Perimenopause Power: How Simple Lifestyle Tweaks Can Transform Your Hormonal Health

by Megha Gokals Sanghi, ND

Naturopathic Doctor at New England Integrative Medicine

 

As we have come to learn over time, decisions surrounding what we put into our bodies, what we surround ourselves with, and how we spend our time makes a significant difference in our health. It is no surprise that our reproductive health is greatly impacted by these lifestyle choices, or as the Naturopathic field likes to term these, “our determinants of health.” There are some determinants that we may not have control over such as our genes, however we do have control of epigenetic factors. Epigenetic factors are these determinants of health that are able to change the expression of our genes. For example, just because your parent had type 2 diabetes, and you have an increased risk for developing diabetes, there are many factors in your life that can be modified so prevent you from developing diabetes. Let’s discuss a few of these lifestyle factors and how to optimize our choices to support our bodies through perimenopause in particular!  

Nutrition

What we choose to nourish our bodies with has a significant impact on how our body functions. Choosing nutrient dense foods provides us with the necessary vitamins and minerals for our bodies to function optimally. For reproductive health in particular, as females transition through perimenopause, there are certain nutritional goals that can ease the transition. 

Phytoestrogenic foods have specific structures that are like the estrogen that our bodies produce. Phytoestrogenic foods can support reproductive health, heart health, weight loss, hormone-dependent tumors, bone health, skin health and the immune system. Due to their similar structure to estrogen, the compounds in phytoestrogenic foods are able to bind to estrogen receptors and support the declining levels of estrogen through perimenopause. Examples of phytoestrogenic foods include flaxseeds, soy, peaches, garlic, red wine, sesame seeds, cruciferous vegetables, and nuts. 

General nutritional guidelines to be followed include a diverse, nutrient dense diet: 

• Aim to get 5 servings of vegetables a day (1 serving = ½ cup cooked or 1 cup raw)
•  Ideally, 2 of these servings will be dark, leafy greens such as spinach, kale, arugula, Bok Choy, Swiss chard and collard greens
• Aim to get 1-2 servings of fruits a day
• Berries are rich in antioxidants and a delicious way to get fruits in!
• Calculate your protein goal with this simple formula
• 0.8g per kilogram of body weight (or 0.36g per pound of body weight)
• Aim to get 6 servings of grains a day
• 3 of these servings should be whole grains such as barley, bulgur, farro, millet, quinoa, brown rice, oatmeal, and whole wheat foods such as pasta, bread, etc. 

During perimenopause and menopause, weight gain is a rather common symptom, and this is due to the basal metabolic rate decreasing as a result of the lower levels of reproductive hormones. Females tend to need 250-350 less calories a day once their estrogen and progesterone levels have decreased significantly, and this can help prevent any unnecessary weight gain that is accompanied by perimenopause and menopause. This is yet another reason why evaluating and understanding hormone levels during this period of time can be helpful to make health decisions. 

Hydration

Our bodies are made up of 60% of water, making it an extremely important substance to sustain all of the body’s functions. Each cell requires water to perform tasks as basic as creating energy. Estrogen hormone replacement can increase sensitivity for maintaining water balance in the body, helping menopausal women maintain healthy levels of hydration. The opposite can be deduced that as estrogen levels decline throughout perimenopause and into menopause, thirst levels tend to decrease, leaving females at a higher risk for dehydration. Hydration should always be prioritized, however with this information it is pertinent to set specific daily hydration goals during this phase of life. 

Calculate your daily water intake body taking your body weight in pounds, dividing it by 2 and drinking that number in ounces for the day! For example, if a female weighs 160lbs, they would need to drink 80oz of water a day. 

Sleep

Insomnia is another common symptom of perimenopause and menopause. This symptom is due to numerous factors such as night sweats, increased cortisol levels causing melatonin dysfunction and mood disturbances. Given the increased likelihood of developing insomnia during this phase, prioritizing good sleep hygiene is of the utmost importance. 

• Be consistent: Go to sleep at the same time each night, and wake up at the same time each morning, even on the weekends 
• Create the right environment: Keep the room dark and cool 
• Avoid electronic devices for 1 hour before sleep 
• Avoid large meals, caffeine, and alcohol for 1 hour before sleep 
• Be tired by the time you get into bed by exercising

Additional techniques can include guided meditation or reading a relaxing book before sleep. 

Mental Health

Females with perimenopause are at a higher risk for developing mental health disorders such as depression and anxiety.  Prioritizing mental health support during this transition is crucial. There are numerous tools that can be used to support mental health. 

• Positive affirmations as your body changes 
• Prioritizing nutrition, hydration, and exercise
• Surrounding yourself with supportive people to ease the transition
• Journaling
• Meditation

There are times where these techniques are unfortunately not enough to manage mental health symptoms, and further help is required. Stress has become a part of our society in a way we could not have anticipated, and we are all plagued by it, which further worsens our mental health. Always reach out to your provider for the appropriate referral to a counselor, therapist, or psychiatrist. 

Exercise

As reproductive hormones decrease through perimenopause, unfortunately cardiovascular risk increases due to the lack of protection from estrogen levels. This makes exercise very important during this phase of life as exercise can decrease cardiovascular risk. Specifically aerobic and resistance exercises are important at this time. 

Aerobic exercises such as brisk walking, jogging, hiking, dance, and rowing support cardiovascular health and a balanced weight, which is particularly important with a decreased basal metabolic rate. 

Resistance exercises such as squats, lunges, bicep curls and bench pressing also support cardiovascular health and a balanced weight. Resistance exercises have the added benefit of maintaining healthy testosterone levels which is another important hormone for energy levels in particular. These exercises can decrease fatigue levels which tend to be high in perimenopause.

Alcohol Consumption

At moderate levels, alcohol causes blood vessels to relax and widen which for most people results in feeling warmer. A study performed showed that increased alcohol intake can worsen the vasomotor symptoms or even cause them to begin earlier in perimenopausal females. Vasomotor symptoms include hot flashes and night sweats. It is best to avoid alcohol during this transition, and if one does choose to drink alcohol, to limit intake. 

Smoking

There are multiple mechanisms of action from cigarette smoking that may be the cause of early onset menopause. Proposed mechanisms include decreasing levels of reproductive hormones as well as direct toxic effects on ovaries which subsequently result in decreasing reproductive hormone levels.  Studies have shown a direct dose dependent relationship between smoking and early perimenopause onset, so for example someone who has a 10 pack-year history has a higher likelihood of early onset perimenopause than someone with a 5 pack-year history. Additional factors include other lifestyle factors such as nutrition, hydration as well as smoking cessation. Someone with a 10 pack-year history who is currently smoking has a higher risk than someone with a 10 pack-year history who discontinued smoking. It is advised to avoid smoking for general health reasons, but in particular for perimenopausal health. 

Hormony’s Holistic Approach 

The ideal way to approach any health concerns is to explore every aspect of how your lifestyle may be affecting your health. The factors we discuss above are just a few things that you can evaluate as you embark upon your perimenopause health journey. We urge you to take a step back and think about different factors that may be impacting your health at this time. We highly recommend working with a holistic practitioner who will not only order specific testing but offer insight on any independent testing you bring in (from Hormony!) and look at a variety of lifestyle factors that are likely affecting your prelude into perimenopause.