olga willemsen | wellbeing blog | hormone replacement in perimenopause and menopause

Navigating Perimenopause & Menopause: Holistic Approaches and Hormone Therapy

ByOlga

I had the opportunity to give a talk on one of the most important health topics for women over 35: the transition through perimenopause and menopause. For many women, this stage of life comes with various symptoms and challenges that can significantly affect their emotional and physical well-being. However, with the right knowledge, lifestyle interventions, and support, we can navigate these changes smoothly and even emerge healthier and more empowered.

In this blog, I will share the key points of my talk, focusing on hormone replacement therapy (HRT) and how a holistic approach can support women during this crucial phase. Whether you’re in your early 40s or post-menopausal, understanding these concepts is vital for improving your quality of life and preventing long-term health issues.

Watch the full video:

Holistic Approach and Hormone Replacement Therapy in Perimenopause and Menopause
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The Journey Through Perimenopause and Menopause

Perimenopause typically begins around the age of 35 when hormonal changes first start to occur. This phase is often referred to as the “second puberty” because, just like in adolescence, hormone levels fluctuate before stabilizing during menopause. Symptoms can include irregular periods, hot flashes, mood swings, and more.

By menopause, estrogen and progesterone levels drop significantly, leading to further challenges such as changes in metabolism and increased risk of inflammation, osteoporosis, cardiovascular disease, and autoimmune diseases.

Despite the natural decline in hormone production, it’s important to understand that estrogen is still produced by other tissues in the body and ovaries, even post-menopause, contributing around 10% of our original estrogen levels.

While we can’t halt the aging process, we can take proactive steps to manage symptoms and safeguard our health. A holistic approach that incorporates lifestyle changes, nutrition, exercise, and stress management is critical for managing symptoms and promoting long-term well-being.

Holistic Lifestyle Interventions: The First Line of Defense

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A holistic approach that incorporates lifestyle changes, nutrition, exercise, and stress management is critical for managing symptoms and promoting long-term well-being.

Nutrition: Supporting Hormonal Balance

Your diet plays a significant role in managing symptoms of perimenopause and menopause. A nutrient-rich diet can help balance hormones, reduce inflammation, and improve your overall health. Focus on:

  • Healthy fats: Include sources like avocados, nuts, and seeds to support hormonal health.
  • Protein: Helps maintain muscle mass, which is crucial as metabolism slows down.
  • Reducing Sugar and Refined Carbohydrates: These can contribute to insulin resistance and weight gain and increase the risk of diabetes and cardiovascular diseases.
  • Supplements complementing your nutrient-rich diet, like Magnesium and Calcium: Essential for bone health, especially as estrogen levels decline.

Simple steps help to keep your blood glucose levels at bay and prevent diabetes:

  • Starting your day with a teaspoon or tablespoon of apple cider vinegar in a glass of water and a savory, protein-rich breakfast rather than a sugary one can help stabilize blood sugar levels throughout the day.
  • Starting your main meals with a portion of salad or other vegetables and an apple cider vinegar dressing;
  • Having your dessert after a complete, nutrient-rich meal;
  • Moving after the main meal.

Exercise: Strengthening Your Body and Mind

Regular physical activity, particularly weight-bearing exercises, is crucial for maintaining bone density and reducing the risk of osteoporosis. Additionally, exercise helps regulate insulin sensitivity, improves mood, and enhances cardiovascular health.

Muscles are your primary glucose consumers. The more muscle mass you possess, the less the blood glucose levels swing. And the less the muscle mass, the stronger the blood glucose level jumps. The excess of glucose leads then to the aging of your tissues, especially the inner lining of the blood vessels and the heart, leading to cardiovascular diseases and inflammation.

The combination of a balanced diet, physical movement, and muscle-building exercise are the critical interventions to keep your glucose levels low and support your healthy insulin sensitivity and longevity. A combination of aerobic exercises like walking, swimming, or cycling, along with strength training, provides the best results.

Managing Stress: The Role of the Nervous System

Menopause can also impact the nervous system, leading to anxiety, mood swings, sleep issues, and even cognitive changes.

Proper night sleep and practices like meditation, yoga, and hypnotherapy can be powerful tools for managing stress and promoting emotional balance during this transition.

Supporting Your Thyroid Health

Thyroid function often changes with age, and thyroid imbalances can exacerbate menopausal symptoms like weight gain, fatigue, and mood swings.

Regular thyroid check-ups and addressing any imbalances through lifestyle changes or medication are important parts of your overall health strategy, especially if you have been having thyroid issues already before (peri)menopause.

The Role of Hormone Replacement Therapy (HRT)

When we talk about managing menopause, HRT often comes up as a key strategy. It involves supplementing the body with hormones like estrogen and progesterone to alleviate symptoms and protect long-term health, especially the heart and bones.

However, it’s essential to approach HRT with a clear understanding of its benefits, risks, and best practices to maximize its effectiveness while minimizing side effects.

Bioidentical vs. Synthetic Hormones

One of the most important distinctions in HRT is between bioidentical and synthetic hormones. Synthetic hormones, like those derived from horse urine (as in some older formulations), can cause unwanted side effects, including increased risks of thromboembolism and breast cancer.

On the other hand, bioidentical hormones closely mimic the body’s natural hormones and offer a safer alternative when properly administered.

Administering these hormones topically, through patches or creams, often results in fewer side effects than oral medications, as the hormones bypass the liver and reduce the risk of clotting issues.

When to Start HRT

A common question is when to start HRT. While there is no one-size-fits-all answer, it’s generally advisable to start HRT during perimenopause or menopause if symptoms are unmanageable and lifestyle interventions are not sufficient.

Women experiencing early menopause (before age 45) are also prime candidates for HRT to protect against osteoporosis and heart disease.

However, it’s crucial to have an open dialogue with your healthcare provider, as HRT is not suitable for everyone, especially those with certain health conditions.

Q&A on Hormone Replacement Therapy

During the talk, several participants raised questions about HRT and its impact:

What if I’m already post-menopausal? Is it too late to consider HRT?

HRT is most effective when started early, during perimenopause, or shortly after menopause. However, post-menopausal women can still benefit from localized or systemic treatments.
You need to speak to a specialist and exclude any contraindications like diabetes, cardiovascular diseases, or cancer.

What about the risks of osteoporosis and cardiovascular disease?

Estrogen and progesterone are essential for maintaining bone density and heart health. Without these hormones, the risk of osteoporosis and cardiovascular diseases increases significantly.
Starting HRT early can help reduce these risks, but even without HRT, lifestyle changes like proper nutrition, weight-bearing exercise, and reducing sugar and refined carbs are key to protecting your bones and heart.

I’ve heard mixed things about synthetic hormones. Should I be worried?

Yes, it’s important to be cautious about synthetic hormones, especially those derived from horse urine. These have been associated with more side effects and risks.
Always opt for bioidentical hormones if possible, and consult with a healthcare provider who understands the difference between the two.

Conclusion: Empowering Yourself Through Knowledge

Perimenopause and menopause can be a challenging time, but with the right information and a proactive approach, it can also be a period of empowerment and transformation.

Whether you choose to explore HRT, embrace holistic lifestyle changes, or a combination of both, the most important thing is to take control of your health and make informed decisions. By empowering yourself with knowledge, you can navigate this phase of life with confidence and clarity.

If you have any further questions or need support, feel free to reach out!

References

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Challenging the Normalization of Feminine Non-Wellbeing

ByOlga

In today’s society, the discomforts associated with women’s health are often considered a norm. From premenstrual syndrome and migraines to the challenges of pregnancy, childbirth, and menopause, there is a pervasive mindset that these discomforts are just part of being a woman.

However, it is time to challenge the normalization of feminine non-wellbeing and explore alternative ways to find relief and wellbeing.

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