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Recent developments in France have brought attention to the labeling of Vitamin D as an endocrine disruptor (ED). French authorities have proposed warning labels on products containing more than 0.1% cholecalciferol by weight, following its classification as an ED. This move, though aimed at consumer awareness, has raised concerns about the potential for decreased consumer trust and consumption of Vitamin D, despite its crucial health benefits. This recent news development feels like a perfect example of why midlife women need to be able to decode the science to make health decisions for themselves instead of relying on agencies and journalism, as we discussed in episodes 8 and 9, “Let’s Talk About Science.”
This article will discuss the functions of Vitamin D in the body, how much women in midlife need of this crucial nutrient, and sources in our environment, diet, and supplementation. We’ll briefly look at the differences in sources. We will also examine the interactions of estrogen with Vitamin D and how the fluxing nature of estrogen in perimenopause can impact its functions and bioavailability during the menopause transition. Finally, we will consider a targeted approach to supplementation and why it’s necessary to test and not guess.
Vitamin D, a fat-soluble vitamin, plays a vital role in our health. It’s found in certain foods, added to others, available as a supplement, and synthesized in the skin upon exposure to sunlight. Unlike other vitamins and cofactors, it functions as a hormone, in that it is involved in cell signaling. Its primary functions include promoting calcium absorption for normal bone mineralization and growth, reducing inflammation, and supporting cell growth, neuromuscular and immune function, and glucose metabolism. It exists in two main forms: D2 (ergocalciferol) and D3 (cholecalciferol), both well absorbed in the small intestine. The primary natural sources of Vitamin D are fatty fish, fish liver oils, and, to a lesser extent, beef liver, egg yolks, and cheese. Fortified foods like milk and breakfast cereals also contribute significantly to Vitamin D intake in many diets. Sunlight exposure plays a crucial role in Vitamin D synthesis in the skin, though factors like season, skin melanin content, and use of sunscreen affect this process.
The active form of Vitamin D is D3, or cholecalciferol. French authorities propose labeling products that are made up of more than 0.1% D3 with the statement: “contains the substance Cholecalciferol. This substance has health benefits when used according to the precautions and dosages on the package leaflet or product labeling. If in doubt, seek the advice of a health professional.”
We will discuss why this verbiage can be misleading and damaging later.
Vitamin D3 interacts with estrogen in a number of important ways. Vitamin D can induce the activity of certain enzymes, such as CYP3A4, which are involved in metabolizing various substances, including estrogen. This induction might affect estrogen’s bioavailability and potentially alter its levels and effects in the body.
Both vitamin D and estrogen play significant roles in maintaining bone health and calcium homeostasis. Estrogen helps regulate bone density and turnover, while vitamin D is crucial for calcium absorption and bone formation. Vitamin D has been found to influence the expression of estrogen receptors. This means that vitamin D can affect how cells respond to estrogen, which is vital in tissues that are sensitive to estrogen, such as breast tissue.
There is some evidence to suggest that vitamin D and estrogen may jointly influence the risk of certain cancers, such as breast cancer. Vitamin D is thought to have a protective effect, possibly by modulating the effects of estrogen on breast tissue.
Vitamin D deficiency can lead to serious health issues like rickets in children and osteomalacia in adults. The National Academies of Sciences, Engineering, and Medicine (NASEM) have set Recommended Dietary Allowances (RDAs) for different age groups to maintain bone health and normal calcium metabolism. For instance, for adults over 70 years, the RDA is 20 mcg (800 IU). However, obtaining sufficient Vitamin D from natural food sources alone can be challenging, necessitating the need for fortified foods, supplements, and sunlight exposure.
Bioavailability must also factor into the conversation, as the type and source of the nutrient impacts our ability to absorb and use it, as does our life stage. For example, fat-soluble vitamin D is optimally absorbed when it is accompanied by dietary fat. It is found in its active D3 form in animal sources. While plant sources of Vitamin D are D2, or ergocalciferol, which is absorbed well in the small intestine, it is bound by phytates and other plant constituents that are difficult to break down during digestion. Certain drugs also interfere with absorption.
There are bodily factors that impact bioavailability as well. For example, celiac disease and other gastrointestinal conditions can impact absorption. Body composition plays a role as well, as D3 can be sequestered in adipose tissue and therefore not available for its functions in cases of obesity. Because dietary D needs to be activated by enzymes in the liver and kidneys, conditions impacting these organs also impact bioavailability of the nutrient.
Because of the complex interactions between estrogen and Vitamin D, estrogen’s fluxing nature and subsequent decline during the menopause transition impacts Vitamin D’s bioavailability and function as well. In fact, while further study is needed, there is mounting evidence that Vitamin D may influence menopausal symptoms. Additionally, aging skin impairs the body’s ability to synthesize Vitamin D. Therefore, midlife women are likely impacted by these bioavailability and function issues.
While deficiency carries its own set of risks, fat-soluble Vitamin D can build up to toxic levels if overconsumed. Upper Limits (UL) are designated by NASEM as lowest level at which no harm will be done. In menopausal women, overconsumption of Vitamin D, particularly in supplements, can cause renal problems such as kidney stones and hypercalcemia.For this reason, midlife women should consult their doctor to test Vitamin D levels before starting a supplement regimen.
The French decision to label Vitamin D as an ED is part of an effort to inform consumers about disruptors in products. This decision could affect consumer trust in Vitamin D supplements, despite the clarification that cholecalciferol’s health benefits are realized when used as directed.
The proposed statement’s wording is also misleading in several ways. First, the technical name cholecalciferol is not commonly used or known by most consumers. Not only is this word choice, as opposed to “Vitamin D” confusing and opaque, it can cause alarm. Secondly, the labeling refers to cholecalciferol as a “substance” – another scary word reminiscent of a drug or non-food … well, substance. Vitamin D is a vitamin, sourced in foods as previously described. Finally, the label states that cholecalciferol “has health benefits,” which, while true, is incomplete. It fails to point out that cholecalciferol – Vitamin D – is a necessary nutrient involved in a variety of important functions.
While the French authorities’ decision aims to increase transparency about endocrine disruptors, it’s crucial to understand the context and the established health benefits of Vitamin D. Adequate intake of Vitamin D is vital for bone health, immune function, and overall well-being. Consumers, particularly midlife women, should be aware of the importance of Vitamin D as well as deficiency risks and the specific disruptions of the perimenopausal hormonal milieu. Critically consider the recommended dietary intakes, food sources, and the role of sun exposure in maintaining adequate Vitamin D levels. If concerns arise, consulting a health professional for personalized advice is advisable.
The journey through perimenopause is filled with challenges. While the “Big Rocks” of health — balanced nutrition, strength training, sufficient sleep, and stress management — should help you manage your health, symptoms, and life better, they can sometimes feel overwhelming.
What if the rock seems too big to fit into your life?
When a sculptor finds the perfect slab in which her next masterpiece resides, she doesn’t quit if it’s still attached to the side of a mountain. Instead, she breaks it away from the rest, and continues cutting away until it’s the right size for transport back to her studio.
And so it is with our Big Rocks. You break them down into smaller rocks, until they easily fit in your life. Then you expand as you can. How do you do that? The solution lies in crafting routines that make these crucial habits manageable and sustainable.
Let’s look at each rock individually, breaking them each down and adding simple routines to make them much easier to manage.
* Corey coaches women in strength training and in fitting the other Big Rocks into their daily lives in her hormone coaching program. You can go here to book a consultation.
A word here. Many perimenopausal women report that they have these rocks in place, and yet they still struggle with sleep. Hearing the tried and true science of nighttime rituals and sleep contributors can get discouraging when your rituals aren’t consistently helping.
Believe me, I get it. Insomnia has been a struggle of mine for years. One of the biggest things that has helped me is a little grace. I allow myself to continue resting my body when I wake up five hours before my alarm, knowing that if I remain mindful and corral my thoughts from straying to the anxious side I can slide back into sleep. Even if I don’t, giving myself grace to continue resting without the berating thought spirals that herald anxiety over lost sleep actually helps me be more centered and rested the next day.
The key to making the “Big Rocks” fit is personalization. What works for one person might not work for another. Listen to your body, adjust as needed, and remember that consistency over perfection is the goal.
Perimenopause is a unique journey for every woman. While the “Big Rocks” are universal, the way we incorporate them into our lives can vary. By breaking them down into manageable habits and crafting routines around them, we can ensure lasting success and optimal health during this pivotal phase.
How have you made the “Big Rocks” fit into your life? Share your routines and tips in the comments below. And for more guidance on navigating perimenopause, subscribe to our newsletter!
Perimenopause is a transformative phase in a woman’s life, marking the transition to menopause. As the body undergoes hormonal shifts and the cycle winds down, it’s crucial to prioritize certain health habits to navigate this period with grace and vitality. These habits, which we’ll refer to as the “Big Rocks,” lay the foundation for optimal well-being during perimenopause.
Definition: Balanced nutrition is about consuming a variety of nutrients that our body needs to function optimally. During perimenopause, this becomes even more essential.
Benefits:
Definition: Whole foods are unprocessed and unrefined, retaining their natural nutrients. Examples include fruits, vegetables, whole grains, and lean proteins. Unlike processed foods, they don’t contain additives or preservatives.
Definition: Strength training involves resistance exercises to build muscle strength. For midlife women, it’s not just about aesthetics but about health and longevity. Without lifestyle intervention, we begin losing muscle mass in our mid-30s, which can leave us metabolically challenged, frail, and weak.
Benefits:
Sleep is the body’s way of rejuvenating. During perimenopause, its quality and quantity become paramount.
Benefits:
Challenges:
Of course, I recognize that sleep in perimenopause is challenging. Hot flashes, night sweats, and anxiety can disrupt sleep during perimenopause. Not to mention that many of us (myself included) have struggled with insomnia for years prior to midlife.
Sleep is a skill, especially when dealing with perimenopausal symptoms that disrupt natural rhythms. It’s crucial to work on it, now more than ever.
Chronic stress can wreak havoc on a perimenopausal body, and what’s more, an unhealthy stress load can negate efforts in nutrition, strength training, and sleep.
Benefits of Stress Management:
The journey through perimenopause can be challenging, but by prioritizing these four “Big Rocks,” midlife women can optimize their health and embrace this phase with confidence and vitality.
If you are a woman aged 45-55 or so, you know!
Society would have you think, sister, that your power is based in your youth. It’s evident in overt and covert ways, in magazine pages and online. Youth is lauded as power, energy, ambition, success, beauty. Youth is virile, fertile.
On the other end of life is Age. As an unfortunate extension of our western-valued Youth standard, Age is weak, fragile, dry, withered. Past its prime, and of course, it’s prime is … Youth.
Kind of a bleak picture. Please forgive the negativity; I promise it’s temporary. It will get better in the end, so stick with me!
In our 20s and 30s we derive power from our youth. Whether we pick it up consciously or it’s foisted upon us from outside, our youth lends us an authority of sorts that we haven’t earned by experience.
But as we travel the line of our life through our 30s and into our 40s and 50s, as our bodies and faces and hair change, we can slip right through that donut hole into the chasm of invisibility. Society would of course deny pushing us into it. And if they do, I’m certain it’s not intentional or blatant. Instead, it’s the unintended consequence of a series of decisions made in a variety of areas that accidentally leads to the omission of women, and the disempowerment of midlife women. The disappearance of the perimenopausal woman, who will re-emerge after a short invisible stint as an elder-mother in her 70s.
Just a couple of short years ago, if you Googled “menopausal woman celebrity” you’d get pictures of Helen Mirren and Lady Judy Dench. Stock image searches I’ve done on “perimenopause” yields grandmothers from every culture, whose beautiful faces are deeply lined and crowned with snowy hair. Yet you and I know that perimenopause can begin in a woman’s mid-30s. I’ve never met a 30- or 40-year-old that looks like the images yielded by my searches.
Midlife has been a hole, where no woman of note appeared until she had reached the other side.
There’s so much work around the sex hormones and how they impact our confidence, our self-image, and our decisions. Take, for example, estrogen. Estrogen is our Power Pose hormone. She’s our inner Wonder Woman. When estrogen is in control, we are more outgoing, we take bigger risks, we’re not afraid to be seen, thanks to how she influences serotonin and dopamine.
But in perimenopause – estrogen is erratic. She’s high one minute and dipping low the next, taking our mood and our confidence along for the ride. Sometimes she exits the building altogether, leaving dry skin and anxiety to fill in for her. We’re left with this body that doesn’t look or feel like we’re used to looking or feeling. It leads to out-of-control introspection, to getting in our heads too much, to self-flagellation and self-pity and self-centeredness of the perverse kind, that keeps us isolated and ashamed of what we’re going through.
Unfortunately, when estrogen leaves us high and dry, it’s all too easy to slip into that invisible space. Sometimes we open it and willingly crawl right in. How?
Instead of seeking out women in our circles who are also going through this transition, we hide. Instead of talking about this completely normal phase of life, we withdraw. Instead of living through perimenopause in a way that can help younger women prepare, we allow ourselves to become… Invisible.
So in our newsfeeds and social media, there lies this gap where the photos of the strong, daring, vocal, beautiful women of midlife should be. Have you ever wondered why it’s common to see women in their 20s and 30s dress daringly, in fun and bold colors and cuts, and then we’re inspired by a group of women in their 70s and 80s that decide to do the same? Where are the women in their 40s, 50s, and 60s? In the donut hole.
Look, I’m speaking from experience here. I sit before you today 30# above my ideal weight – AND I’m a fitness professional. Like many others, I started gaining weight during covid lockdowns, but being the overachiever that I am, I kept going through 2022. My perimenopausal symptoms came to the forefront in 2020 and essentially ran my life for two years.
Do you know how many times I’ve questioned myself? How many times my inner bitch has questioned my ability to do my work – which is my passion – for others when I can’t seem to help myself? And if I’m being honest, I probably would not have gained as much as I did if I had refused to listen to her. Instead, I sunk into the self-imposed donut hole and let my thoughts turn to despair over my health and my body, and let it get worse. I let my symptoms take center stage and push me further down into the donut hole.
But no more. I’ve clawed my way out of that hole. I’m refusing to stay silent and invisible. Because I know we must talk to get the attention we need; we must make an appearance to be visible. We must LIVE to not be dismissed.
Granted, my Google searches are better now, revealing women like Drew Barrymore and Michelle Obama speaking up to shatter the stigma of perimenopause. But again – WHY is there a stigma?!
The menopause transition is not only normal and natural, it’s POWERFUL – IF we embrace the transition. IF we know how to care for our changing bodies and minds. IF we refuse to become dowagers, crones, and frumpy-grumpy-sweaty women that the world seems to expect us to become.
Our hormones are winding down during perimenopause. We cannot control our estrogen and progesterone levels. But we can control our lifestyle and our choices, which influence our hormones.
Our fitness and nutrition can be tweaked to safeguard muscle and bones and keep excess bodyfat to a minimum. Tightening up nutrition by saying no more frequently to your glass of wine, and yes to a healthy serving of cruciferous vegetables can make hot flashes much more manageable. A Certified Menopause Provider can help us dial in hormone therapy or other medical solutions to help manage symptoms if we choose. Knowledge can make the difference between an early retirement you didn’t choose and advocating for yourself and your hard-earned career by working for women’s health support in the workplace.
Every step you take away from the Donut Hole helps women coming up in younger generations to sidestep it completely. Every time you advocate for yourself, you make it easier for our daughters and granddaughters to thrive in equality, and to embrace midlife with awareness and preparedness.
The thing is, what it takes to walk in your power at any age is a healthy dose of self-respect…
Respect yourself enough to demand equitable attention in your healthcare, knowing that once you’re heard, change will start that will impact women around the world.
Respect yourself enough to put yourself first, knowing that caring for yourself will make sure there’s enough of you to go around to care for everyone else.
Respect yourself enough to put in the work, the time, the research, to ensure that you keep glowing, growing, and going. Respect yourself enough to expect respect from everyone around you.
The world needs YOU. Powerful you. Now more than ever. Now, when you’ve lived enough to amass a wealth of wisdom and experience. Now, when you’ve grown to know and love yourself, and can help younger women do the same.
The world needs your wisdom, your love, your knowledge, your passion, your energy, your verve and spunk, your LIGHT. AND the world will try to snuff out your light, because don’t we all fear the exact thing we need?
Don’t fade into the invisibility hole. We can’t afford to lose you. Own your power. Walk in your power. And help others do the same.
While we share a lot of sociological experiences – friendship, love, hardship, a fight for self-determination and autonomy – many assume our biological experiences are at least similar. They’re not, really; so many factors make us biologically unique, differentiated by genetics, ethnic heritage, upbringing, even lifestyle. Not all women will experience fertility and pregnancy. Not all will share the experience of labor and delivery. Yet, regardless of that, we will all experience the end of fertility, the cessation of our sex hormones.
We will all undergo the menopause transition. Yet it is so rarely discussed, especially among younger women. There is no training, no seminar, no “What to Expect When Your Ovaries Quit” books. Definitely not a health class or school assembly to teach us about our changing bodies.
My paternal grandmother, after birthing six children, entered menopause at the ripe old age of 36. That family lore was all the preparation I had, so naturally I began watching for hot flashes and missed periods in my mid-thirties. When they didn’t show up, and the random night sweats didn’t stick around, I quit paying attention around 40.
Had I known then what I know now, I would have taken a lot of things more seriously, and I would have made lifestyle adjustments to ease my ovaries into their expected retirement. In that spirit, I am writing a letter to my younger self, letting her know exactly what I know now. Granted, I can’t change the outcomes for myself now. However, I’m hoping that another thirty-something will read this and benefit from my experience, in the hopes that when (not if) she reaches perimenopause, her transition will be smoother.
I know you think you’ve gotten this health and fitness thing figured out. After all, you’ve successfully won your battle of the bulge, and have maintained substantial weight loss for almost a decade. You’ve beaten the odds, regardless of what it takes to keep it off. Mazel tov.
As your future self, I have the benefit of the rearview mirror when all you can see is the step you’re taking now. I find myself watching you with a mix of pride, awe, and sadness. I see you fighting your body daily, weekly, monthly. Annually. I see you struggling through a mounting list of responsibilities while pushing through regular intense workouts – sometimes twice daily. I see you take on two science degrees while raising two boys, trudging 12,000+ harried steps through that hilly campus, and still dragging yourself to the gym.
I hear your thoughts berating you for not being able to stay bikini lean year long, through sleepless nights that stretch into stressful seasons. I hear you respond to your reflection in the mirror, “Well, it’s not great, but it’s not terrible.” I feel your thoughts turn to fixing your diet/exercise/body like an obsession, a means of controlling anxiety and frustration with other areas of your life.
I’m writing to warn you that most of the things you’re doing in the name of health and fitness are leading to an unhealthy transition to menopause. I know that perimenopause isn’t on your radar right now. True sustained fitness has been replaced by the urgency of your current physique goals and beauty standards. I am now working today to correct the problems that we caused by our shortsightedness.
Self-Love motivates me to point out the things that you are doing that I have learned aren’t good for us.
Don’t stay on a diet. Don’t diet cycle. You and too many GenX women embodied the lie of “thinner is better,” when we were still girls, and have taken decades to break free. Some of us still haven’t. We are still struggling.
That continuous caloric deficit leads to metabolic downregulation, nutrient deficiencies, and hormonal imbalances. Learn how to eat at maintenance. Learn what your true size is at maintenance and embrace it. Let your body settle into a healthy rhythm, your healthy size and leanness, instead of constantly striving to be small.
Do eat ample protein, carbs, fats, and (yes) salt. Interpret your body’s signals and cravings instead of denying them in some warped pursuit of “character” and “discipline.” Supplement well, giving yourself the vitamins and minerals you need. Take everything you will learn in your education and your coaching career and apply it to yourself. You are your most important, most valuable client.
Stay consistent in the gym, for the muscle not the leanness. Muscle is your protection against the ravages of age and disease. Learn to feed your gains. Learn to work out with lower reps and heavier weight. Get more excited about strength gains than weight loss. Pay attention to proper form first, then to intensity. Work on your mobility as much as you work on your deadlift.
Stay consistent with recovery, too. It is not healthy to be all on all the time. Learn to balance intensity with rest and restoration. Including 6+ workouts every week, with at least three HIIT sessions is wreaking havoc on your endocrine system. The fatigue you keep trying to solve so you can return to your grueling workout regimen is a sign of adrenal stress that has caught up with me now. The body you thought you were building has been broken, and I am tasked now with patiently and compassionately rebuilding it so we can finish this race successfully.
Strongly reconsider repeat bodybuilding competitions. Don’t buy the lie of amateur bodybuilding being a good fit for any fitness enthusiast, the perfect next step in every fitness journey. It is a sport, and to reach elite status in any sport requires a good genetic fit and pushing past the boundaries of true fitness into an unhealthy level of performance. It’s expensive, too. For you, the repercussions just aren’t worth it.
Learn how to work with your body, not against it. You are a woman with a hormone cycle that lasts 28-32 days, living in a man’s world constructed around his 24-hour hormone cycle. You can optimize your life by fitting it to your hormone cycle, not his. This requires learning about your basic physiology.
Pay attention to your PMS and quit comparing it to others. PMS is a sign of hormone imbalance. Just because it doesn’t seem as bad as your girlfriend’s doesn’t mean it’s normal, regardless of what your doctor says. Learn that when doctors say “normal” they mean “common.” Get the attention and care you need.
The same with the low libido. It’s not a busy-ness problem. It is a hormonal problem.
And on that topic, prioritize your pleasure in your sex life. Regular orgasms will lead to a healthier endocrine function and a much more satisfying marriage for you and your husband. Avoiding sex, denying sex, or participating without satisfaction not only limits your intimacy, but it also keeps you stuck hormonally.
Get a baseline sex hormone panel at each phase of your cycle, so that you know what “normal” looks like for you later in life. Do the same with thyroid and adrenal hormones. Your doctor won’t understand, and insurance won’t cover it. Demand it anyway.
Don’t forget your postpartum depression, as much as you wish to. It is a breadcrumb, a signal of what could come. Keeping it in mind will help you prepare for perimenopause by recognizing your hormonal sensitivities and symptoms. Being prepared will help you adjust and manage earlier and better.
If you “sleep when you’re dead,” you’ll wish you were dead sooner. Not sleeping well isn’t a righteous statement of determination and drive. It is slowly eating away at your brain health.
That chronic insomnia? It is responsible for poor memory, brain fog, depression, and anxiety. It’s also a sign of hormone imbalance. PUSH the doctor to listen to you and give you the care you need.
Prioritize 7-9 hours of sleep every night. Help your children learn the skill of sleep. Help your husband correct his snoring that drives you from sleep and bed weekly. It’s not just you it hurts.
You think that you can manage your health and fitness by external work alone – diet and exercise. You’ve ignored the mounting evidence that mindset and stress management – the inner work – are just as important. Please don’t do that.
The unregulated cortisol response that you set off by internalizing your stress impairs your ability to produce progesterone. It also blows out your adrenal glands, which will be responsible for producing estrogen and testosterone after your ovaries quit. It also chips away at your insulin sensitivity, setting you up for belly fat accumulation and chronic inflammation.
Stress isn’t just external factors, either. Your inner mean girl is probably your biggest stressor. You can’t just ignore her. You must deal with her. Learn how to stop the thought spirals that your negative inner dialogue sends you down. Learn how to truly love and care for yourself, not just pretend so the world thinks you practice what you preach.
I’m not mad at you. The decisions we made have made me who I am. The experiences have led to greater knowledge that lets me help other women optimize their hormones and health as they enter menopause. I watch you in the rearview mirror at the same time I see younger women doing some of the same things we did. Reaching out to you is a way to reach them also.
I love you. Be well.
According to Science
Menopause – a word that can bring uncertainty and apprehension, even confusion. But it doesn’t have to be. Menopause, a natural life transition that typically occurs in women between the ages of 45 and 55, is a time of significant hormonal changes and cessation of menstrual cycles. Many women feel out of control when they enter perimenopause. Instead of embracing the power and freedom that can come on the other side of this life stage, they succumb to the negative effects of symptoms, assuming that the best of life is behind them. This blog post aims to educate and provide reliable advice, based on menopause research, to help make your menopause transition more positive and empowering.
Perimenopause is the phase in which the ovaries slow down and cease production of sex hormones like estrogen and progesterone. The final cessation results in the end of the reproductive phase of a woman’s life, marked by 12 months without a period. The menopause transition, aka perimenopause, can trigger various symptoms, including the big hitters – hot flashes, night sweats, brain fog, and mood swings – and a rather extensive list of lesser-known symptoms – musculoskeletal pain, anxiety, insomnia, dry skin. In fact, there are 34 known symptoms. Some of them are so weird and seemingly unrelated that they can take over your life if you let them.
Oprah Winfrey has talked publicly about her experience with heart palpitations, a puzzle that her doctors couldn’t solve. Turns out irregular heartbeats are among the 34 symptoms.
I experienced the same thing. The symptoms came during a year that I was struggling with other health things. I contracted giardia in the late spring, and experienced heat sickness in the summer. The palpitations came on the heels of those things, and I was worried about my health. I visited the ER, got a referral to a cardiologist, wore a Holter monitor for two weeks, took a stress test (which was inconclusive) and finally had an exploratory heart catheter. The result? My arteries were beautifully clear. The heart palpitations were a symptom of perimenopause.
Knowing that even the most troubling symptoms you are experiencing are related to perimenopause helps to remove confusion and fear. It’s all too easy to get in your head about all the changes your body is going through, just as easy to think you’re losing your sanity. Knowing which changes are due to the menopause transition can at least help you check the crazy.
Studies like this one and this one show a direct correlation between a woman’s attitudes (and her spouse’s)
toward the menopause transition and the severity of her symptoms.
It turns out that the more positively you think about the natural transition you’re going through, the easier time you will have. Whether or not physiological symptom severity was measurably reduced or that a woman’s ability to withstand the symptom was increased by the positive attitude is unclear. But in the end, does it really matter?
What does matter is that a positive mindset during menopause can empower you to take proactive steps for your health and wellbeing. Actions like eating a healthy diet, strength training, managing stress, getting regular checkups and medical screenings – can ensure better health outcomes in the long run. It’s a virtuous cycle: thinking positively about the experience causes you to act positively, making it overall a more positive experience.
The most effective weapons in your arsenal are your nutrition, exercise, sleep strategies, and stress management techniques. These will positively impact your physical health and your mental health. Diet, particularly protein and healthy fats, and exercise, particularly strength training, play a crucial role in managing menopause symptoms. Regular physical activity can combat weight gain, improve mood, and promote better sleep. Researchers and practitioners alike are recognizing that strength training in particular can treat depression more effectively than any other form, and it is even more effective than medication and talk therapy.
Menopause experts point to new anxiety and depression as a very common early symptom of the menopause transition. Women in perimenopause can make a significant impact on these symptoms by starting or maintaining an exercise schedule that features strength training. Additionally, body composition, sleep quality, and stress levels are significantly improved by proper strength training and a healthy, whole-food protein-rich diet.
Estrogen is important to multiple processes, including many involving micronutrient absorption or turnover. As a result, women in perimenopause tend to be deficient in several nutrients. And while you should test for micronutrient deficits and never guess, supplementation is warranted for many of these nutrients.
Certain supplements, like magnesium, vitamins E, D and B, calcium, zinc, and Omega-3 fatty acids, may help alleviate menopause symptoms, particularly those that are caused or impacted by shortages. Body aches, inflammation, dry and thinning skin, fatigue, poor sleep, and symptoms of low thyroid function can all be a result of or worsened by a lack in any of the above-mentioned nutrients.
Natural remedies like DIM have been shown to be effective in estrogen metabolism and clearing. Other adaptogenic supplements seem effective in managing fatigue, cortisol response, and anxiety, – namely rhodiola and ashwagandha respectively. Yet others, such as maca and saw palmetto, support sex hormone production and balance.
Finally, women experiencing perimenopause should all be taking a good probiotic supplement, due to the impacts of estrogen decline on the gut. Improving gut health will improve digestion, negative estrogen clearing, and neurotransmitter production.
Hot flashes and night sweats can be better managed by wearing moisture-wicking fabrics and using bedlinens that promote cooling, such as bamboo sheets. If you share your bed with someone that doesn’t appreciate your need for lower temperatures, consider the Chilipad dual zone cooling mattress pad, which lets users set different temperatures for their side of the bed. Vaginal moisturizers containing hyaluronic acid can help manage vaginal dryness. My favorite is the Everyday Honor Balm by Rosebud.
So what do you do if you have your habits dialed in and you still struggle? Hormone Replacement Therapy (HRT) is a viable and safe option if lifestyle changes aren’t enough. Recent research shows that HRT is cardioprotective and doesn’t significantly increase cancer risks if you are not positive for estrogen-receptive cancer genes. Non-hormonal medical treatments like SSRIs or Gabapentin can also help with symptoms like hot flashes and mood swings.
However, regardless of whether you choose this option – and every woman should feel free to – it is not a hall pass to bad behavior. Your habits and lifestyle are still crucial to a positive perimenopause. That’s why this section is titled BONUS. No one can expect to pop a pill or slap on a patch and see symptoms disappear if they aren’t checking the nutrition, exercise, and stress management boxes.
Menopause is a significant life transition that should not be taken lightly or dismissed. While it is an inevitable phase of a woman’s life and can be challenging, it doesn’t have to be endless suffering. It can be an empowering and positive growth period with the right attitude, lifestyle changes, and medical support.