Menopause

My name is Nikki Harris and I am a fully qualified and registered nutritional therapist and I specialise in women’s hormone health based in Plymouth, Devon.

My purpose of my work is to help women who are struggling with hormonal imbalances, symptoms of perimenopause, and menopause get back into balance, naturally. I am assessing what is driving women’s symptoms and addressing what their body needs to restore balance to achieve success. By helping women get the support they need, they get back in control of their hormones, and feel confident about how they look and feel.

So we have all heard of “menopause” especially right now as it is a hot topic and with “hot flushes” appearing to be the most common symptom! But what is really going on in our body, why are we feeling the way we do and what can we do about lessening the symptoms? When we can discover what is really going on and why we feel the way we do this helps women to make sense of their symptoms and what they can do to support themselves.

Menopause is a normal process of a life stage in women, it is not a disease and it is not a medical condition every women will go through it, even if it has been through forced via a surgical procedure such as a total hysterectomy. Menopause happens when ovaries stop releasing eggs, periods stop and the most potent form of oestrogen (estradiol) is no longer produced. In the UK the average age is 51 years old.

What are the natural life stages of a woman?

PUBERTY:

The official start of fertility, which begins with your first period

PERIMENOPAUSE:

The transition to menopause which begins with declining hormone levels, generally starts after age 40 leading up to menopause, although this age can vary and can be as early as 35.

MENOPAUSE:

The official end of fertility, which begins 12 months after your last period.

POSTMENOPAUSE:

The time period after menopause until the end of life.

The most common signs and symptoms of menopause are:

• Hot flushes and night sweats • Lethargy, lack of concentration, irritability • Depression, mood swings • Anxiety, sleep disturbances and memory problems • Decreased libido and lack of interest in sex • Increased urgency and frequency of urination

• Decreasing muscle strength • Joint aches and increased risk of osteoporosis • Vaginal dryness and pain on intercourse • Shrinking (reduced size) of breasts or sore breasts

• Headaches and migraines • Weight gain

I want to talk a little more about hormones, so before Menopause our ovaries produce:

PROGESTERONE

As progesterone steadily declines and falls faster than oestrogen, common in perimenopause — this can lead to symptoms of mood swings, headaches, irritability, anxiety, insomnia, and PMS.

OESTROGEN

The peaks and dips of oestrogen levels and the decline in oestrogen can cause night sweats, hot flushes, mood swings, weight gain, vaginal dryness, and loss of interest in sex.

TESTOSTERONE

Testosterone is not just the “male hormone” - in women it is responsible for strong healthy bones, building muscle, libido, desire for sex, mood, sense of well-being, assertive behaviour, self-confidence, and brain function. After menopause, after our ovaries have shut down, our adrenals produce small amounts of progesterone and testosterone and our fat cells are our main site of oestrogen production. This is one of the reasons why it is so important to address our stress, manage our weight and what we are eating.

INSULIN

Insulin is a hormone and it is produced by our pancreas to regulate our blood sugar, in response to glucose (from carbohydrates) in the bloodstream and insulin is our fat-storing hormone. If we eat too many carbohydrates and if this is not used up by the cells or muscles it will be stored as fat, especially around the middle section. Cells also become less responsive to insulin when oestrogen declines making weight loss that bit harder Plus, our fat cells produce their own oestrogen as the ovaries decline, oestrogen is made in fat cells so our body knows that this is a way of making more oestrogen. The more fat cells we have the more oestrogen we produce, again making it hard to lose weight. Low oestrogen stimulates appetite and a loss of oestrogen makes our body more resistant to insulin - i.e. insulin resistant (aka pre-diabetes) this means that the glucose does not get into cells as effectively. Therefore, raising our blood sugar levels and increasing the risk metabolic syndrome - a series of risk factors that include waist circumference over 88cm in women, high blood pressure, increased triglycerides (higher blood fats), and low HDL (good cholesterol) that can lead to type 2 diabetes. If you eat too much sugar or too many refined carbohydrates, basically, all this energy has to be stored somehow, and normally that storage is inside the fat cells and those can accumulate also inside the liver, and can be a cause of fatty liver disease or non-alcoholic fatty liver disease (NAFLD) which is sadly on the rise. Excess sugar and fructose (fruit sugar) are some of the main culprits of a non-alcoholic fatty liver. Your body will store more fat through too many carbs than it will through too much fat due to the spike in insulin that is our “fat-storing hormone”.

THYROID

The most common form of thyroid disorders are hypothyroid (AKA underactive thyroid) which can have the same symptoms as menopause and this is because the body is not producing enough thyroid hormones to keep the body functioning properly and show up as symptoms.

I always use private laboratory tests to look at the thyroid in more detail along with other vitamins and minerals that can show us fatigue and mood symptoms, such as vitamin D, B12, folate, and iron levels.

Symptoms can show up as: • Weight gain • Fatigue • Low libido • Mood changes • High cholesterol • Muscle weakness • “Brain fog” • Depression

CORTISOL

Cortisol is our “stress” hormone (along with adrenaline and noradrenaline) when we are stressed, overwhelmed, worried, have relationship issues, infections, or even pain, it can raise our cortisol levels. When we have high levels of this hormone it packs down fat around our middle, again making it harder to lose weight. If we are constantly stressed this has a knock-on effect on our thyroid. Skipping meals also raises this hormone and interrupts our thyroid function slowing down metabolism.

So the most common top 3 menopause symptoms women experience are:

• Weight gain • Fatigue • Low libido

Let me explain what is happening to cause a hot flush?

Due to a drop in ovarian oestrogen this can result in a hot flush. Oestrogen is protective over the way the body controls temperature from the hypothalamus gland deep in the brain and higher levels of FSH (follicle stimulating hormone) can also play a part.

What else can cause a hot flush?

Stress - an increase of our stress hormone cortisol can also coincide with hot flushes. A hot flush can be suppressed after eating and hot flushes can be experienced when blood glucose falls between meals, therefore skipping meals can exacerbate a hot flush or sweat.

To help prevent a hot flush I recommend:

• Add 2 tablespoons of ground flaxseeds daily (with a large glass of filtered water)

• Sage tea (best to use fresh leaves and let them infuse)

• Avoiding caffeine includes energy drinks

• Avoid Alcohol, spices, chilli and hot drinks What is happening with my mood changes?

Mood changes are common and this may be due to the fact that oestrogen acts as a neurotransmitter (brain signals between nerves) and contributes to mood stability. Any fluctuations of oestrogen may cause changes in mood. Oestrogen also helps the production of serotonin (our happy hormone) this may also be a contributing factor to why many women experience a low mood or depression when they enter menopause.

Progesterone also plays a role in keeping our minds calm as it helps to produce a neurotransmitter called GABA, which has a relaxing effect on the brain. However, as progesterone levels drop significantly during menopause, this may lead to increased anxiety and racing thoughts.

My tips for mood

Did you know your mood and gut are intrinsically linked?

• Avoid stimulants - coffee, sugar, and alcohol

• Get proper rest and take time out to relax - yoga, meditate

• Add probiotic foods - such as kefir, miso, sauerkraut, and kombucha to help your gut bacteria health, which is another vital area that needs to be supported.

What is happening to me to gain weight?

Lower levels of oestrogen stimulate appetite, our oestradiol (a form of oestrogen produced in the ovaries) uses the same biochemical pathways in the body as leptin, a hormone released by fat that reminds you to stop eating food, so as oestrogen lowers you become hungrier.

Our metabolic rate drops due to the loss of oestrogen and progesterone and recognises that fat storage is a way to gain more oestrogen, which is a main component to weight gain during menopause.

Changes in our body shape is also a common complaint and this is due to a decline of oestrogen that changes body fat composition so can go from a pear shape (fat around the hips and thighs) to an apple shape (more fat around our middle). However, an increase in fat around the middle increases our cardiovascular (CV) risks so managing weight is important to heart health.

Tips for weight loss.

Did you know excess carbs are more likely to increase weight gain?

• Avoid sugar and refined carbs (crisps, sweets, cakes, etc)

• Take regular exercise

• Increase fresh vegetables at every meal - think half of your plate!

Why am I not enjoying a good night’s sleep?

So with no egg being released, every month there will be no progesterone produced either. Progesterone is a hormone produced in the ovaries in the second phase of our cycle (known as the luteal phase) after we have ovulated. It also helps with a neurotransmitter (a chemical messenger) in the brain called GABA, which has a calming effect and improves sleep and anxiety. This has a knockon effect with the calming effect within the brain and consequently our sleep.

Once in menopause, our adrenals produce progesterone, however, it is in much smaller amounts. Also, if you are stressed this will impact your sleep so do what you can to find time out to unwind and prepare yourself for bed.

Tips for better sleep

Menopause is a time for self-care!

Dark room - to sleep better, make your bedroom dark; if you can’t, consider using a sleep mask.

Keep your room quiet, if this is not possible wear earplugs, sudden noises can happen and will wake you up but if you have a partner who snores you may want to invest in earplugs.

Exercise - physical exercise during the day leads to better sleep at night. Try yoga and tai-chi, which have the potential to improve sleep quality, as well as mood and overall health.

Magnesium helps to improve sleep and anxiety so choose foods such as nuts, seeds, green leafy veg, and whole grains or soak in an Epsom salt bath. I really hope you have found this information useful and it has given you a deeper understanding of what is going on during this life stage. The most important thing to remember is to take care of yourself, menopause is a time for self care. This includes addressing your diet and lifestyle and I will be clear; we cannot continue to eat and live the same lifestyle we did in our 20s and 30s. We need to support our body in a much more nurturing and nourishing way and addressing your carbohydrates and alcohol is vital.

This is how I support my clients as I know what your body needs to make the changes necessary so you can achieve success and feel better about the way you look and feel. Your health is priceless, there is only one of you and taking care of yourself is a commitment that will serve you if you look after your body in the right way. You will enjoy a smoother transition into menopause.

If you have any further questions or you are interested in learning more and how we can work together? I welcome you to message me nikki@ nikkiharris.co.uk or take a look at my website https://www.nikkiharris.co.uk

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