercise and your eating habits will pay dividends through these years and beyond.
Sign Up for our weekly podcast newsletter so that you can receive all our exclusive updates