At a time when talking publicly about women’s hormones is still viewed as somewhat taboo, Davina McCall’s recent documentary Sex, Myths and the Menopause has been praised for taking on the thorny issue of menopause and perimenopause and oestrogen giving it a much-needed public platform.
Indeed, since this stage is something half the adult population will go through, it seems high time to re-evaluate how we think about and treat this key transition in women’s lives.
Menopause is defined as the point at which a woman has not had a period for at least 12 months and is no longer able to get pregnant naturally. Before this point, there may be a longer transitional stage of anything up to 10 years which may be accompanied by symptoms associated with changing hormone balance. This stage is known as perimenopause.
The symptoms of menopause can be many and varied. Because open and honest discussion of these symptoms have been lacking, historically women have had a hard time obtaining appropriate advice and treatment. Menopause is generally associated with symptoms such as night sweats, hot flushes and insomnia, vaginal dryness, and low libido. However, there are many other less well-known symptoms that fly under the radar and that doctors may not link to menopause. These may include anxiety, depression, and mood swings. When women present to GPs with symptoms like these, one common frontline treatment is antidepressants, but this merely masks the real issue, which is underlying hormonal imbalance.
Hormonal Impacts of Menopause
So, what are the hormones involved in this stage of a woman’s reproductive life, and why do they become imbalanced? Oestrogen and progesterone control menstruation in a finely tuned dance. Together with testosterone they are produced by the ovaries, and indirectly via the adrenal glands. Oestrogen also influences how the body uses calcium and maintains cholesterol levels in the blood.
To complicate matters, even before perimenopause begins, it can be quite common for a woman to be oestrogen dominant. This means that oestrogen levels are too high in relation to progesterone. This can lead to insomnia, decreased sex drive, irregular periods, breast tenderness, bloating and more. Oestrogen dominance can start with an imbalanced gut flora that fails to clear excess oestrogen. Add a congested liver, synthetic oestrogens from the environment and modern-day stress, then this is a recipe for hormone swings that can seriously undermine a woman’s wellbeing. During perimenopause, a woman can still experience oestrogen dominance if progesterone levels are insufficient. As sex hormones decline further, the stress hormone cortisol rises, so it can be common for women to experience weight gain, even if they are not eating more than usual.
Diet and Lifestyle
Many women turn to their doctor for help rebalancing hormones using Hormone Replacement Therapy (HRT), but increasingly women are also turning to more natural methods.
Diet can certainly play an important role, including cutting down on:
- Caffeine
- Refined foods
- Sugar
- Alcohol
This can give the liver a much-needed break so it can do its job of ‘bio-transforming’ hormones ready for elimination.
Consuming gut-friendly foods can improve the ability of the gut flora to sweep excess oestrogen, ready for excretion.
These include:
- Leafy greens and the brassica family
- Pulses and legumes
- Fermented foods such as sauerkraut and kimchi
Lifestyle changes are key and do wonders for resetting stress levels, including:
- Getting to bed early
- Regular breaks from the computer
- Enough exercise to stimulate the lymphatic system/sweating (but not excessive cardio)
- Plenty of sunshine—particularly in the morning
- Meditation
Herbs and Menopause
Herbs can also play an important role during this time. Particularly helpful are the phytoestrogens: red clover, sage, shatavari, fenugreek and motherwort. These are herbs with special compounds that bind preferentially to oestrogen receptor sites, but which have much weaker (1% or less) oestrogenic effects in the body.
Herbs such as maca, ashwagandha and shatavari work as ‘adaptogens’ to support the nervous system, allowing it to respond more appropriately to stress, lowering excess oestrogen levels. Raspberry leaf and nettle support the adrenal glands to produce healthy progesterone levels.
Another traditional herb that has a long history of supporting women’s reproductive health is donq quai, a Chinese herb that can be helpful in improving blood flow, supporting painful periods, cramping and irregular menstrual cycle. Alongside positive lifestyle changes, these herbs can provide a helpful defence against the often confusing and debilitating effects of menopause.
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