Hi friends! I’m excited for this one! In this blog post, I’m going to give you the tools to navigate perimenopause and share a nutrition and fitness protocol for natural hormonal balance and well-being. Are you are a woman between the ages of 35 – 45? If so.. you may have started noticing that things are changing with your body. What worked before, isn’t quite working the same. You may find it harder to keep the weight off or maybe your body composition is changing. You may notice the diet that worked for you before, doesn’t quite cut it, or the exercise routine you previously did isn’t giving you the results it used to. I can’t tell you how many conversations I have with friends, family, and clients about this exact topic.
Here’s the reality – You may be transitioning to perimenopause and what worked before probably won’t work the same now. You may need a lifestyle overhaul or you may just need to tweak your routine a bit. I’ll be 39 in a few months and I am one of those already in perimenopause. How do I know? I’m already experiencing some symptoms I’ll describe below and for many years I’ve worked very closely with a hormone specialist, Dr. Lida Aghdam, to nurture my hormone health.
What is Perimenopause?
Perimenopause refers to the transitional phase leading up to menopause, marking the end of a woman’s reproductive years. It typically begins several years before menopause, which is the point when a woman has not had a menstrual period for 12 consecutive months. For most women, this begins around age 35 to 40, or as late as 45.
Perimenopause can last for several years, with the duration varying from woman to woman. It ends when a woman reaches menopause, at which point estrogen levels have declined significantly, and menstrual periods cease entirely. During perimenopause, the level of estrogen — the main female hormone — in your body rises and falls unevenly and progesterone can decrease significantly. When progesterone starts to drop several changes in the body can start happening.
What is the difference between Perimenopause and Menopause?
Perimenopause
Timing: Most women transition to perimenopause between the ages of 35 – 45, but this can vary.
Balance Hormonal Changes: During perimenopause, estrogen levels fluctuate, and the ovaries gradually produce less estrogen over time. These hormonal changes can lead to irregular menstrual cycles and various symptoms such as hot flashes, night sweats, mood swings, and changes in libido.
Balance Menstrual Changes: Women may experience changes in the frequency, duration, and intensity of menstrual periods. Periods may become shorter, longer, lighter, heavier, or more unpredictable.
Fertility: While fertility declines during perimenopause, it is still possible for women to become pregnant, although the chances decrease as perimenopause progresses.
Menopause
Timing: Most women reach menopause by the age of 51 and 52, but this can vary.
Hormonal Changes: Estrogen levels have significantly declined by the time a woman reaches menopause, and the ovaries have largely stopped releasing eggs.
Symptoms: While some women may experience symptoms such as hot flashes, night sweats, and vaginal dryness leading up to menopause, these symptoms often diminish or resolve after menopause.
Fertility: Once a woman reaches menopause and has gone 12 consecutive months without a period, she is no longer fertile, and pregnancy is not possible without medical intervention.
I’ve followed Dr. Sarah Gottfried for several years. Dr Sara Gottfried is a hormone expert, a Harvard-educated doctor and scientist, and a clinical assistant professor in the department of integrative medicine and nutritional sciences at Sidney Kimmel Medical College, Thomas Jefferson University. She is the New York Times bestselling author of four previous books, including The Hormone Cure and Women, Food and Hormones. I consider her and my doctor, Dr. Lida Aghdam to be two of the top specialists when it comes to women’s health and hormones. Now, I wouldn’t say they are specialists when it comes to women’s fitness, but regarding women’s hormones, they are experts in their field. Dr. Sarah Gottfried made a list of what happens to your body when you don’t have enough progesterone during perimenopause. See below.
What’s Happening with Hormones at Perimenopause + Menopause
- Irregular menstrual cycles or cycles becoming more frequent as you age
- Agitation or premenstrual syndrome (PMS)
- Painful and/or swollen breasts (mastalgia)
- Cyclical headaches (particularly menstrual or hormonal migraines)
- Your blood seems to pool easily, or your skin bruises easily
- Hemorrhoids or varicose veins
- Heavy or painful periods (heavy: going through a super pad or tampon every two hours or less; painful: you can’t function without ibuprofen)
- Bloating, particularly in the ankles and belly, and/or fluid retention (in other words, you gain 3 to 5 pounds or more before your period)
- Ovarian cysts, breast cysts, or endometrial cysts (polyps)
- Easily disrupted sleep, perhaps with night sweats
- Itchy or restless legs, especially at night
- Increased clumsiness or poor coordination
- More cravings for food, alcohol, or anything to calm you down
- Miscarriage, usually in the first trimester
- Infertility or sub-fertility
Why Is It Harder for Women to Keep The Weight Off After The Age of 35
During perimenopause, women experience hormonal fluctuations, which can contribute to several factors that make weight loss more challenging.
Loss of Muscle Mass: “Muscle mass decreases approximately 3–8% per decade after the age of 30 and this rate of decline is even higher after the age of 60.”
“As a woman gets older and enters the second phase of perimenopause, both progesterone and estrogen (specifically, estradiol) are lower. Testosterone drops too, leading to less muscle mass (dropping five pounds of muscle per decade) and rising fat mass, a dreaded combination that accelerates aging.”
Changes in Fat Distribution: Hormonal changes during perimenopause can lead to a shift in fat distribution, with more fat accumulating around the abdomen rather than the hips and thighs. Abdominal fat, in particular, is associated with an increased risk of metabolic disorders and is harder to lose.
Increased Appetite and Food Cravings: Hormonal fluctuations can also affect appetite regulation and increase cravings for high-calorie, carbohydrate-rich foods. This can lead to overeating and make it more challenging to stick to a calorie-controlled diet.
Insulin Resistance: Some women may become more insulin resistant during perimenopause, leading to higher blood sugar levels and increased fat storage, especially around the abdomen.
Stress and Sleep Disturbances: Perimenopause can be accompanied by increased stress levels and sleep disturbances, which can negatively impact metabolism, appetite regulation, and energy levels, making weight loss more difficult.
Psychological Factors: The physical changes associated with perimenopause, such as weight gain and changes in body composition, can also affect women psychologically, leading to feelings of frustration, low self-esteem, or emotional eating patterns that hinder weight loss efforts.
Overall, the combination of hormonal changes, metabolic shifts, changes in body composition, and lifestyle factors during perimenopause can make it harder for women to lose weight compared to earlier stages of life. However, adopting healthy lifestyle habits, such as regular exercise, a balanced diet, stress management, and adequate sleep, can still support weight management during this transitional phase.
How to Navigate through Perimenopause
Navigating through perimenopause involves understanding the changes happening in your body and implementing strategies to manage symptoms and support your overall health and well-being. Here are some tips for navigating through perimenopause:
First off, Educate yourself about Perimenopause: including its symptoms, hormonal changes, and potential effects on your health. Understanding what to expect can help you feel more prepared and empowered to manage this transitional phase.
Healthy Lifestyle Habits to help you Navigate through Perimenopause
Regular Exercise: Incorporate regular physical activity into your routine, including aerobic exercise, strength training, and flexibility exercises. Exercise can help alleviate symptoms such as mood swings, hot flashes, and weight gain, while also supporting bone health and cardiovascular function.
Balanced Diet: Eat a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid excessive consumption of processed foods, sugary snacks, and refined carbohydrates, which can exacerbate symptoms such as fatigue, mood swings, and weight gain.
Adequate Sleep: Prioritize quality sleep by practicing good sleep hygiene habits, such as maintaining a consistent sleep schedule, creating a relaxing bedtime routine, and creating a comfortable sleep environment. Address sleep disturbances promptly, as they can exacerbate symptoms such as irritability, fatigue, and difficulty concentrating.
Stress Management: Find effective ways to manage stress, such as mindfulness meditation, deep breathing exercises, yoga, prayer, tai chi, or spending time in nature. Chronic stress can worsen symptoms such as hot flashes, mood swings, and sleep disturbances, so it’s essential to incorporate stress-reduction techniques into your daily routine.
Hormone Therapy: Consider Hormone therapy (HT) or other medications to alleviate severe symptoms and improve quality of life. HT can help manage symptoms such as hot flashes, vaginal dryness, and mood swings, but it’s essential to weigh the potential benefits and risks and discuss them with your healthcare provider.
Lower Cortisol Levels: Lowering cortisol levels, especially when chronically elevated due to stress, is essential for overall health and well-being.
Strategies to Help Lower Cortisol Levels Naturally
- Stress Management Techniques
- Regular Exercise
- Adequate Sleep: Prioritize getting enough sleep each night, aiming for 7-9 hours for most adults. Poor sleep quality or insufficient sleep can lead to elevated cortisol levels.
- Healthy Diet
- Limit Caffeine and Alcohol: Limit your intake of caffeine and alcohol, as both can increase cortisol levels. Consider reducing or eliminating caffeine consumption in the afternoon and evening to support better sleep quality.
- Mindful Eating
- Social Support
- Time Management
- Relaxation Activities
She goes on to say “As our exposure to endocrine disruptors has increased, so has the incidence of thyroid disease in the United States, particularly for thyroid cancer and thyroid autoimmune disease. People who showed the highest 20 percent of exposure to environmental toxins also experienced up to 10 percent more thyroid function impairment than those with the lowest 20 percent exposure.”
How to Lower Your Toxic Load
Lowering your toxic load involves minimizing exposure to harmful chemicals and toxins in your environment while supporting your body’s natural detoxification processes. Here are some strategies to help reduce your toxic load:
- Eat a Clean Diet
- Stay Hydrated
- Choose Non-Toxic Household Products
- Minimize Exposure to Environmental Toxins
- Reduce Plastic Use or choose BPA free plastics
- Support Liver Health by reducing alcohol and eating cruciferous vegetables like broccoli, cauliflower, Brussels sprouts.
- Practice Stress Management
- Get Regular ExerciseSupport Digestive Health with a fiber rich diet.
Nutrition Protocol for Women in Perimenopause
Balanced Diet: Focus on a balanced diet rich in fruits, vegetables, lean proteins, whole grains, and healthy fats to support overall health and manage weight.
Calcium and Vitamin D: Ensure adequate intake of calcium and vitamin D to support bone health. Good sources include dairy products, leafy greens, fortified foods, and supplements if needed.
Omega-3 Fatty Acids: Include sources of omega-3 fatty acids such as fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, and walnuts to support heart health and reduce inflammation.
Hydration: Stay hydrated by drinking plenty of water throughout the day, as hormonal changes may increase the risk of dehydration and affect skin health.
Limit Processed Foods: Minimize consumption of processed foods, refined sugars, and excess caffeine, which can exacerbate hormonal fluctuations and contribute to weight gain.
Prioritize Fiber and Protein: See my blog post below to achieve a healthy, high protein diet.
Natural Supplements For Perimenopause
Here’s a list of natural supplements that can be helpful during perimenopause. It’s advised that you consult your doctor before taking any supplements to see what is right for you. However, many of these supplements are recommended during perimenopause by Dr. Lida Aghdam and Dr. Sarah Gottfried. These supplements are in my Fullscript Dispensary, a dispensary for integrative nutritionist and practitioners. You’ll need to create a free account first to see the full list.
- Calcium
- Vitamin D3 + K2
- Probiotic
- Multivitamin or Trace Minerals
- Omega 3’s
- Magnesium – improves mood, sleep, exercise performance, blood sugar regulation, maintaining regular bowel movements and more.
- Curcumin – (management of oxidative and inflammatory conditions, metabolic syndrome, arthritis, anxiety, and hyperlipidemia)
- Ashwaganda – (reduces perceived stress and levels of the stress hormone cortisol)
- Protein Powder (Assist in getting adequate protein in your day to maintain muscle.)
- Creatine (If you strength train)
- Cortisol Manager – supports balanced cortisol and healthy stress response. Made up of Ashwaganda and L-Theanine.
- Chasteberry (Only for women in perimenopause that are still menstruating. Reduces PMS: hot flashes, night sweats, mood swings, breast tenderness, pelvic discomfort, and interrupted sleep . Do not take if you have cancer or are breastfeeding. May interact with other drugs.)
Fullscript is an online dispensary that only sells clean, third-party tested, practioner grade supplements. To get 15% off, click the link above, create a free account and see my Perimenopause protocol.
Fitness Protocol for Women in Perimenopause
Strength Training: Focus on strength training exercises at least two to three times per week. This helps maintain muscle mass, which tends to decline with age and hormonal changes.
Cardiovascular Exercise: Incorporate aerobic activities like walking, jogging, swimming, or cycling for at least 150 minutes per week to improve heart health and manage weight.
Important Note on Cardio: If you are a cardio junky, it may be time to switch things up a bit if you’ve stopped seeing the results you used to see. Replace a couple days of cardio in your week with resistance training and you may be shocked with the results.
Important Note on High Intensity Training: While it may seem like intense exercise will get the weight off faster, too much high intensity exercise can lead to elevated levels of cortisol in the bloodstream and heightened symptoms of physical stress, even when exercise is not being performed. Since we, as women over the age of 35, are trying to lower our cortisol levels, I do not suggest high intense exercise training every day. A couple times a week is ok to reap the benefits, but it shouldn’t be a daily occurrence. I am not personally a fan of the dark fitness studios with loud music and intense exercise classes. I loved them in my 20s and early 30’s but I think these types of classes may be doing us more harm than good. We need to see the daylight during the day to help with our circadian rhythm. Loud and intense exercise every day is not the prescription for women over the age of 35. We need to be working on lowering our cortisol levels, not increasing it.
Flexibility and Balance: Include flexibility and balance exercises such as yoga or Pilates to maintain joint mobility and reduce the risk of falls.
Listen to Your Body: Be mindful of any changes in energy levels, joint pain, or other symptoms. Adjust your exercise intensity and duration accordingly.
Rest and Recovery: Allow for adequate rest days between workouts to prevent overtraining and support hormonal balance.
Recommended Workout Routine for Women 30-50
This specific workout routine is for women ages 30-50 that want to achieve a lean and sculpted physique.
- Heavy Resistance Training (10-15 reps, 2-3 sets) – 1-2 days/week.
- Lighter Resistance (low weight, high rep) and/or Mobility Training – 1-2 days/week.
- Cardio Training – 1-2 days/week.
3-Day Workout Split
You could lift heavy 1 day per week and do lighter resistance training, like bodyweight, bands, yoga or pilates 1-2 days/week. Then throw in zone 2-3 cardio 1-2 times per week. That could mean a brisk walk in the neighborhood for 45 min.
5-Day Workout Split
You could lift heavy 2 days per week and do lighter resistance training 1-2 days/week. Then add in cardio 1-2 days/week. Could be zone 2-3 cardio or any cardio you enjoy.
Important Note on Resistance Training: The most important thing is that you are incorporating some sort of resistance training in your weekly routine a couple times a week at least. If you prefer to lift super heavy 5 times a week, that is A-Ok with me. You do you. I just want to make sure you are getting it in as you age.
To see my recommended workout routine for women over 50 see my blog post about functional strength training.
Women Over The Age of 35 are Typically Stressed To The Max – Let’s Not Ignore This
Perimenopause and menopause usually come around the time our children are getting older and our parents are getting older. An unusual amount of stress is put upon women during this time as we care about the ones we love and we continue to pour into them. The teen years can be challenging, aging parents and their health is a concern as well. This is just life. However, friends be sure you are taking care of your own health. Don’t let life consume you during this time. Ask for help and outsource where you can. It’s ok to say no, it’s ok to get a massage, it’s ok to care for yourself.
Find something that brings you joy. Is that tennis or pickleball with friends, a fitness class, dinner or hiking with friends, or taking a timeout from life to make time for your loved-ones? Just take care, friends. Remember… you can’t pour from an empty cup. Remember that old saying, Live, Laugh, Love? Truly though. Are you living, laughing, and loving? If not… it’s time to make time for it. Life is too short.
Stress Relief Tools
I’ve put together a list of tools that can be helpful for destressing. I’ve already bought most of these myself. 🙂
Dead Sea Soak | Lavender Roll-On | Anxiety Therapy Journal | Ancient Minerals Bath Flakes | Relaxation Essential Oil Set | Neck & Back Massager | Migraine Relief Cap | Coloring Book | Ceramic Diffuser | Chill Out Essential Oil | Tranquil Essential Oil | Worry Free Essential Oil | Sleep Easy Set
Lastly, as you go through the hormonal roller coaster of perimenopause and menopause, you don’t have to suffer. Knowledge is power. The best way to take care of your hormones is to take care of your body and prioritize your health. Eat a balanced diet high in fiber and protein, exercise regularly, destress, lower cortisol levels, make time for yourself, prioritize sleep, use natural supplements as you need them, lower your toxic load to the best of your ability, work with a natural hormone specialist if needed and friend, find the joy in life! As Dr. Gottfried says, “It’s entirely possible to tame the chaotic hormones of perimenopause naturally and to ease into menopause with a sense of balance and grace.” I hope you enjoyed this read and found it helpful.
