When a woman gets to a certain age, her menstrual cycle is brought to an end when menopause kicks in. A whole year free from a period is good confirmation that menopause has arrived and marks the end of fertility as well as the end of the functionality of the ovaries. Oestrogen levels at this point decline massively, however the onset of menopause does not occur abruptly, but the female sex hormone production declines over a period of time, which is often referred to as the perimenopause or pre-menopause. It is important to understand how long the transition lasts between perimenopause and menopause, but each woman will have a unique and variable experience.
What is perimenopause?
Put simply, perimenopause is the time before menopause when the ovaries begin to stop producing both oestrogen and progesterone. It is generally accepted that this occurs roughly eight years prior to menopause, which is normally between the ages of 45 and 55. As a result, many women going through the perimenopause experience a whole array of symptoms attributed to the declining female hormones and the relative imbalance between these hormones. The symptoms of low progesterone are different to those of low oestrogen and the relative amounts of these two hormones will determine the symptoms experienced. Progesterone levels normally decline well before oestrogen does resulting in what is termed ‘oestrogen dominance’ with its own array of symptoms. The impact of these low female hormones is very widespread affecting virtually all other body systems. It is for this reason that the symptoms of perimenopause, which are identical to those experienced during menopause, can be very widespread and include hot flashes, stress, fatigue, mental fog, hair thinning and hair loss, unwanted hair growth, gradual loss of elasticity of skin, vaginal dryness, lack of sex drive, sleep disturbances and even recurring urinary tract infections. Unfortunately, the decline in both hormones is slow and erratic leaving many women with feelings of confusion and despair.
To summarise, common and unusual signs of perimenopause include:
Erratic periods and change in monthly flow: A change in the monthly cycle is the most common indicator of perimenopause. The duration of your period may also change and your monthly flow can change from light to heavy or even the other way round.
Hot flushes and sweats: Another common sign of perimenopause; hot flushing is experienced as a wave of heat often originating in the chest and neck moving upward into the face and scalp. Unlike menopause where these hot flushes are usually regular and numerous, hot flushes during the perimenopause are usually infrequent and rather abrupt.
Stress and anxiety: As mentioned above, virtually every single hormonal gland is affected, the most common being the adrenals, which are responsible for stress management and energy enhancement. Female hormonal imbalance leads to an over-production of cortisol which blocks the uptake of the nerve calming and mood elevating hormone, serotonin. If these symptoms arise without undue known stressors, then you may be going through the perimenopause.
Sleep disturbances: An over-production of cortisol by the adrenals as a result of female hormonal imbalances leads to a reduction in serotonin uptake by the brain. Serotonin is converted into melatonin, the sleep hormone, at night time thus serotonin deficiency invariably leads to problems associated both with sleep induction, quality of sleep and the duration of sleep.
Urinary tract infections: Some women going through the perimenopause experience urinary tract infections for the first time and will often experience recurring episodes. This is because the tube that connects to the bladder, the urethra, is oestrogen sensitive. When oestrogen levels are low, the lining of this tube becomes inflamed and infected. Recurring urinary tract infections may be indicative of perimenopause.
Joint and muscle pain: If you are experiencing joint pain for the first time and this is not associated with the wear and tear of joint tissues then this may be yet another sign of perimenopause.
If you have any suspicion that you may be going through the perimenopause then you should take action immediately. Often women are left confused with feelings of despair, searching for remedies that treat the symptoms they are experiencing rather than addressing the causal factor, the lowering of female hormone levels. I am a firm believer of using phytoestrogens for the vast majority of women who experience some of the symptoms mentioned above assuming that they are within the age range mentioned.
What are phytoestrogens and how do they work?
‘Phytoestrogens’ is a scientific word for naturally occurring plant compounds that are chemically similar to oestrogen and thus mimic oestrogen, often without side effects. They really are miraculous in that they have a balancing effect on the body by binding to oestrogen receptors in cellular activity.
Phytoestrogens were discovered as early as 1926, but it was not until much later that they gained popularity. Farmers noticed that sheep eating red clover, which is rich in phytoestrogens, had higher fertility rates. Extensive research to date has pointed to the multiple activities of phytoestrogens, which include maintaining bone density, maintaining lower cholesterol levels (especially during the menopause), cardiovascular protective properties and even brain health.
Phytoestrogens consist of more than 20 compounds and can be found in more than 300 plants such as herbs, grains and fruits. The three main classes of phytoestrogens include:
- Isoflavones (genistein and daidzein) which are primarily found in soya beans, soya products, chickpeas and other legumes.
- Lignans (enterolactone and enterodiol) primarily found in flaxseeds, cereal bran and legumes.
- Coumestans (coumestrol) found in alfalfa and clover.
Most food sources contain a combination of isoflavones in varying degrees and including these in the diet would be a good idea, although I believe there is no substitute for a herbal supplement such as Sage Complex by VH, which contains the right amounts of varied phytoestrogens to achieve hormonal balance.
Most women going through the perimenopause experience some of the concerns mentioned above and yet never seem to fully understand why. They often treat the symptoms rather than the causal factor and hence I often recommend the use of phytoestrogens as part of a holistic approach. In my opinion nearly every woman over the age of 35, with a few exceptions, should consider the use of phytoestrogenic supplementation on an ongoing basis.