Get prepped FOR PERIMENOPAUSE

Soften the symptoms with tweaks and treatments

Menopause can be empowering, but self-care is key

Menopause is an inevitable life stage, yet it’s something that too few of us are fully prepared for. Officially, menopause is the one-year anniversary of your last period. Most women will reach this milestone between the ages of 45 and 55, with the average age being 51.

Perimenopause, however, is the hormonal roller coaster beforehand. It typically lasts for four to eight years, starting as early as age 30, and can be a rocky road for the 80 per cent of women who experience erratic and unpredictable symptoms. In addition, for those who experience menopause suddenly – for example, because of cancer treatment – the symptoms may be much worse and more difficult to manage.

The good news is that it’s possible to have a positive perimenopause.

Here’s how…

Know the signs

The earliest signal that a woman is perimenopausal is changes to her periods. “Before perimenopause, your oestrogen and progesterone levels rise and fall in a consistent pattern during your menstrual cycle,” explains Dr Tania Adib, Harley Street gynaecologist and women’s health specialist. “In perimenopause, hormone changes become more erratic, which can result in unpredictable bleeding patterns. It can make onceregular periods suddenly irregular and once-light periods extremely heavy, and vice versa.” Fluctuating hormone levels can have a much wider impact, too, and eight in ten women will have additional symptoms, including hot flushes, night sweats, sleep problems, reduced sex drive, vaginal dryness, headaches, mood changes, palpitations, joint stiffness, brain fog, and weight gain.

“As we hit menopause, our body has to adjust to a significant decline in levels of the hormones oestrogen and progesterone,” explains Dr Martin Kinsella, cosmetic doctor and hormone expert (Re-enhance.com). “This can lead to changes in mood, anxiety and energy.”

Our bodies can undergo physical changes during this period and weight gain is common. “Weight gain occurs partly because of a drop in oestrogen levels. Lowquality sleep and regular, age

related reductions in metabolism and muscle tone can also contribute, which can have a very visible impact on a person’s self-esteem.”

Joint pain is another symptom that can present itself at this time. “Women may overlook aching or painful joints as a natural sign of getting older, but it’s important to understand the impact hormonal changes can have,” explains Dr Anne Henderson, consultant gynaecologist and menopause expert. “Oestrogen has a direct impact on the musculoskeletal system, particularly joints. It can impact collagen, which is found in muscles, tendons, ligaments and the joint itself, as well as the ‘synovial buffering’ fluid in joints, such as the hip and shoulder.”

Although rarely discussed, vaginal dryness can be a major symptom for many women. “This is unfortunately still a taboo subject, but it can have a detrimental effect on a person’s self-esteem and confidence,” adds Dr Kinsella. “Decreasing oestrogen levels cause a gradual thinning of the vaginal walls. This condition is known as vaginal atrophy, atrophic vaginitis or genitourinary syndrome of menopause (GSM).” Combined with lower libido due to decreasing testosterone levels, women’s sex lives and personal relationships can be diminished or even devastated.

Perimenopause can spell disaster for the complexion, too. “In my experience, dryness

– be that skin or vaginal – is the commonest reported symptom,” adds Dr Sonia Khorana, GP and dermatology doctor. “Dropping oestrogen levels leads to decreased collagen levels, and hot f lushes can trigger rosacea, too. Adult acne and skin discolouration – such as melasma or hyperpigmentation – are other symptoms, particularly affecting darker skin tones.”

How to help

The good news is that many perimenopausal symptoms can be managed with overthe-counter remedies, lifestyle changes and tweaking your diet. “Eating a diet that’s rich in magnesium and vitamin C can help improve symptoms of anxiety and mood swings,” says Lola Biggs, dietitian at Together Health (Togetherhealth.co. uk). “Try avocados, nuts, tofu, whole grains and bananas – all rich in magnesium. And when it comes to vitamin C-rich food, think blackcurrants, strawberries, citrus fruits, broccoli, Brussels sprouts, kiwis and red peppers.

“If you’re feeling like your brain is all over the place, you could consider taking ashwagandha. It helps promote a healthy response to stress and supports normal levels of mental clarity and concentration.”

For joints and bone health, Lola recommends a combination of gentle exercise and good nutrition. “Yoga is great for keeping your joints flexible and supple,” she says. “A diet rich in calcium and vitamin D is essential to prevent bone loss. Eat dark leafy vegetables, oily fish, dairy, and legumes, and aim to eat two to three portions of calcium-rich food every day, such as semiskimmed milk, natural yoghurt or some cheese.”

Avoiding certain foods can be helpful in managing weight f luctuations, too. “Watch out for trigger foods such as refined carbs and processed foods, as these can exacerbate symptoms leading to an increase in stress and inf lammation on the body, as well as weight gain,” says Lola. “Eat everything in moderation and don’t feel guilty about the odd treat. Cut back on saturated fats, salt and refined sugars and eat more cruciferous vegetables – studies have shown that broccoli has a positive impact on oestrogen levels.”

“Cutting out stimulants like spicy food and alcohol can help to level out symptoms,” adds acupuncturist and natural menopause expert Jo Darling, who stresses the importance of self-care. “In the east, menopause is called ‘second spring’ and is celebrated. Yes, you’re no longer bleeding [through menstruation], but that energy is expelled in other ways and this period can mark a burst in creativity. Menopause can be empowering, but self-care is absolutely key.” “Breathing in fragrances can relax the mind and lower cortisol,” says aromatherapist Simone Stevens. “There’s an essential oil to help you at every ebb and f low of menopause. Geranium, for example, helps with hormonal changes, while ylang ylang works with stress and trauma – which, in a way, is what the body experiences during menopause. Rose oil is good for skin dryness and rosacea, and citrus oils are antiinflammatory to calm hot flushes and skin flare-ups and have antidepressant properties. Finally, sage oil is great for clearing brain fog.”

If lifestyle tweaks don’t provide enough relief and your symptoms are affecting your day-to-day life, consult your GP. “Don’t be scared of HRT [hormone replacement therapy],” says Dr Sonia. “Ask questions. There are different types of HRT and it can be prescribed depending on an individual’s needs.” She adds, “It’s important to remember that menopause is not an illness, it’s a life transition.”

We just need to make the transition as smooth and comfortable as we can.