It’s hard to believe that in this day and age, peri-menopause and menopause are topics that are still taboo in conversation. Do you find it uncomfortable to talk about the changes in your period and the mood changes and fatigue that often go with it? This can make it hard to get help and must feel isolating.
But when women find out I am “that hormone lady”, the flood gates often open and I get to hear all sorts of stories. It must be such a relief to be able to talk to someone who understands what could be going on in your body and can help you find a solution.
Linda came to see me this week. She’s feeling worn out – like she’s running on an empty fuel tank. People are continuing to ask too much of her and she is continuing to give more than she’s got. She’s noticed she has a really short fuse at the moment. No patience left for her kids or husband at all. Things that would never have bothered her in the past can make her rage and boil over like lava spewing from a volcano. After these episodes Linda feels incredible guilt which sucks up more of her dwindling reserves of emotional energy. She is in a cycle of fury, guilt and over-compensation, where she tries to make amends for the anger and lack of patience she previously dealt to her family.
Linda has also noticed her period is starting to change. Her period is much heavier than it used to be. Large clots are present on days 2 and 3 of her period. She has started getting period pain again which she hasn’t had since she was a teenager! Her cycle is becoming irregular. Over the last 4 months she has had a 58 day cycle, a 20 day cycle, a 28 day cycle and a 16 day cycle.
“And don’t get me started on the PMS”, Linda sighed in exasperation. “That’s the real killer. What the hell is going on? It’s got to be my hormones. Do you think I’m menopausal?”.
I explained to Linda that no…she is not menopausal. To be menopausal you need to have a gap of 12 months with no periods at all. Once this happens, you can be fairly confident that you won’t have another one and that you are menopausal.
However, at the age of 47, it is likely that Linda is peri-menopausal. She is suffering from the rollercoaster of PMS, mood changes and period problems that can mark the early days of peri-menopause for some women. She is definitely experiencing symptoms of a hormone imbalance.
There is so much that you can do naturally to balance the hormones during peri-menopause.
If you balance your hormones before you hit menopause, you are more likely to breeze through the transition and feel free to enjoy the next stage of your life. Linda was relieved to discover that she is not “going crazy”. There is a cause and a solution for her problems.
Step 1 Start as Early as You Can
Can you relate to Linda’s story? This is a very common story that I hear all the time from women in their 40s. But I want you to know that it’s not normal. You might be thinking… “I just have to put up with this”, or “It’s normal for women of my age to feel like this.” So…not…true. Just because symptoms are common, it does not mean that they are normal. It also does not mean that you need to take medications like anti-depressants or the pill in an attempt to feel normal again (unless you want to of course). There are other options and solutions for women in their 40s and 50s who are experiencing symptoms of a hormonal imbalance.
And the good news is…
The earlier you address the problem, the better the result you will get and the easier the transition through menopause will be for you. So don’t put up with anything less than vibrant good health. Listen to your body and address any imbalances as early as possible. The “wait and see” approach often ends up being a “wait and worsen approach”. The longer you wait, the worse your symptoms get and the more difficult it becomes to re-balance the body. Don’t wait until you have severe night sweats, depression, anxiety, menstrual flooding or period pain. Be pro-active about your health and take action now.
Step 2 Get Your Hormones Tested
The first step in balancing your hormones naturally is to get your hormones tested. Hormones can be tested through a blood sample, a urine sample or a saliva sample. For women who are peri-menopausal, I recommend saliva hormone testing.
Saliva hormone testing is very sensitive
It can pick up even small imbalances in your hormones that may not show up through blood work. Through saliva hormone testing, we can assess your reproductive hormones, your stress hormones and your sleep hormone. The reproductive hormones are E1, E2 and E3 (the three types of estrogen your body produces), progesterone and testosterone. The stress hormones assessed through the saliva sample are DHEAS and Cortisol. The sleep hormone is melatonin. By assessing each of these hormones you will be able to identify your unique hormonal blueprint at this point in time.
You can then be very specific in taking the correct prescription of herbs and nutrients that may be needed for you to balance your hormones. This might be different to another woman who is also peri-menopausal but may have a different hormonal blueprint than you. By taking natural medications that are targeted to address your unique hormonal blueprint, you can be sure that you are spending your money wisely and are much more likely to see results.
Step 3 Check Your Thyroid
Many of the symptoms that women experience during peri-menopause can also be caused by a thyroid hormone imbalance. If you are experiencing weight gain, fatigue, mood changes, brain fog or changes in your hair/skin/nail health, I suggest you also get your thyroid checked.
Thyroid hormones are best assessed through a blood test.
The most common blood test assesses Thyroid Stimulating Hormone (TSH). This is one way of measuring the health of your thyroid. But I encourage you not to rely on this test only as a diagnosis of thyroid disturbances. I have had too many women come to my clinic who have been told their thyroid function is normal, even though they have significant symptoms of an underactive thyroid. For these women, the best test to do is a thyroid hormone profile. This test measure TSH, free T3, free T4, reverse T3 and the thyroid auto-antibodies. It is not unusual for TSH to be within the normal range but an imbalance presenting in one of the other hormones or the thyroid auto-antibodies.
Thyroid disorders don’t occur overnight.
There is often a lengthy period of time before a thyroid disorder is diagnosed that a woman has experienced symptoms. This is often called sub-clinic hypothyroidism (an underactive thyroid) or sub-clinical hyperthyroidism (an overactive thyroid).
If the thyroid auto-antibodies are elevated above the normal range, it means you have an auto-immune condition. The conditions are named Hashimoto’s Disease (underactive thyroid) or Grave’s Disease (overactive thyroid). By assessing the complete thyroid hormone profile you will get to the underlying root cause of your symptoms.
The hormonal changes that occur during peri-menopause can also be a trigger for the activation of a thyroid hormone imbalance. You want to make sure all of your thyroid hormones are within the optimal range to protect your hormonal health long-term.
Step 4 Replace Self-Sacrifice with Self-Care
Have you travelled recently on an aeroplane? I love travelling and make regular flights every year for work and to go on adventures with my family. I love the first message that is presented in the flight attendant’s safety presentation: “In the event of an emergency, make sure you put your own oxygen mask on first before assisting children or other people.”
The reason I love this is because the message is so applicable to every area of our lives. Women have a tendency to willingly sacrifice their own needs and self-care in order to help other people. Women have been encultured into this way of life from infancy and childhood. Girls are encouraged to nurture and take care of other people. Selfishness is actively frowned upon.
Whilst many women (including you I am sure!) are wonderful nurturers, this often comes at a silent cost. Feelings of frustration and resentment grow and many women suffer the health consequences of burnout from trying to be everything to everyone. The problem is that when you are burnt out, you can’t help other people anyway.
For the benefit of not only yourself but also your family you need to prioritise self-care. This is just so important. My personal aim now is to prioritise my own self-care so that it is the first activity I do each day. Every morning, I wake early. I try to go to bed at the same time as my children each night so that I can wake up at least an hour before them every morning. This way I still get plenty of sleep and am waking up feeling refreshed. But the first hour of the day is my time to do things that make me feel good. Click below to download the Self-Care Checklist to help you make this part of your routine.
My Morning Routine
- I brush my teeth and drink a mug of hot water to re-hydrate my body.
- I do 20 minutes of yoga. There are so many great yoga sequences of YouTube that you can follow. I love yoga. It refreshed my mind and body and helps me deal with stressful situation with a clear mind and calm body.
- I follow this with 10-15 minutes of meditation and visualisation. At the moment I love the One World Academy Soul Sync Meditation.
- I also spend about 10 minutes really checking in on my life goals, values and affirmations. This helps me stay on track with living the type of life that is important to me. It has helped me have so much clarity in my thinking and made it much easier to prioritise projects and tasks that are most important to me.
- The final 15 minutes are flexible. Sometimes my children wake up early and I spend this time cuddling in bed with them. If they are still asleep, I will often have a second mug of hot water and spend the time writing in my journal, or reading a good book. Sometimes I just have a relaxing hot shower and wash my hair in peace and quiet.
This is just my own routine. There are no rights or wrongs here. The trick is to find activities that make YOU feel good and begin your day doing them. If you spend the first hour of your day doing things that make YOU feel good, you will start to build up your reserves of emotional energy and well-being. You will find that this puts you in a great position of being able to give to other people from the overflow of your own positive energy, rather than drawing from limited reserves.
Step 5 Get Your Energy Back
Fatigue is a common problem many women experience during peri-menopause and menopause. Most women really want more energy and equate being energetic with feeling normal again. There are many possible causes for fatigue and low energy during this time of your life and it is important to get a clear picture of what is going on in your body. The three most common causes are:
- Disturbed sleep patterns and insomnia
- Iron deficiency and heavy periods
- Emotional burn out due to long-term stress
Disturbed sleep patterns often accompany this phase of life. For many women, this begins to occur in the pre-menstrual phase. Insomnia the night or two before the start of your period is a common first sign of a hormonal imbalance. If this is not addressed, the disturbed sleep patterns can continue to worsen, often lasting for more than a week. If premenstrual insomnia is combined with hot flushes and night sweats, the effect on your energy levels can be significant.
Improve Your Sleep with a Good Sleep Routine
Make sure you work on improving your sleep pattern with good sleep hygiene. We know that going to bed at the same time each night and getting up at the same time each morning can help regulate your sleep cycle. The best quality sleep you will have all night is between 10pm and midnight. Getting into bed early so that you can take advantage of this really helps. If you are normally a night owl, take some time to do this. Don’t expect your body to change overnight. Try going to bed 15 minutes earlier each night to give your sleep cycle a chance to adjust.
Research also tells us that it is important to keep your bedroom cool and dark. Avoid having your mobile phone next to the bed. Give your body a break from the electro-magnetic radiation and leave your phone to charge in another room. Make sure there are no lights from other electrical appliances in the room (eg TV stand by light). Block out blinds can help if you notice light from the moon or exterior lights coming into your bedroom. Turn off the heater in your bedroom and use extra blankets if you need to. Make sure that at least your face feels cold when you are going to sleep.
As soon as you wake up in the morning, try to get natural UV light on your eyes. Open all the curtains and blinds in your house. Go outside if you can. Maybe go for a quick walk around the block. Or sit in your back yard and drink a cup of herbal tea and watch nature waking up around you.
Iron Deficiency and Heavy Periods
Heavy periods are a common cause of iron deficiency for women who are peri-menopausal. Ironically, iron deficiency can also cause heavy periods. If you are tired, it is important you have a blood test to check your iron status. If you become anemic it will really affect your energy levels and make it harder to fix your period.
Heavy periods can also be caused by endometriosis, fibroids or estrogen dominance. One of these pre-existing conditions may be the primary cause for your heavy periods. But without fixing the iron deficiency, your period will only get heavier.
Did you Ovulate this Month?
It is not unusual for women to start to have annovular cycles in the peri-menopausal phase. You can still be having a regular period but not ovulating. This can cause heavy periods due to the imbalance that occurs between progesterone and estrogen when you are not ovulating. It is difficult for your body to produce enough progesterone to counteract the proliferative effects of estrogen if you are not ovulating. This means the endometrium thickens more than it normally would. This can cause a large amount of blood to be shed when your period starts. Click here to learn how to chart your menstrual cycle and download a Menstrual Symptom Diary.
Fix your iron deficiency by taking a highly absorbable, bioavailable iron supplement. I like Metagenics Hemagenics Intensive Care. This supplement contains a well-tolerated form of iron – iron bisglycinate. It is combined with an iron dense herb – Chickweed – and B vitamins that can also support energy production. Increase iron containing foods in your diet. Red meat is a great source of iron if you eat meat. Non-meat iron sources including green vegetables, herbs like parsley or nettle, eggs and legumes are important for vegetarians. You can improve your body’s ability to absorb iron by eating a high Vitamin C food at the same time as your iron containing foods. Having tomato, capsicum or citrus foods will help. You could also take a Vitamin C supplement at the same time as your iron supplement.
Emotional Burn-out due to Long Term Stress
This would be the most common cause of fatigue I observe in my clinic. If you sacrifice self-care for long enough, the end result is a flat battery. You run out of energy and lose your sparkle and zest for life. If you combine this with a lot of external stress for long enough, it is a recipe for exhaustion.
By making self-care a daily part of your routine, you will give yourself the breathing space to relax. Training your body to induce the relaxation response on a regular basis will give you the ability to respond to stressful situation when you need to, but then relax after the stressful situation has passed. All too often, women adapt to functioning in the fight or flight response and feeling stressed starts to feel normal. However, your body can only tolerate this for a certain amount of time until eventually you reach your threshold of tolerance. If you cross this threshold your body will enter the exhaustion phase of the stress response. You can find out what stage of the stress response your body is in by having your stress hormones tested through a saliva hormone test.
Step 6 Balance Your Mood – Feel Joyful and Calm Again
Long-term stress and emotional burn-out can really affect your mood. If you combine this with PMS or an imbalance in estrogen/progesterone, feelings of anxiety, sadness, frustration, overwhelm and anger occur. Do you have a short fuse? Things that would never have bothered you in the past now cause intense anger? Or do you find you are now very sensitive? You might find that all of a sudden you are in floods of tears after watching a TV commercial or reading a story in the newspaper?
The Emotional Rollercoaster of Peri-Menopause
The emotional rollercoaster before you hit menopause can be distressing. Balancing your stress hormones can really help you feel joyful and calm again. Herbal medicine can be a fantastic support. Having a daily self-care routine is essential. And don’t forget about exercise. Twenty minutes each day of vigorous cardio-vascular exercise like brisk walking can help your body release mood-boosting brain chemicals and burn up stress hormones like cortisol. Click here to read more about Stress and Your Hormones.
Step 7 Ease Your Body through a Natural Transition
Remember that menopause is a natural transition. During peri-menopause, the goal is not to cure anything. Instead you want to nurture and support your body and mind so that you are able to move through this natural transition with ease rather than discomfort. The cessation of menstruation is a normal, natural process. I want you to be a woman who breezes through this transition, because you have made the effort to prepare by balancing your hormones during the peri-menopausal phase.