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Perimenopause and menopause

Whether you choose to ignore it or not, all women will enter menopause eventually. 47 million women enter menopause each year and 85% of all menopausal women experience symptoms.

But do you know what it is?

Do you know what signs and symptoms may go hand in hand with it?

What age it might start?

Perimenopause can start from the age of 35 though more commonly around the age of 45 and can last up to 10 years. When you have had no menstrual bleed for 12 months this is then menopause.

Perimenopause can often come with more symptoms than menopause itself. If you are experiencing any of the following this may mean you are perimenopausal:

  • Irregular or otherwise abnormal menstrual periods (including heavier periods)

  • Hot flashes or night sweats

  • Bloating (water retention)

  • Breast swelling and tenderness

  • Headaches (especially premenstrually)

  • Mood swings (including anxiety, irritability, and depression)

  • Foggy thinking, memory loss

  • Fatigue

  • Trouble sleeping/insomnia

  • Decreased sex drive

  • Worsening PMS

Oestrogen versus progesterone in perimenopause


Progesterone is known as our calming, mood, sleep, libido and bone-enhancing hormone.

As we age, the amount of progesterone we produce reduces. This is because not only do our eggs decline but also the follicles that the eggs grow in are lost too and progesterone is produced by the follicle remnant in the second half of the menstrual cycle, therefore progesterone levels decrease. For peri-menopausal women, they may have a normal first half of the cycle (follicular phase) and a shortened second half of their cycle (luteal phase) resulting in a fluctuation of oestrogen and progesterone levels. This may cause symptoms in the second half of the cycle with perhaps increased PMS and mood and sleep changes.


Oestrogen is responsible for regulating the menstrual cycle, but also affects the reproductive system, the urinary tract, the heart and blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles, and the brain.

Oestrogen levels generally fall during perimenopause but weirdly levels can actually rise in perimenopause mainly due to the rollercoaster ovarian function at this time.

What can you do? The best thing really is to just start now!

Whatever stage of life you’re in, whether you are pre – perimenopausal, perimenopausal or menopausal, it’s never too early to start preparing your body for the inevitable.

So what can you do?

1. Fruit and Vegetables

Include a rainbow of fruit and vegetables, particularly broccoli, sprouts and carrots. The more colour in your diet, the more vitamins and minerals you’ll benefit from.

2. Lean Protein

Try to focus on lean protein, such as fish, eggs and chicken, ideally free-range or organic. If you are vegan opt for pulses and complex carbs such as quinoa and sweet potatoes.

3. Consume More Phytoestrogens

It's also good to start to introduce soya, lentils, chickpeas, flaxseeds, oats and wholegrain rice into your diet - all of which contain phytoestrogens. These are plant-based foods which help to balance hormones and provide oestrogenic ‘activity’ where required. Try and include a portion of these foods every day.

4. Check Your Iron Levels

Many menopausal women are also low in iron, so it’s important to be tested if you think you may be at risk.

5. Omega-3

Omega-3 fatty acids can be beneficial for many women during the menopause, as they help to maintain a healthy heart and flexible joints. They’ll also help to maintain youthful-looking skin. You can increase your dietary intake by eating oily fish such as mackerel, salmon and herring. Flaxseeds are also a great source of omega-3’s.

6. Reduce Foods That Cause Inflammation

It’s also beneficial to eliminate certain inflammatory foods from the diet. Foods which spike our blood sugar levels should be reduced, including pastries, cakes, white bread and white pasta. Try to steer clear of refined sugar wherever you can because this not only inflames the body but also spikes your blood sugars, which can lead to weight increase especially around the middle.

7. Avoid Spicy Foods

Hot flushes and night sweats are common symptoms of the menopause, so eating foods that create heat in the body is only going to make matters worse. Try to avoid eating foods that are spicy such as curries and spicy stir-fries.

8. Eat More Legumes, Nuts and Seeds

Eating legumes such as beans, peas, chickpeas, lentils, soybeans, peanuts, and tamarind, along with seeds and nuts such as sunflower seeds and almonds may help prevent dry skin and balance hormone levels. That's because they contain vitamin E, zinc and calcium.

9. Gentle Exercise and Resistance Training

Aim to take regular aerobic exercise for 30 – 40 minutes 3 times a week

Post menopausal women and vaginal dryness, itching and urinary tract infections

This is something that is not often talked about but it can have such a huge effect on quality of life. Low levels of oestrogen can cause the vagina to become drier and less elastic. Also through menopause the pH of the vagina changes from being more acidic (which defends against infections) to more alkaline due to the fall in oestrogen. This means that you can be more prone to urinary tract infections, itching and vaginal infections.

So what can you do?

If you have become so sore and dry that intercourse is painful it is better to consult your gynaecologist about using a topical oestrogen that can be inserted into the vagina.

Most importantly follow the above recommendations. But the following will also be helpful:

  • Omega-3 oils – support mucous membrane production and reduce inflammation

  • Vitamin C – supports the production of collagen which helps the walls of the vagina remain elastic helping to reduce urinary tract infections.

  • Probiotic – improves the levels of good bacteria in the gut which will help protect against thrush and vaginal and urinary tract infections

  • Cranberries – can be beneficial if experiencing cystitis as cranberries stop the bacteria from sticking to the walls of the urinary tract. This should be unsweetened cranberry juice or can be taken as a supplement.

The above is general advice, everyone’s body is different and often a more targeted approach following testing is necessary.

Article written by Catherine Piner


Jenn Salib Huber - Function and Intuitive Nutrition for Women in Midlife:

Marilyn Glenville PhD Natural Solutions to Menopause, How to Stay Healthy Before, During and Beyond Menopause

Ovarian aging, follicular depletion, and steroidogenesis R G Gosden , M J Faddy, Available at:

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