Perimenopause is the transitional phase before menopause marked by hormonal changes that can significantly impact a woman's health and weight. Recognising and managing these changes is crucial to maintaining immediate and long term quality of life.
If you're 35 years or older, or have a loved one that you suspect is in the transition, keep reading.
What is Perimenopause?
It’s a period of hormonal transition, much like puberty was the transitional stage of adolescence. It can begin anywhere from mid-thirties and last four - ten years before the cessation of ovulation (menopause) actually takes place. The hormone picture seen in perimenopause is very different to that of menopause. It involves fluctuating hormone levels, particularly a decline in progesterone and variable (often highly variable) estrogen levels. Changes in levels affect the entire body (not just the ovaries), influencing metabolism, mood, immune health, bone mineral density, cardiovascular health and weight.
Signs and Symptoms of Very Early Perimenopause
There is no one blood test that can diagnose early perimenopause, though according to Prof. Geralyn Prior (Professor of Endocrinology and Metabolism at the University of British Columbia in Vancouver, BC), very early perimenopause is characterised by subtle hormonal shifts (as outlined above) and the associated symptoms.
Praise Progesterone
Progesterone is a hormone to celebrate. It helps to thin the uterine lining (counteracting oestrogen’s role in thickening it) and therefore helps to lighten periods. It’s a calming hormone, so can reduce anxiety and support quality sleep. It’s also anti-inflammatory, builds bone mineral density, increases metabolic rate and is cardio protective. It’s pretty important.
Low levels of progesterone met with fluctuating oestrogen levels (or not) can lead to:
Mild changes in menstrual cycle length, especially a shortening of the cycle initially.
Heavy menstrual bleeding. Technically defined by the loss of 80ml or more of liquid during a menstrual bleed.
Worsening of pre-menstrual symptoms (PMS) such as breast tenderness, mood swings, irritability, insomnia and anxiety.
Occasional hot flashes or night sweats.
Slight weight gain or difficulty losing weight.
If you’re over 35 years of age and noticing more and more of the above within yourself then there is a good chance you’re in early perimenopause. Perimenopause does not mean you are ‘broken’, ‘over the hill’ or even infertile, but if you want to lose weight, regain quality of life and avoid risk of disease in future it’s helpful to be aware of what’s happening within your body.
How Hormonal Changes Impact Weight Gain
Individual circumstances aside, evidence indicate it's the relative oestrogen dominance and increase in cortisol production that lead to stagnant weight and weight gain in perimenopause. Poor quality sleep (caused by hot flushes or anxiety), high stress levels (caused by demanding lifestyle and lowering progesterone) significantly impact insulin sensitivity, blood sugar control and ultimately fat burning ability.
When was the last time you found it easy to eat and train well when you were tired, drained and frazzled from successive nights of poor-quality sleep?
If you’re resonating with some of the signs and symptoms above then please stay tuned for Part ii where I’ll share priorities for addressing perimenopausal weight gain.
If you're ready to address perimenopause symptoms, unlock your weight loss potential right away and want my support then I invite you to learn more about Mind Body Makeover.
References
Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause. 2012;19(4):387-395. doi:10.1097/gme.0b013e31824d8f40.
Burger H, Woods NF, Dennerstein L, Alexander JL, Kotz K, Richardson G. Nomenclature and endocrinology of menopause and perimenopause. Expert Rev Neurother. 2007;7(11 Suppl):S35-S43. doi:10.1586/14737175.7.11s.S35
Woods NF, Mitchell ES. The Seattle Midlife Women’s Health Study: a longitudinal prospective study of women during the menopausal transition and early postmenopause. Womens midlife health. 2016; 2, 6 (2016). doi.org/10.1186/s40695-016-0019-x
Woods NF, Mitchell ES, Smith-Dijulio K. Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study. Menopause. 2009;16(4):708-718. doi:10.1097/gme.0b013e318198d6b2
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