Embrace Menopause At Victoria Biddick Nutrition we want to reframe perimenopause as the perfect opportunity to make some positive changes to your health and wellbeing to live your best midlife and beyond. The advice below is general advice. For any specific tailored advice relevant to any health conditions please talk to your health professional. As we enter peri-menopause, our bodies undergo various changes. These changes can begin anywhere from 2 to 10 years before the final menstrual period (1). Some are noticeable and can be easily acknowledged as they happen, while others may go unnoticed, gradually emerging until we notice a shift in how we feel or physical changes in our body. Navigating these transitions can be challenging, especially if our lifestyle remains unchanged, often leading to a loss of confidence and uncertainty about how to adapt Why is my body changing ? Your body is changing due to fluctuating and declining levels of the sex hormones; oestrogen, progesterone and testosterone(1). A lead player in body changes is Oestrogen who has had a protective role in our overall health during childbearing years. Oestrogen is involved in many processes throughout the body from our head to our toes not just our reproductive organs, which is why we experience a variety of symptoms and body changes. Natural ageing is another factor contributing to body changes. Our cells have some general wear, tear and damage, the immune system starts to slow down, and we begin to experience chronic low-grade inflammation, known as inflammaging (2 ). Our metabolic hormones, such as thyroxine and insulin, which are responsible for converting nutrients into energy and regulation of energy levels, also decline (1). Body changes-Impact on health and wellbeing Body changes during perimenopause can significantly impact our health and wellbeing. By understanding the risk factors, we can take proactive steps to limit and reduce these effects, ensuring better overall health. During perimenopause some of the changes occurring include : Decrease in : Bone density Our bones act as a calcium bank for the body(2). If we don’t have adequate calcium in our diet some of the bone breaks down, when we have enough in the diet the bone rebuilds itself. This remodelling process keeps occurring in women till we are about 30 years old. After the age of 30 any bone broken down will not rebuild, and if we don’t have enough calcium in the diet, bone density will decrease(2). Oestrogen helps to prevent bone loss and as levels decline this makes women more suspectable to falls, fractures and osteoporosis(1). Muscle mass Natural aging results in loss of muscle mass as the body becomes slower at building muscle and physical activity levels decline(2). Falling oestrogen levels accelerate the process of muscle loss in perimenopause. Muscle mass and strength are important for movement and balance and maintaining muscle mass is linked to ageing well(2). Metabolism Your metabolism is the rate your body processes and breaks down food eaten to provide energy to fuel the body. During perimenopause this slows down due to reduced levels of metabolic hormones and changes in body composition(2) . A decrease in the insulin hormone makes it harder to breakdown and absorb carbohydrates which can increase risks of type 2 diabetes. The Thyroxine hormone responsible for overall metabolism and energy levels can also reduce leading to tiredness and weight gain. Muscle mass also burns energy at a faster rate, so declining levels contribute to reduced metabolic rate. (2). Increase in: Belly (visceral) Fat During childbearing years the oestrogen hormone signals fat to deposit in the hip and bottom area. These fat deposits act as an energy reserve for times of restricted food availability. As Oestrogen signals weaken, fat redistributes to the belly area, this type of fat is associated with increased risk of type 2 diabetes and heart disease (1). Blood pressure Oestrogen helps keep blood vessels healthy and dilated, allowing blood to travel freely throughout the body. As oestrogen levels decrease, there is an increased risk of high blood pressure, which can damage blood vessels and increase the risk of heart disease – the leading cause of death in New Zealand women (3). LDL cholesterol LDL cholesterol, often referred to as “bad” cholesterol, is associated with a higher risk of heart disease (3). As oestrogen declines, the liver’s cholesterol production is affected, leading to higher levels of LDL cholesterol. Excess LDL cholesterol can build up in arteries, increasing the risk of heart attack or stroke (3). Perimenopause is the perfect opportunity to make positive changes to support your health and wellbeing The combined effects of perimenopause and natural aging can make this stage of life feel particularly challenging. While it might seem like you’re “falling apart,” many symptoms will ease once menopause is complete(1). Oestrogen will continue to provide some protective effects health for up to 10 years after menopause, but after that, we are on our own. We can’t change what’s happening to our bodies, but we can change our attitude towards how we respond. Instead of thinking, “I’m miserable and falling apart,” we can shift our perspective to, “I’m strong and I can take this opportunity to make positive changes to support my health and wellbeing.” The symptoms of perimenopause are a call to action, a chance to do things differently to live an awesome midlife and beyond. What action can I take to improve my health and wellbeing? No matter where you are on your menopause journey, it’s never too early or late to make positive lifestyle changes. If you’re unsure of your current stage, you can learn more by reading “Where are you at on your Menopause journey?” Menopause Series – Christchurch Osteopathy Steps for improved health and wellbeing on your menopause journey include : · Midlife WOF at the GP We highly recommend a visit to your GP for a midlife check-up. This is an opportunity to talk about menopause symptoms, body changes and if HRT or other treatments might be suitable for you. It’s also good to check to make sure that the symptoms you are experiencing aren’t something else. Christchurch based GP, Dr Sarah Marr recommends booking a double appointment to allow plenty of time for a general check-up and to discuss and explore options that could support your symptoms. · Eating a Wholefood Diet Focus on a diet rich in vegetables, fruits, quality proteins, whole grains, low-fat dairy, and healthy fats. As our metabolism slows, it’s crucial to make each meal nourishing. The Heart Foundation offers great guidance on healthy eating (https://www.heartfoundation.org.nz/wellbeing/healthy-eating/eating-for-a-healthy-heart). · Regular Exercise Something is better than nothing however there are specific exercise routines that can support midlife changes. This includes prioritising lifting heavy weights, incorporating SIIT ( Short Intensity Interval Training) and HIT ( High Intensity Training) into your exercise regime. Read Dr Stacy Sims article for more information on midlife movement Perimenopause vs Postmenopause: What Active Women Need · Reducing Alcohol Intake This may naturally decrease during perimenopause as the body’s ability to process alcohol diminishes and you feel the side effects. Ideally, no alcohol is best, but if you do drink, aim to reduce it to a “safe level” of 10 standard drinks per week (4). · Sleep Hygiene Disrupted sleep is one of the many challenges of perimenopause. Nikki Bezzant suggests prioritising sleep with a regular bedtime, pre-bedtime routine, putting the phone on night mode( or removing from the bedroom), avoiding alcohol(most of the time!) and no coffee after lunch. She also says, “ don’t stress about sleep this will make things worse”. · Stress Management Be kind to yourself. There will be times where you feel overwhelmed by family, work and friends. It is important to take time out for yourself, push back on some activities and outings and support yourself through perimenopause. You are going through a period of change, and it will take some time to adjust to your new normal. If you’re feeling uncertain about where to start, it’s important to seek support. This can come from your GP, friends and family, or lifestyle health provider. VICTORIA BIDDICK NUTRITION can help you navigate your journey through menopause with specific nutrition and lifestyle advice. Remember, you’re not alone; there are many resources and strategies available to help you navigate these changes. References 1. Australasian Menopause Society(2020). What is menopause? Australasian Menopause Society. https://www.menopause.org.au/images/infosheets/AMS_What_is_menopause.pdf 2. Whitney,E.,Rolfes,S.,Crowe,T.,Walsh.,A(2019).Understanding Nutrition.(4 th Australia and New Zealand ed.).Cengage Learning. 3. Heart Foundation NZ(2023).Why does menopause increase the risk of heart disease. Heart Foundation NZ. https://www.heartfoundation.org.nz/about-us/news/blogs/why-does-menopause-increase-the-risk-of-heart-disease 4. Ministry of Health.(2020). Eating and Activity Guidelines for New Zealand Adults: Wellington: Ministry of Health. https://www.health.govt.nz/system/files/documents/publications/eating-activity-guidelines-new-zealand-adults-updated-2020-oct22.pdf VB Nutrition
