Creating Your Perimenopause Plan

Hormones: Progesterone

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Progesterone Progesterone begins dropping around 30 and continues into our 40s. Progesterone is made in both our ovaries and (in a small amount) in our adrenal glands. Low progesterone can impact women of any age, often started by high stress levels (more on this later). However, in women generally over 35, progesterone levels decrease naturally as your ovaries decline in their ability to produce it. Your body can draw from progesterone in your adrenals but, if your adrenals are chronically pumping out cortisol (the stress hormone), they will not supply any progesterone which, in turn, lowers your progesterone levels even more. Hence, the absolute necessity of finding ways to lower your stress levels as you enter perimenopause. In addition to being an essential reproductive hormone, progesterone helps reduce anxiety and depression. When progesterone levels are optimal, you’re relaxed and sleep well.

Symptoms of low progesterone can include:

*Insomnia and trouble sleeping

*PMS, PMDD, and irregular periods

*Low mood, anxiety, and depression

*Drastic mood swings or irritability

*Weight gain, bloating, and excess fluid retention

*Tender breasts

*Brain fog and migraines

*Decreased libido

*Overall inflammation and pain

*Loss of pelvic floor muscle strength and instability in SI joint/pelvis

 

To help increase progesterone levels naturally: Lower stress (more on this in the Stress + Self-Care section); clean up your diet (more on this in the Nutrition section next); and try supplements and herbs (more on this in the Supplements + Herbs section)

Hormones: Estrogen

Did you know estrogen is carcinogenic? (I didn't!) It is normally produced every day of the month but, just as it peaks, progesterone (an anti-carcinogen) comes in to balance it out. Estrogen is important for bone formation, which is why women can suffer from osteoporosis as they age. It helps maintain the strength and thickness of the vaginal wall, skin, hair and mucous membranes. Produced in the ovaries and in body fat, estrogen hangs on longer than progesterone but when it drops (by about 60% when all is said and done) it can cause symptoms like hot flashes and night sweats that can disrupt our sleep. On the flip side, chronic stress lowers progesterone, leaving our bodies with an excess of estrogen. (It’s the ratio of progesterone to estrogen that’s important.) Add that to the onslaught of xenoestrogens in our environment (BPA, takeout plastic and Styrofoam containers, canned foods, plastic water bottles, herbicides, pesticides and hormones in our food, petrochemicals in shampoo, hair dye and cleaning products, pharmaceutical drugs--these things are ubiquitous) and estrogen dominance can be a fairly common fact of life. When you hear the term ‘estrogen dominance’ you might think that you need to decrease your estrogen levels. That is not at all what it means. Estrogen dominance refers to the ratio of estrogen to progesterone in your body that I mentioned above. So if you’re experiencing common symptoms of estrogen dominance, what you most likely need (besides cutting out all the xenoestrogens I mentioned above) is more progesterone. Make sense? It took me a minute to get this too, so go back and read this section again if you need to!

Symptoms of low estrogen:

*Hot flashes/night sweats

*Heart palpitations

*Insomnia

To help increase estrogen levels naturally: Add more phytoestrogens to your diet: soy (preferably unprocessed: edamame is one of my favorites!), flax, wild yam, whole grains and lentils are some good examples.

Symptoms of estrogen dominance:

*Heavy periods (some of my friends have likened theirs to crime scenes, in case you’re wondering if you’re normal)

*Severe PMS

*Fibroids

*Stubborn weight

To help decrease estrogen levels naturally: First, remember that it’s probably not the estrogen that’s the problem. It’s probably that your progesterone levels are too low in relation to your estrogen levels, so start there (especially if you’re under a lot of stress). But also do some more research on xenoestrogens, and see where you can cut out things like plastic and add more organic foods to your life.

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Hormones: Testosterone

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Most women have plenty of testosterone until their mid 20s, then levels start to decline until around age 40. That means that by the time you hit perimenopause your testosterone levels have already dropped.

Symptoms of testosterone deficiency:

*Loss of motivation, confidence

*Inability to concentrate

*Fatigue

*Trouble sleeping

*Low libido

*Indecisiveness

*Hair thinning and loss

*Thinning skin

*Weight gain

*Loss of bone density and muscle strength

 

To boost testosterone naturally:

Move your body (especially lifting weights), eat more protein (more specifics in the Nutrition section), B vitamins and zinc (avocados, pumpkin seeds, bananas and cabbage are high in one or both of these), cut out xenoestrogens, which may increase your body’s estrogen levels relative to testosterone levels (again, it comes back to those ratios), minimize stress, increase your exposure to natural light, and add more sex and intimacy into your life.

Hormones: Cortisol

Besides the three main sex hormones above, there are a few more hormones that I think are important to address. You are probably already familiar with cortisol, the stress hormone. This hormone is made by your adrenal glands in response to--you guessed it--stress. While we need cortisol in our body for it to function well, in particular in times of true danger, in our modern world we tend to run around stressed more often than not, which can cause our cortisol levels to be dangerously high. Eventually, our overworked adrenals can't produce enough cortisol and our cortisol levels tank. Whether too high or too low, dysregulated cortisol can wreak havoc on your body: inflammation, mood disorders, sleep issues, chronic diseases, and that stubborn belly fat that is a very common symptom of perimenopause. This is why it is so important to find ways to manage and lower your stress. I will offer more on this topic in the Stress + Self-Care section.

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Hormones: Insulin

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Insulin affects your sex hormones (estrogen, progesterone, and testosterone) so when it is out of balance, your other hormones can get out of balance too. Insulin's main job is to get blood sugar (glucose) to your cells for use as energy. But in perimenopause many women may have insulin resistance. This means that your cells stop absorbing the glucose they need for energy, leading to a higher level of sugar in your bloodstream, which your liver converts to fat. One reason you may develop insulin resistance is because your body might not be able to deal with high amounts of carbohydrates anymore—even healthy ones like fruits, whole grains, or brown rice. Too much sugar building up in your blood can cause symptoms like hot flashes, weight gain, and more. Another reason you may develop insulin resistance is chronic stress. When your body is stressed cortisol is released, as is glucose. While this helps when you are facing an acute emergency, it can cause hormonal imbalance if you are chronically stressed. Again, more to come on this important topic of stress...

Hormones: Melatonin

I’m adding melatonin to this section on hormones because I think it is one that is often overlooked. (I didn’t even know it was a hormone until I began this research.) Melatonin is a neurotransmitter-like hormone produced by serotonin that regulates your circadian rhythm (your body’s sleep-wake cycle) and relies on darkness for production to increase. As nighttime approaches, your body’s melatonin levels begin to rise. In the morning, levels decrease and cortisol levels rise to wake you up and get you going. When you fight against your body’s natural circadian rhythm by staying up late looking at screens with the lights on, over time you alter your body’s melatonin levels. On top of that, both lower estrogen levels and stress can have an adverse effect on your melatonin levels. I'll offer some tips on boosting your body's melatonin levels naturally in the Sleep section. Taking a melatonin supplement before bed has really helped me get a better night’s sleep during perimenopause. (No, it's not just for jet lag.) You will see dosages ranging from 2-5mg, so experiment for yourself. If 2 mg doesn’t seem to work don’t give up; I need 5mg to help me get a good night’s sleep.

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Create Your Plan: Hormones

*Do you notice any symptoms of progesterone, estrogen or testosterone imbalances? List them.

*Having learned more about these 3 main sex hormones, which of the suggestions that I mentioned above are you willing to try to help keep these hormones as balanced as possible?

*Having learned more about 3 other important hormones (cortisol, insulin and melatonin), which of the suggestions that I mentioned above are you willing to try to keep these hormones functioning optimally?

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