Perimenopause - Part 2
Common (and weird) Symptoms
In this part we’ll be looking at a variety of common Perimenopausal symptoms, including weight gain, sleep problems, and a whole host of weird and wacky symptoms.
Why Am I Gaining Weight? (And Why Is Nothing Working???)
Weight gain during perimenopause can feel like a cruel joke. You’re eating the same way, moving the same way, but suddenly your jeans are tighter, and that stubborn belly fat seems impossible to shift. So, what’s going on?
Let’s take a moment and look at it from your body’s perspective.
Your body’s only interest is to keep you healthy, well, and vibrant. Everything it does is for that one goal.
So…why am I gaining weight when I don’t want to gain weight?
This hormone change is massive and stressful on your body. Life is also stressful right now. Work, life, kids, bills, all inside a cost of living crisis.
Your hormone fluctuations increase cortisol on their own. This hormonal transition is a stressor on the body. Your body can handle that, but not on top of the other stressors.
So, your body needs a place to store some of that cortisol so it doesn’t wreak havoc on your body, and your fat cells are a perfect place. Your fat cells are an amazing receptacle for cortisol; they can keep expanding to make room for more and more cortisol.
Also, your fat cells make estrogen, helping to balance out the estrogen deficiency that builds toward menopause.
So…you can see why your body is holding onto some extra weight to balance your body.
What Doesn’t Work Anymore
What used to work—calorie restriction, intense exercise, low-carb diets—are also stressors. They trigger more cortisol that needs to be stored in those precious fat cells.
Makes sense why that doesn’t work anymore!
Muscle Mass and Aging
And let’s not forget about muscle mass. As we age, we naturally lose muscle, and muscle burns more calories than fat. This means that even if you’re active, your body might not be as efficient at burning calories as it used to be. Strength training can help maintain and build muscle mass, which is crucial during perimenopause.
So…What Does Work?
So, what can you do about it? Here are some strategies to help manage weight gain during perimenopause:
Eat Regularly
Eating regular, balanced meals is key. When you skip meals or go too long without eating, your blood sugar can drop, leading to intense hunger and overeating later.
Fasting and waiting longer than 5 hours between meals is also a stressor—and you don’t want to add more reasons for your body to release cortisol!
Aim to eat every 3-4 hours to keep your blood sugar stable and your metabolism humming along. Include a mix of protein, healthy fats, and complex carbohydrates in each meal to keep you feeling full and satisfied.
Increase Protein and Fiber
Protein is essential for building and maintaining muscle mass, which, as we discussed, is crucial for keeping your metabolism active and acting as a cortisol sponge. Aim to include a source of protein with every meal and snack. This could be lean meats, fish, eggs, dairy, legumes, or plant-based proteins like tofu and tempeh.
Protein is also very satiating, which means it keeps you fuller longer. Protein also takes a lot of energy to digest, increasing your overall energy requirements for the day (aka, you can eat a bit more during the day).
Fiber, on the other hand, helps keep you full and supports healthy digestion. High-fiber foods like fruits, vegetables, whole grains, and legumes can help feed your good bacteria (which is helpful for metabolism). Plus, fiber helps stabilize blood sugar levels, which can reduce cravings and energy dips.
Increase Strength and Muscle
Building muscle is one of the most effective ways to boost your metabolism and manage your weight during perimenopause. Muscle tissue burns more calories at rest than fat tissue does, so the more muscle you have, the more calories you’ll burn throughout the day.
Strength training exercises, such as lifting weights, resistance band exercises, or bodyweight exercises like squats and push-ups, can help you build and maintain muscle mass. Aim for at least two strength training sessions per week, targeting all major muscle groups.
Additionally, muscle acts as a sponge for insulin and glucose. When you have more muscle, your body can handle insulin and glucose more effectively, which helps keep your blood sugar levels stable. This is particularly important during perimenopause when your risk of insulin resistance can increase.
Be conservative with cardio. It’s still important for your overall fitness level, but can be a major stressor if you go too hard. Do what you enjoy for as long as you enjoy it—don’t push your body just to “burn more calories.” Instead, you’ll just release more cortisol.
Tips for Managing Weight
Here are some additional strategies to help manage weight gain during perimenopause, with one major caveat: Your body may require that extra weight to keep you healthy. So, if you’re doing all you can but your weight won’t budge, be kind to your body and understand it knows better.
Stay Active: Incorporate both gentle cardio and strength training into your routine. Aim for at least 150 minutes of moderate-intensity exercise per week.
Eat a Balanced Diet: Focus on whole foods, including plenty of fruits, vegetables, lean proteins, and healthy fats. Avoid processed foods and sugary snacks.
Manage Stress: This can be easier said than done, am I right? This is a great time to find some tools to help you manage stress, such as yoga, walks in nature, meditation, or simply taking time for yourself each day.
Get Enough Sleep: Poor sleep can lead to weight gain, so make sure you’re getting enough rest (more on this in the next section).
Stay Hydrated: Drinking enough water can help control hunger and support your metabolism.
Now, let’s move on to another common issue—sleep disturbances, and how to tackle them effectively.
How to Get Some SLEEP! (Why Is Sleep So Hard!?!?!)
If you’re struggling to get a good night’s sleep during perimenopause, you’re not alone. Sleep disturbances are one of the most common complaints. But why is sleep so elusive during this time?
Hormonal Impact on Sleep Patterns
Fluctuating hormone levels, especially estrogen and progesterone, can affect your sleep-wake cycle. Low estrogen levels can cause night sweats and hot flashes, which can wake you up multiple times during the night. Progesterone, which has a calming effect, also decreases, making it harder to fall and stay asleep.
Sleep is very individual, and you’ll probably need to do a bunch of experiments before finding what works best for you. But don’t give up; I believe there’s an answer for even the most elusive sleeper!
Don’t Watch the Time: A visible clock can create some “sleep performance anxiety” a.k.a. counting down the hours left to sleep. If you need an alarm clock, consider one that doesn’t light up.
This has helped me enormously. I used to get very stressed when I would see how little sleep I had left. My current alarm clock has a button I can press if I need to check the time at night, but I rarely do that. This little change worked so well that I cover clocks in hotel rooms so I don’t fall back into that old bad habit.
Have a Bedtime Snack: Especially if you wake up in the middle of the night. Your body is more sensitive to insulin and cortisol, and both a blood sugar crash and a cortisol spike can wake you up in the middle of the night and not let you fall back to sleep.
A carb/protein bedtime snack can be enormously helpful. Nut butter on some crackers, yogurt & granola, or a nibble of leftovers can work like a charm.
Cool Hot Flashes with Bedding: Don’t add fuel to the fire by being very particular with your bedding! Most importantly, no synthetic fibers, like microfiber! They trap in the heat and fan your hot flames.
Also, consider a cooling pillow. There are many different varieties—some are foam and water, and they stay cool even when your heat is rising. This can keep you cool enough that a hot flash doesn’t even wake you up :)
Avoid Caffeine: Especially if you wake up with anxiousness. Caffeine has a long half-life, which means it stays in your system much longer than it seems. Any caffeine after noon can cause sleep problems, but for some, any caffeine is a problem.
I love a cup of black tea in the morning, but if my stress and anxiety are high, the only thing that will let me have a good night of sleep is cutting out that glorious cuppa. I’ve found that it reduces my overall anxiousness…even though I miss it when it’s gone.
Exercise: A tired body tends to sleep better! Okay, not always—sometimes it causes a restless body, but in our sedentary world, it’s worth a try. :)
Your Bedroom: Make sure your bedroom is set up to help with sleep. Be sure it’s fully dark, cool/cold, and comfortable. If there’s space in your budget, this is a good time to make your bed your comfortable oasis.
A controversial point—if you have a snoring or restless partner, try sleeping separately for a few nights to see if that helps. Yes, it’s wonderful to sleep in the same bed as your partner, but not if you’re sacrificing your sleep. A small experiment for a few nights is all that’s needed to see what might help.
Consider Journaling: Does your head spin in the middle of the night, making sleep impossible? Try writing down your thoughts before you go to sleep and even during the night. Your body is processing a lot of old emotions throughout your perimenopausal years, and journaling/writing can be an effective way to help calm the mind to allow some restful sleep.
Helpful Herbs for sleep:
These herbs are available at your local health food store and can be used as a tea, tincture, or capsule. All of them also help the body deal with stress.
Saffron: Saffron isn’t just for cooking; it’s great for sleep too, especially during perimenopause. This has become my favorite sleep aid.
During the day it helps calm mood swings and reduce anxiety, which can mess with your sleep. And, at night, it helps with a deep, restorative sleep. Aim for 30mg-50mg 1-2x per day.
I take saffron every morning and often that’s enough for sleep. But, during stressful times, I add another dose in the evening and it works like a charm :)
Kava Kava: This is a nervine herb that helps calm the nervous system. It’s very effective for sleep and relaxation.
Passionflower: This is also a nervine and helps with a spinning mind and anxiety.
Ashwagandha: This popular herb is an adaptogen and helps your body adapt to day-to-day stresses. It also supports the thyroid and is a great addition during perimenopause (it comes up a lot in this masterclass). It’s also a potent sleep aid. It can be taken during the day for help with stress and again at night for sleep.
Weird Symptoms of Perimenopause
Does it suddenly feel like you don’t understand your body? Ya, you’re not alone. There are about 100 symptoms related to perimenopause and menopause, and here are the ones I see the most.
One I didn’t list is smelling weird smells…it’s a really common symptom and it’s very real. I’m constantly asking my husband if he smells what I’m smelling…it’s so weird. But, I haven’t found anything that helps, so I didn’t add it.
Gallbladder Issues (or Trouble Digesting Fatty Food):
As estrogen dips, your bile gets thicker and stickier. This can lead to diarrhea, loose stools, right-side pain, or even gallbladder attacks.
You might not be digesting the fat in your diet very well, including essential fats, which can lead to more inflammation and itchy skin.
What you can do: Pay attention to your digestion. If you think your gallbladder might be unhappy, work with a trained practitioner if you think you need some support (you can work with me :), and/or consider adding Digestive Bitters to your supplement regime.
High (or Higher) Cholesterol:
As estrogen levels fall during perimenopause, there is often a corresponding increase in cholesterol levels.
Estrogen plays a role in regulating cholesterol metabolism, promoting the production of high-density lipoprotein (HDL) cholesterol, known as "good" cholesterol, and aiding in the removal of low-density lipoprotein (LDL) cholesterol, often referred to as "bad" cholesterol.
When estrogen levels decrease, this delicate balance is disrupted, and you’ll start to see this in your bloodwork. LDL cholesterol levels may rise, while HDL cholesterol levels may decline, contributing to an overall increase in total cholesterol levels.
Higher Blood Sugar and Insulin Levels:
Lower estrogen also triggers insulin levels to rise. Estrogen plays a crucial role in maintaining insulin sensitivity, the ability of cells to respond to insulin and regulate blood sugar levels effectively.
When estrogen levels decrease, this delicate balance is disrupted, leading to reduced insulin sensitivity and increased insulin resistance. As a result, the pancreas may produce more insulin to compensate for the decreased sensitivity of cells to its effects.
Elevated insulin levels can be part of the reason why it’s easier to gain weight, especially around the belly. Balancing your blood sugar becomes extra important, and all of the food advice in this masterclass will work to balance your blood sugar :)
More UTIs:
The vagina has its own defense from bacteria and viruses. Hormones help create an acidic pH of the vagina, which kills off the bad guys. As hormones lower, the pH becomes more alkaline, which can create more infections.
UTIs can present differently! UTIs in menopausal women may present with atypical symptoms, different than how a UTI felt when you were younger. These symptoms can include confusion, cognitive impairment, agitation, delirium, and even hallucinations, which may be mistaken for signs of dementia or cognitive decline.
IMPT: IF YOU FEEL LIKE YOUR MEMORY (or a family member’s memory) HAS CHANGED OVERNIGHT, GET TESTED FOR A UTI.
(Sorry for yelling, I didn’t want you to miss this point.)
What you can do: D-Mannose powder can help prevent UTIs. Take 1 tsp 3x per day if you have a UTI, or 1 tsp per week for prevention.
General Memory Issues:
Your brain is going through a full rewiring during your perimenopause years. The change in hormones changes your brain and how you look at the world…and a side effect of this change is memory issues.
Feeling fuzzy-headed is a very common symptom during perimenopause. It can be extra frustrating, especially if your job or role in your house requires a sharp memory. Think of it as all of your circuits are busy in your brain, and it’s struggling to find another open space to remember your grocery list or where you left your keys.
Research has found that while your ability to learn new things does decrease in perimenopause, it does rebound back to old levels. Your memory will come back!
Random weirdness:
Skin Sensitivity: Hormonal fluctuations can lead to increased sensitivity to sunlight or changes in skin reactions to cosmetics, detergents, or other environmental factors.
Increased Static Electricity: I find this one incredibly weird. Some women may notice an increase in static electricity, leading to more frequent occurrences of static shocks when touching objects or other people. I really want to know why this is.
Changes in Hair Texture: Along with hair loss or thinning, perimenopause can also cause changes in hair texture, such as increased frizziness, brittleness, or changes in curl pattern.
Changes in Handwriting: Hormonal fluctuations can affect fine motor skills and coordination, leading to subtle changes in handwriting, such as alterations in size, spacing, or legibility.
Changes in Body Temperature Regulation: Hormonal fluctuations can disrupt the body's ability to regulate temperature, leading to episodes of feeling excessively hot or cold, even in comfortable environments.
Changes in Nail Health: Hormonal changes can affect nail growth and strength, leading to changes in nail texture, shape, or brittleness that may be unexpected or unexplained.
Do you have a weird symptom you’d like me to add? Let me know!
Got any questions or comments? Comment below, jump to our private Facebook Group, or the Ask Lisa page :).