Perimenopause: the hormonal shift, occurring over months-years, which transitions you into menopause. ‘Peri’ means “around” or “near”, so - you get the point.
For some, perimenopause starts in their 40s. And for others, it only starts in their 50s. And interestingly enough, cigarette smoking has been associated with earlier menopause, by 1.5-2 years. (1) And significant alcohol consumption is associated with a delay in menopause onset. (2)
Premenopausally, your ovaries are responsible for producing a significant amount of estradiol (a potent form of natural estrogen). And approximately one year prior to menopause, your ovaries start producing less and less estrogen. (3)
The hallmark feature of declining estrogen is the hot flash. Hot flashes usually occur for 2 years after estrogen becomes deficient/low, but can persist for 10 or more years. The average time for persistence of bothersome hot flashes is 7.4 years. (4) I’m sorry, but that’s way too long.
And one of the most disruptive things about hot flashes is their profound effect on sleep. Sleep efficiency lowers, and for women who have hot flashes, they tend to take longer to enter into REM sleep than a woman who doesn’t deal with hot flashes. So the sleep is compromised, and then so is your energy and mood.
Seeing so much of this in my own practice, I love providing women with tools to balance out their hormones. And I love when these same women realize that they have way more control than they ever thought.
Reference(s): (1) PMID: 24672198, (2) PMID: 4026083, (3) PMID: 21159842, (4) PMID: 30401547
If you’re anything like me, you’ve excused yourself from exercise because of your period. The last time I did this, I pondered it. Would it make me feel better? Or would I actually just continue hanging out with Aunt Flow in misery?
Mittelschmerz – the lovely, weird name for the physical sensation experienced during or directly after the release of an egg from an ovary (ovulation). This pain is felt in the lower part of your abdomen and is often one-sided (but can alternate between sides, month-to-month). Some women will experience this ovulatory pain as a mild, dull, aching sensation and some women may even experience even greater discomfort. Some won’t experience it at all.
Androgens are often referred to as ‘male sex hormones,’ but they’re present in both men and women. When it comes to women, we hear the most about testosterone, DHEA-S and DHT.
Birth control is NOT the only option for painful (dysmenorrhea) and/or heavy periods (menorrhagia). And before jumping on a medication or supplement your HCP should always look into potential causes of extreme cramping – ie. endometriosis, fibroids, etc.
Prostaglandins are a major factor in menstrual cramps – once a month (when Aunt Flow comes to town) they cause uterine muscles to contract in order to release the uterine lining (endometrium). Prostaglandins aren’t bad (they are important for blood clots, inducing labour, etc.), but if certain prostaglandins are high in your cycle – this can predispose to more painful menstrual cramping.
I have seen great variation in the amount of time it takes for a woman’s period to return and regulate. To start, prolactin is the main hormone responsible for milk production. And when elevated (hence, for breastfeeding) it works to prevent ovulation.
Amenorrhea: the absence of your period.
And then amenorrhea is divided into 2 categories: primary and secondary.
We’re going to talk about secondary amenorrhea, which can be observed as: the absence of a period for 3 months in women who had previously had REGULAR cycles, or the absence of a period for 6 months in women who had already been experiencing IRREGULAR cycles.
I talk a lot about cortisol, but it doesn’t exist as a lonely hormone. If you look closely, you can see that the thyroid (see TSH, T4, T3 and rT3) and adrenal glands (ACTH, cortisol) are tightly connected. The (+) and (-) icons indicate positive and negative feedback throughout this entire axis – how fascinating.
So - the liver is responsible for detoxing alcohol. But it’s also important for metabolizing estrogen. In women, more than one alcoholic drink per day has been shown to increase circulation of androgens (ie. testosterone) and estrogens (1, 2) – this predisposes you to symptoms of estrogen dominance.
When you have healthy, restful sleep, cortisol levels are reduced to their lowest levels (typically around midnight). If cortisol doesn’t drop appropriately, this contributes to fat production and provides very little fuel (glycogen) to the muscles. So, you’ve got weight gain. And you’re tired.
The World Health Organization (WHO) recognizes BURN-OUT as an occupational phenomenon. “Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”