Perimenopause
Written by Shalini Nair Kozlowski (Naturopath)
We hear a lot about menopause and the menopausal transition, but what is perimenopause? It is the stage before menopause, and is sometimes referred to as ‘the change before the change’. Women typically go through perimenopause in their 40’s, but some women can start going through changes in their late 30’s as well. In perimenopause, symptoms can be caused by fluctuating hormone levels, as opposed to symptoms caused by declining hormone levels at menopause.
Women present with a myriad of symptoms that include:
Irregular menstrual cycles
Erratic or heavy menstrual bleeding
Headaches
Breast swelling and tenderness
Worsening of premenstrual syndrome
Mood swings, anxiety and depressed mood
Memory difficulties
Crawling sensations under the skin
Disturbed sleep patterns
Weight gain and central adiposity
Perimenopause can be a challenging time for women, because at this age, they are often at important stages in their careers, and they are also balancing this with family life. These women can also be caught in a ‘sandwich generation’ situation, where they are caring for children as well as ageing parents. The stress involved in these complex situations often plays a part in the severity of symptoms. Chronic stress and high cortisol leads to dysregulation of the hypothalamic-pituitary-adrenal axis, which combined with fluctuating hormone levels, can worsen many of the perimenopausal symptoms.
How does this lead to naturopathy?
Women come to us because they are often unhappy with the conventional treatments offered to manage this stage of their lives. Common treatments include oral contraceptives, hormone replacement therapy, antidepressants, anti-anxiety medications, sleeping aids and various painkillers. A longitudinal study involving Australian women in 2017 found that the use of complementary medicine to manage their perimenopausal symptoms had increased over time. Naturopathy is one of the modalities of complementary medicine that can help.
What can you expect when you see a naturopath?
First we take a thorough history to assess where you are in your perimenopausal transition, and what types of hormonal changes are contributing most to your symptom picture. We also assess whether or not stress is impacting your perimenopausal symptoms. Finally, we look at your overall health picture to assess if there is anything else not related to perimenopause that is causing you to not feel your best!
What sort of treatment will I receive?
Naturopaths can prescribe herbal medicine and nutritional supplements to help reduce the impact of hormonal fluctuations and promote healthy menstruation. We can also treat your nervous system and adrenals to reduce the impact of stress. The most important aspect however, is the dietary and lifestyle advice that you will be given, which will help not only in perimenopause, but for menopause and for healthy ageing in general. The most medically relevant changes in perimenopause are its effects on metabolic, cardiovascular and bone health, and getting educated on diet and lifestyle as early as possible will set you up to continue to have a long and healthy life.
Finally, the thing I hear most from perimenopausal women who come for treatment is the reassurance that they feel when they are told that what they are going through is normal. If you are reading this and feel that it is resonating with you, don’t hesitate to see a naturopath! You could be feeling a lot better soon, and be well on your way to a healthy transition to menopause and beyond!