5 things I always get asked about peri-menopause and Menopause

1. How can I lose the weight I have gained around my middle?

It is common for women to gain weight once they hit the perimenopause and this can occur for several reasons.

As we age we lose muscle mass and, as muscle burns through calories, we end up burning less calories even though we may be consuming the same diet as in previous years. To fight weight gain start doing resistance exercise - working with dumb-bells, a barbell or doing yoga are all ways in which we can increase muscle mass.

As oestrogen levels decline (late perimenopause and menopause) we become less sensitive to insulin, this results in more of the glucose from our diet being stored as fat. This fat tends to be stored around the middle so that we can start to become more apple shaped.

To counteract our declining insulin sensitivity:

• Cut down on all foods and drinks containing added sugar.
• Reduce refined carbohydrates such as white bread, pasta, pastry, biscuits, cake. Switch to more fibrous carbohydrates such as brown rice, butternut squash, lentils, chickpeas and try to avoid having more than a fist sized serving at any meal.
• Eat proper meals that contain plenty of vegetables, some protein (such as fish, chicken, egg, tofu) and some healthy fats (oily fish, olive oil, avocado, nuts, seeds).
• Avoid snacking unless you are legitimately hungry. A lot of people snack because they are bored, feeling low or feeling tired.
• Aim to have at least a 12 hour fast between finishing dinner and eating breakfast the next day.

Another reason for weight gain in menopause is that the fat around our middle is an important source of oestrogen once our ovarian production of oestrogen comes to an end. The body is thought to ‘hang on’ to adipose fat because of its ability to produce some of this vital hormone.

If you have gained weight it is a good idea to see your GP to get your thyroid tested, an underactive thyroid might be the cause of your weight gain and is quite common in women in their 40’s and beyond.

2. How can I improve my sleep?

Firstly, make sure you are following the basic sleep hygiene rules:

• Keep your bedroom to a cool 18 deg. C
• Ensure that your bedroom is in complete darkness
• Avoid looking at screens for at least 2 hours before bed
• Avoid eating for a couple of hours before bed
• Avoid caffeine after midday; in the evening try lavender/camomile herbal teas

If you are following these rules and still finding sleep is difficult then it could be worth trying a magnesium glycinate supplement – start with 200mg and take up to 600mg before bed. Magnesium is calming and glycinate helps to increase GABA a hormone which promotes sleep.

Some people find eating a little starchy carbohydrate (potato, brown rice, lentils etc) at their evening meal helps with sleep. Carbs can help to increase the brain’s production of melatonin which is the hormone we need for a good night’s sleep.

Working on stress reduction is also key, if stress is keeping you up at night it might be worth learning some mindfulness or meditation techniques. Yoga nidra classes are also helpful for de-stressing and calming down before bedtime. In an ideal world this is a good time to reduce your life load – stop saying ‘yes’ to everyone and start to look after yourself!

Doing some gentle exercise every day so that you are physically tired at night might also be helpful; this doesn’t have to be at the gym it could be a long walk or an online yoga class.

Sleep can also be disrupted by night sweats. Taking Eostre can help to relieve night sweats and might be the answer if sweats are waking you up at night. Avoiding or restricting alcohol, caffeine and chocolate can also help to prevent night sweats.

3. What can I do about migraines?

During Perimenopause many women suffer from headaches and migraines, this is thought to be caused by the fluctuating levels of oestrogen and progesterone during this time. In early perimenopause oestrogen is often relatively high in comparison to progesterone (unopposed oestrogen) which stimulates the blood vessels to dilate and is linked to headaches. The pycnogenols in Eostre might help with migraine attacks as they improve blood flow. Oxidative stress is also thought to be a factor in migraines and pycnogenols are powerful antioxidants which can reduce oxidative stress.

Iron deficiency might also be a factor in headaches and migraines so ask your GP for a blood test to look at iron levels. Heavy bleeding in perimenopause can lead to lower iron levels.

High histamine foods and drinks, in particular red wine, might also be linked to headaches, especially during perimenopause (when oestrogen can reach relatively high levels) so try cutting out all red wine and see if this helps.

4. What can I do to improve my thinning hair and skin?

As perimenopause progresses towards menopause oestrogen levels fall quite dramatically which results in the loss of collagen throughout the body. Declining levels of collagen cause hair and skin changes.

To support collagen production eat plenty of foods rich in Vitamin C – red peppers, parsley, kiwis, sweet potato, papaya and citrus fruits are all good sources. You might also choose to supplement Vitamin C (which is also good for the immune system).

Many of us neglect to eat enough protein and it is vital for healthy skin and hair. Make sure every meal contains some protein; choose from eggs, lean meat, chicken, fish, tofu, nuts and seeds, beans, lentils, quinoa.

Avoid added sugars as far as possible and limit fried foods to a minimum as these are linked to poor skin health. Bake and poach foods rather than frying.

Eat a mostly plant-based diet to ensure plenty of plant nutrients (phytonutrients) which support healthy hair and skin.

5. Why can’t I tolerate wine anymore?

As we age many of us seem to be less tolerant of alcohol.

In early perimenopause fluctuating oestrogen can cause a temporary histamine intolerance, this can result in an inability to tolerate wine, especially red wine. Avoid wine until your hormones settle.

It might be that your liver has become ‘overwhelmed’ by a lifetime of too much alcohol, caffeine and processed food. Switch to a healthier diet and cut out all alcohol and caffeine for a few weeks and monitor how you feel.

Alcohol intolerance might be caused by poor gut health. If you are frequently bloated or suffer from loose stools or constipation it is time to work on your gut. Switch to a ‘real food’ diet processed or refined, introduce some fermented foods such as natural yoghurt, sauerkraut, kimchi, kombucha. Consider taking a probiotic supplement.

As we age, we carry less water weight and therefore have less water in the body to dilute the effect of alcohol. Focus on staying hydrated, switch from caffeinated drinks to more herbal teas and water throughout the day.