I'm Hormonal | functional hormone insight + advice

Perimenopause: what to know about midlife's hormonal shift | Ep. 27

• Episode 28

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#28. Perimenopause? She's menopause's sister and is our topic for today. The transitional time between your regular fertile/cycling years and your non-menstruating years (menopause) can illicit changes in your hormones and the way you feel normally starting in your late 30s or 40s.

Listen to this episode to hear about:
- What perimenopause is
- What are the phases of perimenopause
- What you can do now to prepare your body for perimenopause

I referenced Dr. Lara Briden's book, Hormone Repair Manual, to build my notes for this episode. Great reference... check it out. 

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Speaker 1:

Welcome to I'm Hormonal, your source of information about women's hormone health and how to support your body. Naturally, I'm your host, bridget Walton, and I'm a certified functional hormone specialist and menstrual cycle coach. I am on a mission to hold these hormone conversations with as many menstruators as possible, because you deserve easier access to accurate information about what's up with your unruly menstrual cycle and with your fertility mysteries. Don't you think it's time that we figure this out once and for all? Hey there, welcome to I'm Hormonal. My name is Bridget and I'm excited that you're back and that you're here with me for this episode where I'm going to be talking about perimenopause. If this is your first time listening, then I'll just share with you that I started this podcast late last year because I think that you deserve better access to more information about how your body works, what's going on, what do your symptoms mean, just so that you can make sense of what's happening. So my hope is that we'll be able to accomplish that together. I always like to give this disclaimer that the information I share with you today is for educational purposes only. It shouldn't be used as a replacement for any type of one-on-one support with a certified practitioner or other healthcare provider. Now, that being said, if you are looking for some support from a practitioner, then you can always reach out to me. Check out the link in the show notes or you can head over to bridgetwaltoncom slash coaching, check out my coaching packages and reach out to me from there.

Speaker 1:

So, as I mentioned, I'm going to be talking about perimenopause today. If you've heard of it before, then you'll know that perimenopause is the transitional period of time when you're going from regularly cycling in your reproductive fertile years, or that phase of life, and transitioning to the phase of life menopause, when you're no longer menstruating. When you reach menopause, that is like I just mentioned, that phase of life when you're no longer menstruating. So we're going to be talking about what is perimenopause, what changes might you observe in your body or how you feel? What changes might you observe in your body or how you feel? When does it normally come about? And what are some things that you can do now in order to set yourself up for success when it comes to menopause? And no surprise there that a lot of those recommendations I'll go through are just good principles for overall health and wellness, so good things to consider all the time. If you're listening to this podcast, then I know that you are somebody who you care about your health, you care about your wellness and you want to plan for the long term of your health. So if you're saying to yourself, bridget, I'm 24, or I'm 30, you know I have a bunch of years before I go into this phase of life, well, you're right, but I think this will still be a good lesson for you. You'll still get a lot out of it, because it's all about just being prepared and knowing what's ahead, and that is a chunk of the battle for sure.

Speaker 1:

Let's talk first about when perimenopause normally starts, and that will be in your late 30s or early 40s in general. Of course, there are menstruators out there who will experience symptoms of perimenopause earlier in life and some later, but late 30s, early 40s is a good kind of rule of thumb. Also, it can be helpful for you to ask your mom, ask your sisters, ask your aunts when they started experiencing perimenopause or where they actually went into menopause, because oftentimes you know that's a big genetic component right of perimenopause and so if I know okay, well, my mom started menopause when she was 51 years old then I can kind of use that as a gauge. It's not a perfect solution, but it can be helpful for you. Now it's not just like a one day thing, of course. It's a transition, and so this whole transition can take anywhere between two and 12 years, which is like a pretty big range, right? That's a whole decade difference.

Speaker 1:

The two to 12 year span is going to be broken up into four distinct phases, so let me run through those phases real quick, and then we'll go through them a little bit more in depth. The first phase in this sequence of events is low progesterone, moving on to the second phase, which is high and wildly fluctuating estrogen. Third is lower estrogen levels, and then the fourth phase in this sequence is possible insulin resistance. So one more time you're going to go, or you'll start to have lower progesterone levels, followed by higher estrogen levels. Eventually, higher estrogen will drop off, you'll have low estrogen, and that will leave you in this final phase of possibly dealing with insulin resistance.

Speaker 1:

Let me give you one quick recap. If you've been listening, then you've probably got this down by now, but for anybody who needs a refresh, I'll just remind you that estrogen is the hormone that is predominant in the first half of your cycle. It's really essential for ovulation and for ensuring a successful, strong ovulation and healthy egg to go out there and get fertilized For the second half of your cycle, that's when progesterone is the predominant hormone and that's really good for helping to create a good environment for an egg if it is fertilized, and to help keep a pregnancy moving along. But then, of course, if you're not pregnant, then both your progesterone and estrogen levels will go down, you'll start your period and the whole process starts all over again. When you heard me say insulin resistance, if you thought, hmm, okay, familiar, then let me remind you that insulin is the hormone that is produced in response to having higher blood sugar levels. So when we eat Swedish fish or pineapple or anything else that turns into glucose in our veins, insulin is going to be the hormone that's released in order to bring that glucose into our cells so our body can actually use it as energy.

Speaker 1:

All right, now let's come back to the sequence of events. So lower progesterone. When that starts to happen, that can be a result of inovulatory cycles, so a menstrual cycle where you're not actually ovulating. As we get older, our follicle health and our egg health is declining, and so that's what can lead to inovulatory cycles. It is certainly common to have anovulatory cycles once in a while, or if you're somebody who has PCOS or another condition, then maybe you are finding that you have more anovulatory cycles than normal.

Speaker 1:

If you have experienced that, you'll know that low progesterone that follows can result in things like anxiety, breast pain you could see heart palpitations, night sweats, migraines and heavy periods. That's a good indicator heavy periods of low progesterone, because progesterone is what helps to thin out the lining of your uterus. Mars estrogen builds it up. So this is what's happening first, low progesterone and then moving into high and wildly fluctuating estrogen. This can be especially, let's say, acute, because normally estrogen and progesterone are trying to balance each other out. But when you have low progesterone and particularly high estrogen levels, that can really emphasize irritability, also more instances of breast pain and then again heavy bleeding. So those are some things that can help you to kind of get an indication of where you're at or how you're feeling or what your symptoms mean.

Speaker 1:

After a certain period of time, your estrogen levels are going to lower, and this is the third phase again, and so what this could look like as far as symptoms go maybe insomnia. It may have an impact on your memory, because we know estrogen is really key in our clarity and mental processing, for our brain health. And then, third and final, for lower estrogen. I'll mention that vaginal dryness is common with this phase as well, because estrogen helps to keep our skin moisturized, keep our hair looking good. That's why, when women are pregnant or around the time of ovulation, you're like, oh wow, my skin really looks great, I'm really glowing right now. So, anyway, that's what you can expect with a third phase.

Speaker 1:

When you're past that, there's possible insulin resistance, and that basically means that your body needs to produce more insulin in order to kind of respond to the same thing that it was reacting to before. So again back to my Swedish fish example. Maybe when you were cycling, or right now, while you are cycling, you eat five Swedish fish and I'm making up a unit here, but your body produces one unit of insulin, and that's what's needed. But in an insulin resistant state, you eat the same number of Swedish fish, but you need more insulin. So you need two of these made up units in order to get that glucose into your cells. What impact does this have on you? Well, insulin resistance can contribute to abdominal weight gain and also to prediabetes. So it's something really important to consider and also important to note that if you have insulin resistance before you go into perimenopause, then that might be harder or take a little bit more time and diligence to address after the fact. So I'll get to some recommendations about what you can do now, but this will be one of them that you'll hear me come back to is addressing any potential insulin resistance.

Speaker 1:

I want to reiterate here that most of the symptoms that are experienced during perimenopause are temporary, but let's talk a little bit about what factors play into how your perimenopause experience is going to be. It really breaks down into these three different categories, which are one, genetics, two, your general health and three, your period health before perimenopause started. You should also know that about 75% of people have low or no symptoms, but it still is a really critical window for health, regardless of what your symptoms are like, and that's because during perimenopause there's this whole recalibration of your brain. It's something that also happens during puberty, when we're young. Coming back to the genetic piece, that's what I mentioned earlier about having a good understanding of when your mom or your older sisters or other female family members or menstruating family members went into menopause. That can give you a good idea of what to expect. Family members went into menopause. That can give you a good idea of what to expect.

Speaker 1:

Second, when it comes to general health, and the main thing that comes top of mind again is related to insulin resistance. But what is your body facing? What sort of inflammation do you have in your body or stress that's going to exacerbate symptoms as you're in this transitional phase of life? And then, third, your period. Health before perimenopause started is really essential because you know, if you're having regular cycles and by regular cycles I mean you're ovulating each cycle, your hormones are more or less balanced, then you're naturally going to be set up for an easier time as your hormones get a little bit out of balance, or at least a new shift.

Speaker 1:

I want to touch on the fact that if you have had a hysterectomy but you still have your ovaries, then all of these four phases that I talked through, those are all going to remain the same. Of course, you know that you won't have your bleed, because you don't have a uterus to bleed, but you can expect to potentially see symptoms that fall in line with low progesterone, high estrogen, low estrogen and followed by insulin resistance. Next, if you're somebody who is using hormonal birth control now, or you're somebody who, as you go into perimenopause, you're using hormonal birth control, you won't have any symptoms. You might not know how things are, or you won't know how your hormones or how your ovaries are changing, because you are still going to see that same pill bleed every month or however often, based on your form of contraceptive, and it'll only be once you come off that hormonal birth control and your body starts to balance its hormones or produce its own hormones, then that's when you'll start to see some symptoms. Now, estrogen can be kind of addictive, so having those estrogen withdrawals, or more specifically, your body's tissues having those estrogen withdrawals, can result in more severe or more noticeable symptoms than you might otherwise have.

Speaker 1:

So just something for future thought if you are using hormonal birth control, then you could be using it, you know, indefinitely. You know you're just following your same system that you've been doing for the last decade. But be thinking about what's that transition off going to look like and how can you work with your healthcare provider to make that as smooth and stress-free as possible. Let's talk about follicle stimulating hormone or FSH. So how would you know if you are using hormonal birth control or even if you're not. But how will you know if you are in menopause or in perimenopause? What is the difference? And the answer to that question, or one of many answers, really is FSH. Your FSH levels will be going up higher as you reach menopause, and so that's something that, if you go to your doctor and they do a test, that's what you could expect to see them test for, something that just happened to pop up on my TV yesterday, I guess, because I do a lot of Googling and you know internet searches as they relate to hormones.

Speaker 1:

But I saw that Clear Blue has a perimenopause testing kit, which this was new news to hormones. But I saw that Clear Blue has a perimenopause testing kit, which this was new news to me, maybe news to you as well. But basically what it'll do is you will do, I think, a series of tests integrated with an app, and basically it'll help to tell you which of those four phases that I mentioned earlier are you in, and as they label it it's pre-menopause, early menopause, late menopause or post-menopause. But I thought that was super interesting. I've got no affiliation with them, I don't know. I've never tried it or researched it by any means, but I just saw that yesterday and thought that was very aptly timed, wanted to share with you all.

Speaker 1:

Let's take a quick break and when we come back I'll walk through what are the things that you can do now in order to prepare your body and your mind for perimenopause changes. Let's talk about one of my sponsors for the show today, which, as always, is actually my own hormone coaching packages. So if you're listening to this episode in real time as it comes out the beginning of April, I'm just about to begin my beta group for a three-month coaching package, and what does that mean for you? If you're somebody who wants to understand what's going on with your hormones, if you have irregular cycles, if you have period pain any of those things and you want to break free of that and change your lifestyle, improve your lifestyle, work on integrating a more healthy lifestyle that'll support more normal and natural hormone balance, then check out the link in the show notes, because what I'm going to be doing is taking up to 10 women to work with me at no cost. The only cost to you would be if you want or need to do any hormone testing. Then that would be something you cover on your own. If you think that being a part of this beta group is something that you're interested in, that you would benefit from, check out the link in the show notes where you can learn more about the details of what the coaching would entail, what you can expect as results. But ultimately, take this as your first and next.

Speaker 1:

All right, friend, we are back and we're getting ready to wrap up the episode today with some recommendations or considerations for what you can do now. But before I go any further, I need to tell you that Dr Lara Bryden's book Hormone Repair Manual is a great resource for more information on perimenopause, really for anything menstrual cycle related. But this is the book that I use, that I the book that I use, that I reference, that I use to put together the notes for today. So if you have more questions on what I've been talking about today, of course you can shoot me a note, but also, if you want a longer read, then check out Dr Laura Bryden's book Hormone Repair Manual Every Woman's Guide to Healthy Hormones After 40.

Speaker 1:

All right, now I've got four things on my list, so let's run through them. The first thing that you can start doing now is cycle as long as possible. So make sure that you're having healthy menstrual cycles where you're ovulating for as long as possible, because having this amount of estrogen and progesterone, that balance, in your body, is going to pay dividends in the long run. It's going to help you to prevent osteoporosis, prevent breast cancer, prevent heart disease all things that are related to estrogen receptors and overall estrogen levels in the body throughout a lifetime. Just for a quick reference to, that, note was taken out of Dr Lara Bryden's book, and Professor Pryor is the subject matter expert that she references as well, so I mentioned that again in case you're looking for more information on this topic. So, one cycle as long as possible. That means if you're using hormonal birth control and you're at a point in your life when you're able to switch to another form of contraception that you feel confident in, then maybe that's a great option. Or if it is another underlying hormone imbalance that drove you towards hormonal birth control in the first place, then consider what are your options in moving beyond that. Just some things to think about.

Speaker 1:

Number two on my list here is build muscle, build muscle, build muscle, build muscle. Focus on protein, focus on movement. And why is this helpful? Well, this is good to focus on because it's going to help you combat insulin resistance, right. When we have more muscles on our body, that's more muscle to use the glucose that's in our veins, right, and so having more muscles, using our muscles so that it can soak up the glucose and it's not just floating around, you know, more or less that's what is going to be helpful for the long run.

Speaker 1:

Third on my list is to soothe the nervous system. So, again, if you've been here before, then you've heard me talk about the nervous system. If not, then welcome. Let's talk about the nervous system for a second, because when we are in a state of fight or flight or freeze, if we're not in a rest and digest phase, which maybe you've heard some of those buzzwords before like that's where you want to be is rest and digest, because that's going to support healthy or normal levels of cortisol, which is your stress hormone, and cortisol can really impact or cloud the communication pathways for our other hormones that we've mentioned, like estrogen and progesterone. So, soothing your nervous system, eliminating stress from your life as much as you can, eliminating things that are inflammatory, like foods or people, or allergens, things like that, that's one thing to consider here.

Speaker 1:

The fourth and final thing I have on my list is to focus on healing any gut problems that you may have, or intestinal permeability, leaky gut If you you know, if you consume alcohol or other sugary foods or if there's just any food, in general, you're like, oh yeah, I know, every time I eat eggs I break out in acne and my stomach feels bad Like just take a break from those foods. Figure out what is a better alternative that's not going to cause inflammation and stress in your body and will help you to feel better. So let's just recap that really quick. The things that you can start doing now are to focus on cycling through your menstrual cycle for as many menstrual cycles as you can before you move into this next phase of life, when your ovaries are ready, more or less. Two focus on building muscle, lifting heavy weights. Focus on getting enough protein so that you can convert you know your hard work into muscles on your body. That's going to help with insulin resistance. Three soothe your nervous system. Get stress out of your life. Four heal your gut problems. Focus on addressing any intestinal permeability. If you have a yeast problem, like I do or did, then focus on that, because that's going to help your hormones. Well, it'll help your hormones, but what I meant to say was it'll help your body to now be more calm and support your overall general health. That's it for today.

Speaker 1:

I hope you found this episode to be helpful. If this was an intro to perimenopause for you, then enjoy. Let me know. If you have any questions, if there is anything that I kind of missed that you're wondering, shoot me a message. You can always connect with me on Instagram at Bridget Walton. You can reach out to me through the link in the show notes and, of course, if you're interested in any sort of one-on-one coaching or work together, then reach out to me through the link in the show notes and we can see what'll be a good fit for you. Consider sending this episode to a sister or a friend. You know that she would appreciate it and, honestly, I would really appreciate it if you helped me to grow the I'm Hormonal community. Thank you so much for listening. I really, really, really appreciate you, and especially for those of you who have made it all the way to the end here. So thank you so much and I will see you here again next week. Seguind is Seguind.