menopause

By Seema Bhandri

Following on from Felicity’s post on the perimenopause she asked me to share my own experience of the perimenopause and how it affected me, what I discovered when I researched it and what helped and worked for me, as well as resources I used or have found along the way.

My Story

I went into an early menopause in my early 40’s and only realised when I stopped a hormonal contraceptive pill. I’d had no periods on the pill, which was a normal occurrence on that type of pill, and they never returned, and it was all a bit of a shock when a blood test (FSH) showed I was post menopausal. On reflection my periods had been dwindling in my late 30’s with occasional gaps of 2months here and there. As Felicity eloquently put it you have either stress hormones or oestrogen hormones, and at that time in my life I was busy starting a new career as a GP, and working and adapting was a stressful time. In hindsight I do feel stress played a role in my perimenopause journey.

On writing this I notice a couple of things, firstly, I talk of ‘my’ periods. I see how we relate to our menstrual cycle is very personal. How bothered we are by them, how much we take notice of them, how much we like them or dislike them. The same is true in my clinical experience of the menopause. Everyone is different in how they are with the changes and that can change over time too.

Secondly the shock I felt. I hadn’t anticipated the arrival of the menopause so swiftly. Looking into it I found that 5% of women in the UK experience an early menopause (see below). An early menopause is defined as it occurring between the ages of 40 and 45. Premature ovarian insufficiency (POI) is a menopause that occurs before 40 years old. This is much less common. The shock is and was for me like a grief. At that time and even now I don’t feel we really are that open about that aspect of it.

All that said the symptoms that really triggered me to find out what was going on was not the lack of periods (I had thought the lack was just related to the pill working it’s way out of my system) but forgetting names of people, word finding difficulties and quite overwhelming anxiety. I was also seeing an acupuncturist for sleeplessness. But I hadn’t pieced all together! This is not an unusual feature…. the symptoms being a bewildering array that often we don’t connect together! Thankfully there is much more information out there in the public domain following celebrity publicity (eg Davina McCall) and good sources of information exist now like https://www.balance-menopause.com. 

After the penny dropped I found acupuncture helpful for the hot flushes that were keeping me awake! And within 3 sessions things were improving. And that was partly because acupuncture brought back my periods briefly. And worked well to control my symptoms for several months.

I remember a friend telling me about a book called Natural solutions to menopause by Marilyn Grenville because at that time there wasn’t as much information available online. I used the book to direct me to herbs especially sage tincture initially then I did seek help with a medical herbalist. I tried yoga breathes that were like a dog panting (sitali pranayama) for the hot flashes! I used magnesium for the night cramps and reduce the anxiety/help sleep. I did try over the counter herbal mixtures and they didn’t work as well as a concoction that was directed at my symptoms.

I did some training in functional medicine in 2017 and in the process of doing a gut reset diet I went sugar free and found all my peri menopausal joint pain went and my sleep improved considerably allowing for more tolerance of the remaining hot flushing/night sweats symptoms.

Over time I recognised the more active and stress free I was the symptoms were hardly noticeable. An example was a sabbatical I took where I walked 4-8hours each day. And spent a lot of time outdoors, away from work in the NHS the symptoms were unsurprisingly absent!

I met patients in the NHS managing the symptoms so differently, as I realised what was affecting me I got more interested how patients were managing the thing that I too was trying to get my head around. I met patients who knew, for example, if they did 3 classes of aerobics a week they coped well. Some changed their diet too to great benefit.

Fortunately more and more has been written/spoken about the perimenopause and menopause, and GPs are better equipped (https://thebms.org.uk/education/rcog-bms-menopause-advanced-training-skills-module/  ) to answer questions, sometimes, and maybe more workplaces/society are aware of the profound changes that can occur.

I noticed a big change when the pandemic came along, my symptoms significantly deteriorated and all the usual places I would have gone weren’t available so I briefly for a time went on to HRT from the doctor. Somehow it helped but never really felt like it was what my body wanted….I used to forget to take it and find myself not using it regularly.

As time passed the symptoms have come and gone. I’ve found the strategies that worked for me: changing my diet, managing stress, and most importantly being active, have been the most helpful and loops back to Felicity’s blogpost. I feel it was an opportunity to know my body better, and it was a real reckoning of the toll stress takes. And was part of the unfolding impetus to change careers.

One other book I read was Passage to Power by Leslie Kenton. It was about the menopause being a time for women to come into their own sense of themselves. And around the same time I listened to a radio 4 programme about the whale menopause (https://www.bbc.co.uk/programmes/b07mxv62) which was curious and consolidating somehow.

As much as learning strategies to cope, the menopause changed my perspective of what it was to live with a sense of wellness and integrity of purpose.

Reference

Early and premature menopause

https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/early-and-premature-menopause/#:~:text=Menopause%20before%20the%20age%20of,before%20the%20age%20of%2045.

Other Resources

Home

https://www.daisynetwork.org for women affected by Premature ovarian Insufficiency

Home

Menopause Wellness Hub

https://www.menopausematters.co.uk

https://www.womens-health-concern.org/help-and-advice/menopause-wellness-hub/

I have had some request for more help and information on managing the peri menopausal stage, and my research has been really interesting. Menopause is being discussed much more which is really helpful for men and women to get a greater understanding. But what I found really interesting is how different a women’s body reacts to food and exercise compared to a man’s, and that most of the research is based on male physiology. So the research doesn’t take into account how a women’s body physiology changes as her hormone levels start to change in their 40’and 50’s.

Did you know, for example, that a women’s cholesterol is higher in the first half of her cycle compared to the second half?

And that as you get older your insulin resistance increases as a women?

Let me just explain what insulin resistance is. Insulin is what opens a cell membrane so that glucose can get into the cell to fuel it. All cells need glucose, but if it can’t get in easily, then the glucose stays in your blood stream. This is called insulin resistance, and its the high blood glucose levels that cause lots of problems such as inflammation, diabetes and heart disease. So what does this mean for women in their 40’s and 50’s?

It means that the diet and exercise that worked for them in their 20’3 and 30’s no longer has the same effect, and that the body starts to store the glucose as fat, usually around the tummy and organs! So you could still be going to the gym, and eating your healthy diet but you are putting on weight.

My next really interesting find is that; a women’s body needs different types of exercise and food depending on where she is in her cycle! This is a revelation to me, because on those days in your cycle when you are tired and you just want to eat carbohydrate, you body is actually telling you to slow down, reduce your stress and fuel your body.

Which brings me to my next revelation. You either have stress hormones or sex hormones, not both. This is simply put, but if you are working all hours and not getting enough sleep, not eating the right foods, or working out too much then that acts as a stressor on your body and it produces stress hormones rather than sex hormones. So for women at a peri menopausal stage when oestrogen and progesterone levels are starting to drop, it really knocks those levels down further. Leading to irregular or heavy periods, brain fog, fatigue, hot flushes etc.

However there are stages in a women’s menstrual cycle when they can cope with some stress and exercise better and it can actually improve your oestrogen production. This is at the beginning of the cycle, not long after you have started your period. And this is because oestrogen thrives on strenuous exercise. This is because the hormone needs to be moved around the body, otherwise it can sit, usually in your breast area leading to breast tenderness. This stage lasts until ovulation in the middle of your cycle and then for a few days after. But the week leading up to your period is when progesterone needs to be rising. Progesterone needs reduced stressors and regular good sources of carbohydrate. So this is the time to relax, and take pressure off yourself. Then your period will start on time and reduce the spotting just before.

In the middle of a women’s cycle there is a peak of testosterone. This helps you build muscle so its a good time to use weights in your exercise. Using weights at this point of your cycle will produce much bigger results than if you lifted heavy weight at other stages in your cycle. Muscle mass as you age is important because it increases insulin receptors reducing that insulin resistance affects on the heart and other organs and also improves strength and flexibility reducing pain from arthritis and osteoporosis.

So instead of having a weekly or daily routine for exercise, as women, we need to have a monthly cycle so that some weeks we can really push ourselves to get out of breath, and other weeks to lift more weights and then really slow down at the end of our cycle. This means we are augmenting our hormones rather than fighting them.

There is so much I could on with, as I haven’t started on fasting yet and how that affects our hormones, but I think I will have to put that in my next blog. To find out more all this information this is the work of Dr Mindy Pelz. She has written ‘Fast Like a Girl’ and ‘ The Menopause reset’ which are really helpful books to read. You can also listen to Dr Ragan Chatterjee’s interview of her, on his podcast ‘Feel Better, Live More’

I would be interested to hear your experience of diet and exercise and your hormones. So please get in touch @felicitybooty

Tag: menopause

My Story

Peri-menopause, Diet and Exercise