Introduction
First and foremost, it’s important to say that menopause (whichever stage you’re speaking of) is not a “condition” that has to be “dealt with” anymore. The “Change” isn’t whispered about in darkened back rooms any longer but is spoken about freely and intelligently, by women and doctors, in the context of a woman’s overall cycle of health during her lifetime. There’s no reason to believe that a woman should be any less healthy after menopause than she was prior to this transition.
Today, menopause is simply viewed as a turning point in a woman’s life when her body begins the transition from being able to have children to a state in which she can no longer become pregnant. Having said that, it is undeniable that there are symptoms to be addressed, and with today’s advancement in medicine, they can be addressed easily and effectively. This transition point should no longer be a cause of anxiety to a woman but rather it should be looked upon with excitement that the next chapter in her life is about to begin.
It’s important to remember that no two women experience menopause in exactly the same way. One woman might suffer with night sweats and insomnia, while her best friend may have no trouble sleeping but can’t seem to get a grip on her mood swings. Some women begin experiencing perimenopause symptoms as early as their thirties, while others see no significant signs of transition until their late forties or early fifties. However, the common opinion amongst the medical community is that there is a genetic link as to when menopausal symptoms might appear. You certainly can ask your mother or older sister when they began to see a change and then estimate that this transition may begin for you roughly around the same age, but this will only be an indicator or guideline, not a definate.
As Marcelle Pick, OB/GYN writes in her article What I love about menopause, “The secret no one tells you is that midlife can be the most radiant, passionate years of your life. Self-knowledge and self-confidence are the true gifts of menopause…” This can be a time of true self-discovery, a time to figure out who you are and what you’d like to do with the second half of your life.
Let’s begin taking a look at all three stages, beginning with perimenopause.
Perimenopause
Have you ever had to prepare for an upcoming event, say a celebration, a change in profession, or a move to a new city? There was very probably a lot of preparatory work to be done before the actual event occurred. And it’s no different with menopause. This is why a woman’s body goes through perimenopause prior to full-fledged menopause.
Also known as the menopausal transition, perimenopause is the stage in which a woman’s body makes the natural shift from more-or-less regular cycles toward menopause, or the cessation (pause) of menstruation (meno). Once a woman’s regular monthly cycle has been absent for twelve months, perimenopause is over and she is considered in full menopause.
There actually isn’t a precise time frame for perimenopause because it’s really more of a progression than a series of specific events. You might start to notice symptoms as early as ten years before your period completely stops or just a few months/years before. Women can begin perimenopause as early as their thirties or as late as their late forties/early fifties.
In preparation for full cessation of a monthly period, a woman’s hormone production and levels begin to fluctuate and become inconsistent. These fluctuations increasingly diminish a woman’s chances of becoming pregnant but don’t completely disallow the possibility of a pregnancy until actual menopause is reached. It’s important to realize that a perimenopausal woman can still become pregnant. And it cannot be determined that a woman has reached menopause until she can look back, over the past twelve months, and confirm that she has not had a period during that time.
Follicle Stimulating Hormone (FSH)
FSH, secreted by the pituitary gland, is a crucial hormone for regulating the reproductive processes of a woman’s body and determining whether or not a woman is approaching menopause. FSH stimulates follicle development in the ovaries. As the follicles mature, they produce estrogen, and eggs are readied for ovulation.
Perimenopause, cont.,
When ovulation takes place, FSH levels drop and estrogen levels rise. When no ovulation takes place, as is the case during menopause, FSH levels remain constant. It follows then that menopause can be determined by the existence of higher FSH levels.
FSH levels in a non-menopausal woman lie between 5 and 25mIU/ml. If the level is higher than 25, then a woman is generally judged to be perimenopausal. If the level is higher, up around the 50mIU/ml mark, she is considered menopausal. A simple urine test to determine FSH levels, coupled with the existence of other symptoms, helps a health care provider make a diagnosis of perimenopause or menopause.
Symptoms of Perimenopause
Believe it or not, perimenopausal symptoms can be difficult to recognize and, initially, may be attributed to stress, age, or life events rather than perimenopause. When you read through the list, you’ll see how some symptoms can be misinterpreted. However, the quintessential symptom that generally starts a woman wondering about menopause is the “hot flash” (or hot flush, night sweats, or “power surge”).
A hot flash is so named because it comes out of the blue; a feeling of warmth that spreads all over the body, but is most strongly felt by the majority of women in the head and neck area.
The hormonal hot flash is sometimes described as a peripheral sensation of heat and sweating that occurs when blood vessels in the upper body dilate, allowing a sudden rush of blood into the area. But surprisingly enough, it has been demonstrated that a woman’s core body temperature increases only very slightly during episodes of hot flashes.
This feeling of warmth can range from just that, warmth, to full-on “call the fire department” heat, making a woman feel very uncomfortable indeed. A hot flash generally lasts thirty to sixty seconds, can cause visible redness on the skin, and induce excessive sweating. Dressing in layers of natural fabrics such as cotton, lowering your room temperature, running your wrists under cold water, or having access to a fan, are all options that can relieve the discomfort until the heat dissipates.
The complex hormonal changes that accompany the [transition] process, in particular the declining levels of estrogen as a woman approaches menopause, are thought to be the underlying cause of hot flashes. A disorder in thermo-regulation is responsible for the sensation of heat, but the exact way in which the changing hormone levels affect thermo-regulation is not fully understood.
If you experience hot flashes that make you really uncomfortable, there are things you can do to alleviate the discomfort. Dress in layers and stick with natural fabrics like cotton. When a hot flash flares up, excuse yourself to the washroom and run your wrists under cold water or place a cold cloth on the sides of your neck. You might even consider purchasing a small, battery-operated fan that can fit into your purse for just such an emergency.
Pascofemin Oral Drops are a homeopathic remedy used to relieve symptoms associated with menopause and other hormonal disturbances. Just a few drops in a glass of water, three times per day, can help alleviate the discomfort that comes with hot flashes.
Irregular periods, either becoming lighter, heavier, longer, shorter, or occurring outside your regular time frame (e.g., every twenty-eight days) are another symptom to watch for. While it’s true that other life events (stress, an extreme change in diet, an extreme change in exercise routine, illnesses) might deregulate your periods, in the absence of other causes, a real roller coaster of changes over a measurable length of time is more likely down to perimenopause. This happens as ovulation becomes more erratic. It’s time to consult with your primary health care provider if your periods become very heavy, if they last several days longer than usual, you spot between periods, or if your periods are abnormally close together.
Sleep disturbances can also be attributed to a lot of things, however, when they go on and on and they become more difficult to handle, they’re probably related to perimenopause, especially if they are accompanied by the other symptoms listed here or night sweats.
Mood swings, rage that comes out of nowhere, or crying jags can all be caused by hormonal disruption during perimenopause, or lack of sleep, or both. There is an increased risk of depression for women during perimenopause. If you feel a loss of control that is hard to reverse, please consult with your primary health care provider.
Other symptoms include, but are not restricted to:
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Some women sail through perimenopause and into menopause with very manageable, if not unnoticeable, symptoms while others may have to endure a more intense ride. If your symptoms become unmanageable for you on your own, it’s time to consult with your primary health care provider. He/she can suggest options for you to consider, including hormone replacement therapies, and discuss how to best manage your symptoms so that they’re not dominating your life.
Nutter’s Can Suggest these products to help with menopausal symptoms.
 Chia seeds contain highly concentrated amounts of EFA’s, protein needed to make hormones, fibre, amino acids needed for hair/skin/brain health. |  A. Vogel Menopause is an organic, all-natural capsule that helps relieve menopausal symptoms, including hot flashes. |  Natural Factors Tranquil Sleeps is fast-acting and safe. Fall asleep, stay asleep, sleep soundly. Ingredients are supported by extensive research. |
Other products that may help include the whole line of Lorna Vanderhague menopause preparations, especially Menosmart Plus which contains herbs that can halt hot flashes, night sweats, mood swings, lower cholesterol and more.
One of the best one-a-day multivitamin + mineral supplements on the market today is Megafood Women’s One Daily – a wholesome nourishment in a convenient one tablet daily formula that also supports healthy emotional balance and stress response.
Menopause & Post-Menopause
The term menopause simply means a cessation of menstruation. It is technically defined as occurring exactly one year from your last period.
The term post-menopause simply means the time after menopause, similar to postpartum (referring to the time after childbirth) or postpubescent (referring to the time after puberty).
The two terms are essentially the same and can be used interchangeably. Because you’ll hear them both, it was important to explain them both. And, in actuality, because all three (peri, meno, & post) are so intertwined, they are generally considered together, without any separation, simply referred to as “menopause”.
If you’re looking to be literal, the real distinction is actually between perimenopause (the few years before and after the final period) and menopause (defined as beginning one year after your final period ends). Having said that, it’s important to remember that perimenopause and menopause progress one into the other, more like a series of events without specific time frames for each.
Menopause
Menopause is a much simpler state to recognize than perimenopause and it follows that, once you know you’ve entered perimenopause, all you have to do is keep track of your periods to confirm that you haven’t had one for twelve consecutive months.
Unfortunately, the same symptoms that followed you through perimenopause don’t stop all at once when you hit menopause. It may take some time before things start to return to normal.
Menopause & Lifestyle Changes
Early or Premature Menopause
It is possible for a woman to experience menopause at a much earlier age than usual, sometimes as early as before the age of 40. When this happens, there is generally a specific reason for the onset of menopause. Reasons include outside forces such as hysterectomy, ovarian surgery, chemotherapy, radiation, or medical conditions such as premature ovarian failure (POF), genetics, autoimmune diseases, and chromosomal defects.
Post-Menopause and Symptom Relief (or Life After Menopause)
Post-menopause usually comes with less fatigue, fewer mood swings, and less cravings because your hormones don’t go up and down the way they did during perimenopause. But there’s a trade-off that comes from all the hormonal changes your body just went through. You may get your energy back but you’re now at higher risk for conditions such as osteoporosis, heart disease, and stroke. Lower collagen production can lead to drying and thinning of the skin. This is why it’s so important to take care of yourself (if you haven’t started to already) and make some lifestyle changes that reflect this new time in your life.
You can’t control the symptoms and bodily changes you experience during menopause, but you can control how you respond to them. Your best bet is to support your body as much as possible while it makes the necessary adjustments for the next phase of your life. This support includes eating well, exercising, maintaining a healthy weight, and taking supportive supplements and herbs.
Personalized Nutrition
When you think about balanced nutrition, think about what your body needs. Are you losing more iron than the next woman? Are you more fatigued than other women you know? Are you having more problems with memory or sleeping? If this is the case, you’ll want to add more foods into your diet that are packed with iron, B vitamins, omega’s, and magnesium. Get the idea? Nutrition is as personal as your dress size so why not “tailor” it to exactly what you need.
When and where you eat is almost as important as what you eat. Looking at eating from a primitive point of view, the intake of food was done while it was safe to do so, while you didn’t have to be on the lookout for sabre-tooth tigers. It still rings true today that sitting down to a meal is perceived as an enjoyable time of nurturing, relaxation and socialization. It follows then that you should schedule meals for a time when you can sit quietly, with no other distractions, and consciously consume your food.
Make mealtime a calming event in your day by tuning out external sources (television, telephones, etc.), listening to relaxing music, leafing through a favorite magazine (if you’re eating alone), and using dinnerware that’s pleasing to the eye. It is said that eating is as much about presentation as it is about taste; a feast for the eyes if you will. So, for example, if you’re trying to drink more water, purchase a water glass that is so pretty, you won’t even realize you’re drinking water from it! Or put flowers on the table and use the best china once and a while.
Menopause & Lifestyle Changes, cont.,
The following are examples of how you can improve on your current diet to meet the needs of your body during menopause…
| Trouble Sleeping | *Magnesium, powder form, 30 min. before bed, in your smoothie each day | Apples, apricots, avocados, bananas, brown rice, cantaloupe, figs, grapefruit, green leafy vegetables, nuts |
| Mood Swings | Omega 3 fatty acid, 5-HTP, SAMe, **B vitamins, Calcium/Magnesium | Flaxseed, extra virgin olive oil, dark green leafy vegetables, salmon, walnuts, avocados, broccoli, oatmeal, mushrooms |
| Hot Flashes | Vitamin E, Lecithin, Quercetin, Vitamin C | Dark green leafy vegetables, whole grains, oatmeal, sweet potatoes, citrus fruits, avocados, asparagus, broccoli |
| Fatigue, Energy loss | B vitamins, Coenzyme Q10, Maca, Red Clover, Lecithin, Red Reishi | Whole grains, walnuts, dark green leafy vegetables |
| Cholesterol “Creep” | Omega 3 fatty acid, healthy fats, increase water consumption, fiber | Oats, legumes, bran, barley, apples, fatty fish (salmon), extra virgin olive oil, avocado, raw fruits/vegetables, garlic |
| Lack of concentration/ability to think clearly | Omega 3 fatty acid, Vitamins A, B, C, and E | Flaxseed, walnuts, salmon, halibut, dark green leafy vegetables, apricots, broccoli, carrots, oats, citrus fruits, whole grains |
*Magnesium works best when coupled with calcium. Try to find a supplement that has both and vitamin D3. **Some B vitamins are more concerned with energy than others, but to benefit from one, you should take the whole complex. In order for one B vitamin to work properly, the others must appear with it, in concert. For a more complete outline of which foods contain which vitamins, CLICK HERE. If you’re increasing your fibre intake, remember to increase your water intake as well. Talk with your
doctor before taking any new supplements.
Menopause & Lifestyle Changes, cont.,
In addition to personalizing your nutritional intake, here’s a few other things to consider:
- Learn how to “graze” – eat five small meals a day to keep your blood sugar levels even, to avoid cravings, and to keep your metabolism revved up.
- Try to include a source of protein at every meal – lean meat, cheese, protein powder, lentils, beans, quinoa, spinach.
- Eat more raw fruit and vegetables; great fiber, less sugar.
- Consider cutting back on dairy – you don’t have to cut it out completely, just cut back.
- Avoid processed foods, refined sugars, preservatives, trans fats, colorings, artificial sweeteners, and fast food.
- Drink loads of water!
Consider Adding Herbs to the Mix
Herbs such as Black Cohosh, Red Clover, Passionflower, and Ashwagandha have all historically been relied upon for women in menopause. According to a study referenced by the Bastyr University Center for Natural Health, Black Cohosh increases HDL levels, lowers blood pressure levels, and reduces hot flashes and anxiety. Red Clover is used to reduce hot flashes, night sweats, and improve bone health and cardiovascular function. Passionflower has a long history of use for calming anxiety and treating insomnia. It’s been said that hot flashes can feel “hotter than the hinges of Hades” and for some women, that would be accurate. Other women refer to them as “power surges”. Ashwagandha, or Indian ginseng, is an herb that has traditionally been used as an adaptogen; a substance that improves the body’s ability to adapt to stressful situations without as much disruption to normal functioning. In regards to menopause, it is used to reduce symptoms of anxiety, depression and sleep disturbance. Again, consult with your primary health care provider before taking any new herbs.
Don’t Forget to Exercise
With today’s hectic schedules, who can find the time to fit in exercise? However, our hectic schedule is only one good reason to make sure you’re fitting enough exercise into each day. Exercise reduces stress, helps you sleep, gives you some personal time, gives you a real sense of accomplishment, helps you better handle the pressures of daily life, keeps unwanted pounds at bay, improves your mood, and is good for your heart and joints. Exercise may also help you ward off the advancement of conditions such as osteoporosis, heart disease, stroke, and diabetes.
Exercising doesn’t have to consist of rigorous gym workouts; there are plenty of alternatives you can choose from. When choosing to become active, make sure you incorporate a variety of activities that will work your upper and lower body equally and provide a little aerobic activity. If you choose activities you enjoy, you’re more likely to stick with them. For instance, you can hit the pool two days a week, get outside into your garden another day, go for a long walk with a friend (inside a mall if the weather is bad), or go for a bike ride (inside or outside). Have you ever heard the saying, “I’m in no shape to exercise”? There’s a bit of truth in that giggle. Make sure you have your primary health care provider’s permission before starting a new exercise routine. That way, you’ll know you’re healthy enough to begin.
Sleep Like a Baby
Sleep can be evasive during menopause so try to keep as regular a bedtime routine as possible, including going to bed at the same time every night and getting up at the same time every morning, even on weekends, begin relaxing at least an hour before hitting the sheets – turn off the TV, don’t take phone calls, read a book, have a warm bath, or enjoy a cup of camomile tea, keep your bedroom dark and on the cool side, wear natural cotton nightclothes, try a natural sleep aid (Natural Factors Tranquil Sleep, Valerian, 5-HTP, Hyland’s Calms Forte, Pascoe’s Pascoflair, Rescue Remedy), if you can’t sleep, get up — lying in bed, “trying” to sleep, doesn’t work, and last but not least, a warm glass of milk and a small piece of cheese sometimes helps induce sleep. Just make sure this nocturnal noshing doesn’t become a habit.
Above all, learn to accept what is happening in your life instead of fighting it. As outlined in this chapter, there are so many options to choose from which can help ease this transition. Like the old saying says, “You can’t fight Mother Nature” so you should work alongside of Her instead.
Emotional and Physical Wellbeing
Having your doctor confirm that you’ve entered menopause can hit different women in different ways.
For some women, it definitely is a significant realization, a real eye-opener to the fact that they are entering another phase of their life. There may be a lot of self-reflection on what this last part of their life will be like, what it will mean to them, what it will look like now that their focus is not child-rearing and raising the family – now that a woman is actually “her own woman”.
Some women absolutely blossom at this realization; others may not react to it all that well if their sense of self is intimately tied up in their family. The message here is to take your feelings seriously, explore them, journal about them, talk with a professional if you need to, or just work it through with a close friend.
Mark this transition with a meaningful event if you wish; start a class at college, volunteer in your community, or start a new job and, above all, know that this naturally-occuring transition happens to every woman at some point in her life. Look to the future with a sense of closure, anticipation, and joy, all at the same time. Take a deep breath and move forward!
Menopause Symptom Tracker
Postmenopause Directory
Menopause and Good Nutrition
The Wisdom of Menopause: Creating Physical and Emotional Health During the Change
A Smart Woman’s Guide to Hormones
What Your Doctor May Not Tell You About Menopause