Understanding your hormones in your 40's 

What is perimenopause? Am I menopausal? Are my symptoms normal?  
Prior to becoming a nutritionist, like many women I had no idea what to expect from the transition to menopause. I didn’t even know there was a transition! All I knew was that some women seem to get a lot of hot flushes. But there is so much more to know and understand about the changes that occur to our hormones during this period and the more you understand your body the better equipped you are to adapt to this transition. 
We all learn about puberty, sex, how to have babies, how not to have babies but nothing about menopause. Another example of how women’s health still has a long way to go and why women often feel invisible in this age group. 

What is perimenopause? 

Perimenopause is often described as the second puberty. It is the two to twelve years before menopause where symptoms can be at their worst. 
Menopause is the life phase when you have not had a period bleed for twelve consecutive months. 
Women in their late 30’s and throughout their 40’s can recognise if they are perimenopausal as they can usually tick at least three of the following symptoms. 
1. Heavy bleeds or longer periods 
2. Increased period pains 
3. Shorter periods <26 days 
4. Sore, tender, or lumpy breasts 
5. Waking during the night 
6. Night sweats 
7. Increased migraine headaches 
8. Worsened premenstrual mood swings. 
9. Weight gain without changes in eating or exercise 
10. Foggy brain, unclear thinking. 

What to expect and when.  

On average, women achieve menopause around the age of 50. Perimenopausal symptoms can start 8-10 years before then. Here is a simple timeline to to help gauge where you are on your journey. 
Late 30's early 40's is very early perimenopause. We are still having regular periods but symptoms are creeping in, the hormonal rollercoaster ride has begun. This phase can last between 2-5 years. 
Mid 40's is a period of transition, we start to have irregular periods where the cycle varies in length by 7 or more days. 
Late 40's we are still in transition but may experience some skipped periods and no bleeding for a couple of months. 
Just as we think our periods are finally ending it comes back and the uncertainty continues. The transition period can last for roughly three years. 
Early 50's for most women is the home straight, we have our final menstrual bleed and if this period of no bleeding lasts for 12 months you are officially post-menopausal and can finally get off the hormonal rollercoaster. 

What is happening to our hormones? 

As our ovarian function starts to decline the first stage in early perimenopause is a drop in progesterone levels which leaves us in a state of oestrogen excess.  
Low progesterone leads to hormonal imbalances and irregular cycles as oestrogen levels are unopposed. 
High oestrogen also leads to high histamine which produces symptoms such as: - 
• Heavier and more painful periods 
• Worsening fibroids and adenomyosis 
• Breast pain 
• Anxiety and insomnia 
• Nausea and diarrhea 
• Tinnitus and nasal congestion 
• Headaches, migraines and joint pains 
The later stages of peri-menopause include a drop in oestrogen and this is where the classic symptoms more strongly associated with menopause are common. Symptoms of low oestrogen include:- 
Night sweats and hot flushes 
Vaginal dryness 
Joint pain 
Memory loss 
Premature ageing 
Hair loss 

Nutrients that support perimenopausal symptoms 

The different phases of perimenopause have different symptoms which require different types of support, that is why it is always helpful to get professional advice to guide you and meet your specific needs. 
In the early phases of perimenopause it is important to support oestrogen excess. This involves gut and liver support for healthy oestrogen clearance. Nutrients that support oestrogen metabolism include: - 
Fibre for regular daily bowel movements. 
Magnesium, zinc, folate and B12 for healthy oestrogen detoxification via the liver. 
Always rule out thyroid conditions that may be affecting your ability to clear excess oestrogen and check your iron levels if your periods are heavy. 
Nutrients that support progesterone production include Vitamin C, B6, magnesium and zinc. 
Magnesium taurate alongside vitamin B6 helps support sleep, mood and hot flushes. 
If your symptoms are very bad, speak to your G.P about body identical progesterone to counteract the effects of excess oestrogen. If symptoms still persist then speak to your G.P about body identical oestrogen.  
Body identical means that these medications are structurally identical to our own hormones and don’t carry the same risks to health as synthetic hormones such as progestins. 
Nutritional therapists look at your hormonal balance alongside your stress levels, lifestyle, liver and gut health to ensure a whole body approach to your menopausal symptoms. Get in touch to acheive your hormonal balance. 
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