There's some scary stories about menopause symptoms. Integrative Medicine Practitioner Julie Farrelly explains what happens in the years leading up to menopause and how these earlier years can impact the menopausal symptoms.

Key points:

  • Managing menopause is best started 10 years earlier

  • Stress in these years is not helpful for the hormones

  • Imbalanced pre-menopause symptoms include craving sweet foods, feeling bloated, gaining extra weight, feeling emotionally vulnerable, weepiness, painful breast or lumpy breast tissue, cramping in the uterus, very heavy menstrual blood flow

  • To fix and give yourself the best chance of managing menopause, start with an analysis of hormone levels

What can go wrong with imbalances in sex hormones? Hormonal imbalances can be associated with the huge array of disorders that we are experiencing – particularly in the western world these days – and especially women during perimenopause. You may not be aware that the hormonal changes of perimenopause actually start occurring 10-15 years leading up to menopause.

What’s happening in our 30’s and 40’s?

In the perimenopause years we are often juggling our growing families and household duties alongside our careers and other commitments.  Chronic stress activates our adrenal glands and we send out high levels of cortisol. Cortisol is a steroid hormone that affects the levels of all the other hormones in our blood and in our tissues. Our bodies will actually prioritise the need to ‘survive’ over the need to produce our sex hormones. There is a very powerful interconnection between our mental, emotional and physical experiences of our environment – our body is following our mind and our thoughts.

Progesterone is a hormone that is made all throughout women’s fertile years, in both the ovaries and the adrenals. In the perimenopausal years we become dependent on our adrenal glands to pick up the slack, to help provide extra progesterone. If the adrenal glands are busy making a lot of stress hormones and flooding us with cortisol, they don’t have a lot of energy left over to make progesterone. They are too busy making cortisol.

This is one of the biggest reasons why progesterone deficiency in perimenopausal women, between the ages is a huge issue. We tend to live busy lifestyles and we are busy going and doing. Accelerated stress takes away our bodies ability to keep us in sufficient amounts of progesterone.

Why worry about progesterone levels?

Progesterone is the precursor to the other downstream sex hormones including oestrogen and testosterone. Women cannot make oestrogen without also being able to make testosterone. So if we’re suffering from a lack of progesterone we are going to suffer from the imbalance downstream. We need to look upstream to address the root causes of hormone imbalances.

However too much of a good thing is not necessarily better either – a great example is oestrogen. Oestrogen plays some extremely vital roles in women’s bodies and is made in the ovaries, adrenals and fat tissue. But we also have a huge amount of what is called ‘exogenous’ or external oestrogen coming in from things like hormone replacement, oral contraceptives, meat and dairy. So we don’t just have sources of oestrogen made internally from our body, but also coming in from external sources.

With the explosion of commercial chemical use, many of these look a lot like oestrogen in their molecular shape and how they fit into our cell receptors. If the chemical can fit into an oestrogen receptor on a cell, then as far as your body is concerned it is reacting to oestrogen. This will show downstream effects of high levels of oestrogen and essentially tricks the body into thinking our oestrogen levels are higher than they really are.

Don’t feel all that great now…?

Excess oestrogen in the body blocks thyroid hormone absorption, leading to sluggish metabolism, weight gain, fatigue, coldness, elevated LDL cholesterol & constipation. Unfortunately these are all too common complaints of women throughout the perimenopause years.

Progesterone and our primary stress hormone cortisol compete for the very same receptors on cells. If our cell receptors are full of cortisol, we are not going to feel the positive effects of progesterone. This is a huge driver for hormone imbalance – in particular for oestrogen dominance in women. We have a huge surplus of places that oestrogen can come from and when our progesterone levels are overwhelmed by our stress response, this makes it very difficult for the body to keep progesterone and oestrogen in balance.

From the age of 35-50 the average women’s progesterone decreases 75%, while oestrogen production from the ovaries only drops by about 35%, so you can see how women can start to have all sorts of symptoms of hormone imbalance or dysfunction due to oestrogen dominance. Simply with the slow steady dropping of progesterone can create the foundation for oestrogen dominance. Effects of oestrogen dominance can cause symptoms that mimic severe PMS such as craving sweet foods, feeling bloated, gaining extra weight, feeling emotionally vulnerable, weepiness, painful breast or lumpy breast tissue, cramping in the uterus, very heavy menstrual blood flow.

How does our body adjust?

By far the most common imbalance challenge that women today in western countries have is oestrogen dominance. We struggle to detoxify and excrete it, so even when the body is trying to correct the high levels we find it difficult to get rid of it. The gut is ultimately where surplus hormones need to be excreted from. If we have dysbiosis, or an imbalance of gut microbes, low motility, constipation, bacterial or yeast overgrowth creating inflammation in the gut, then hormones can be reabsorbed. Instead of being escorted out via our stool, they get reabsorbed through the intestinal wall and put right back into the system, creating a toxic load of hormones.

What to do…?

Integrative medicine practitioners don’t just provide bandaid solutions for the downstream symptoms of hormone imbalance. We test the levels of your hormones and other blood parameters and from these we can provide treatment plans to correct any upstream imbalances. Often nutritional and lifestyle changes can help, but occasionally bioidentical hormone supplementation (usually progesterone) is required to help provide relief of symptoms.

Book an Integrative Medicine appointment with River Tree Health if you have any concerns regarding symptoms of perimenopause, or if you would like to discuss bioidentical hormone replacement therapies.

Article written by Julie Farrelly, Integrative Medicine Practitioner, River Tree Health, 17th October 2017