5 Science-Based Tips for Perimenopause Symptom Relief

The attacks of Perry Menopause in the Holderness family videos are real. From brain fog and lack of sleep to itchy skin and blemishes, not to mention general raging hormones – the transition into menopause isn’t fun. And, starts a whole lot sooner than our grandmother’s ever clued us in on! Heck there are even scientific studies about how little women know about our own bodies. If you’re not ready for hormone replacement therapy or also not loving the side effects, here are 5 Science-Based Tips and Tools for Perimenopause Symptom Relief.

Spoiler Alert, here’s what you’ll find below:

1. Remove additional hormonal burdens
2. Avoid use of estrogenic personal care products
3. Become un-dependent on substances
4. Do not skip breakfast
5. Support Your Body with Added Nutrients

WATCH: Perimenopause Symptom Relief Tips on YouTube

Remember: perimenopause and menopause are a completely natural and normal progression in the reproductive cycle. And I’d argue a privilege, as not all women have this natural progression. Menopause brought on by health concerns or surgery is a completely different, difficult experience.

Onset of Perimenopause

Perimenopause is the transitional state between fertility and before menopause. While you can absolutely get pregnant during this time (in fact many do, not realizing they are still fertile), your body is physically transitioning. During perimenopause, levels of female hormones, such as estrogen, start to decrease. You will begin experiencing menopause-like symptoms, such as hot flashes or irregular periods. Really, the things most people associate with menopause are actually perimenopause which, unfortunately can last for years.

What is the difference between perimenopause and menopause? Perimenopause is a transition to menopause. Menopause is the state of complete menstruation cessation. When you have no menstrual cycle for a full 12 months, it is officially referred to as menopause.

Why does perimenopause happen? During the transition to menopause, your ovaries and hormones can go a bit haywire (that’s the technical, scientific term by the way). Your body cues begin with producing less estrogen in preparation to stop releasing eggs entirely. And, it often releases even more eggs during that transition – to “get rid of them” in preparation for menopause. Again, lots of ups and downs.

When does perimenopause begin? Perimenopause usually begins about 10-15 years before menopause. The changes can be noticed as early as mid-thirties, but usually start in your early-to-mid 40s. Completing menopause before age 40 is called premature menopause. Some medical conditions or procedures can cause early menopause.

How long does perimenopause last?

Depending on your body and how severe your symptoms, you may notice them for more than a decade. But, medically it is claimed that the average length of perimenopause is about four years. Some people may only be in this stage for a few months, while others will be in this transition phase for years. You may even think you’ve reached menopause if you have menstruation gaps of 4-6 months, but when it returns it is with a vengeance and you will likely experience a lot of the symptoms below.

Some factors are linked to early perimenopause, including:

• Smoking or using tobacco products
• A family history of early menopause
• A history of cancer treatment
• If you’ve had your uterus or ovaries removed

Physical Changes during Perimenopause

As your body transitions to menopause, the decrease in estrogen will cause physical changes.

What are the first signs of perimenopause? Beyond the first sign of perimenopause as irregular periods, common symptoms can include hot flashes, night sweats, brain fog, moodiness, anxiety and depression, and vaginal dryness (vaginal atrophy).

How is perimenopause diagnosed? You don’t need to see a healthcare provider for a perimenopause diagnosis, simply noticing the changes in your body that coincide with the age window it is expected would align with knowing you were in perimenopause.

What are the hormonal changes during perimenopause?

The ovaries make estrogen, which plays a vital role in maintaining the reproductive system. As you age, the quantity of your eggs reduces and your estrogen levels start to decrease. As estrogen decreases, it throws off the balance with progesterone, another hormone produces by the ovaries. These two hormones together are responsible for ovulation and menstruation. It’s common for hormone levels to fluctuate during perimenopause — to go up and down like a rollercoaster. (9)

Symptoms of Perimenopause

Your body’s estrogen levels fluctuate at several points in life: puberty, pregnancy, and perimenopause. Here, once your estrogen levels begin to decline, your body has to adjust to the changes in hormones. The symptoms vary, but most people experience at least several of the following:

• Irregular periods or skipping periods
• Periods that are heavier, lighter, longer, and shorter than usual
• Increased symptoms of PMS
• Hot flashes (a sudden feeling of warmth that spreads across your body)
• Sweating, especially at night
• Vaginal dryness and discomfort during sex
• Urinary urgency (needing to urinate more frequently)
• Sleep problems (insomnia)
• Changes in mood like irritability, depression or mood swings
• Decrease in estrogen also can lead to bone thinning
• Increased inflammation
• Changed cholesterol levels.

Due to the potential impact to long-term health, it is important to continue to have regular checkups with your healthcare provider to keep an eye on your health. For those experiencing unmanageable symptoms, there are a lot of safe options for Hormone Replacement Therapy. But, there is a lot you can do on your own to help reduce symptoms as well.

pro tip: if you’re having a super heavy menstruation, at the onset physically clear your vaginal canal of the heavier clotted clumps with your fingers; it reduces my menstruation by days!

Can perimenopause be treated?

There isn’t any treatment to stop perimenopause. Perimenopause is a natural part of life. The “cure” for perimenopause occurs when your periods stop and you enter menopause. But, there are many ways to help ease symptoms:

With a Medical Professional

• Antidepressants: These medications help with mood swings or depression.
• Birth control pills. These medications stabilize your hormone levels and typically relieve symptoms.
• Estrogen therapy: This treatment stabilizes estrogen levels. You may take estrogen therapy as a cream, gel, patch or swallowable pill.
• Gabapentin (Neurontin®): This medicine is a seizure medication that also relieves hot flashes for some women.
• Vaginal creams: Your provider can tell you about prescription and over-the-counter options. Treatment can decrease pain related to sex and relieve vaginal dryness.
• Your healthcare provider will discuss the risks and benefits of perimenopause treatment with you and recommend the best option based on your needs.
• Certain lifestyle changes like eating a healthy diet, light exercise and avoiding foods or activities that trigger hot flashes can also help.

What You Can Do at Home

• Eat lots of fruits, vegetables, whole grains, lean protein and healthy fats.
• Perform weight-bearing exercises like walking, hiking or strength training.
• Improve sleep hygiene by avoiding screens and doing relaxing activities before bed.
• Limit alcohol and caffeine.
• Practice meditation or other stress management techniques.
• Quit smoking

All of these above are from sources below, specifically (9). I know no one wants to hear to quit alcohol, caffeine, and smoking if you’re already stressed and depressed. And, as someone who personally did this – I can tell you it helped me.

Perimenopause Warnings: what not to do

1: Remove additional hormonal burdens

Endocrine disrupting chemicals is another term for “things that mess with your hormones.” Removing things like plastic food containers from your home, saying no to receipts and lined take out containers high in PFAS, switching over your home cleaning products and personal care – especially removing fragrance as an ingredient, have been shown in numerous studies to have measurable improvement in hormone health within days.

GOOD NEWS: after 3 days use of safer ingredient products reduces toxic chemicals levels:

• 44 percent down in levels of methyl and propyl paraben. Parabens are preservatives widely used in cosmetics, shampoos and skin lotions.
• 35 percent down in triclosan, an antibacterial chemical common in liquid antibacterial hand soap, dishwashing detergent, toothpaste, face wash and deodorant. Triclosan has been linked to the disruption of thyroid and reproductive hormones.
• 27 percent down in mono-ethyl phthalates. Phthalates, common industrial plasticizers, show up in some nail polish and fragrances.  [4, source]

2: Avoid use of estrogenic personal care products

Estriol and Estrodiol have become all the vogue for over-the-counter anti-aging skincare. However, they and placental extracts, which are likely to contain natural progesterone and estrogens, as well as estrogenic compounds themselves, are listed as a known carcinogen by the International Agency for Research on Cancer (IARC) and the National Toxicology Program (NTP). (2) While estrogen may be added to some anti-aging creams for its effectiveness in raising collagen count and increasing skin hydration, it can also cause our internal hormones to go askew. If seeking hormone replacement therapy, do so under the supervision of a medical professional and not something marketed by an influencer.

This is the clinically-proven anti-aging line I use. EWG Verified safe with no hormone disrupting chemicals, and scientific studies to show it reduced the age of more than 2/3 users over a decade with 100% seeing reduced signs of aging using the measured (not perception) Skin Aging Index.

3: Become un-dependent on substances

If I hadn’t seen incredible results from my own hormone regulation from this, I wouldn’t be suggesting you “take away” something that probably feels near and dear to your heart. I get it, I had the same feelings! And, as we age between the brain fog, energy dips, and unstable mood we can become tempted to reach for a quick fix. But the more potentially harmful substances we are leaning on, the worst our symptoms will get. Many of the symptoms below overlap with perimenopause, which means they will compound with use.

Alcohol Causes

Here’s how alcohol can affect your body:

Brain: interferes with the brain’s communication pathways, and can affect the way the brain looks and works. These disruptions can change mood and behavior, and make it harder to think clearly and move with coordination.

Heart: can damage the heart, causing problems including: Cardiomyopathy – stretching and drooping of heart muscle; arrhythmias – irregular heart beat; stroke; high blood pressure.

Liver: can lead to a variety of problems and liver inflammations including: Steatosis, or fatty liver; alcoholic hepatitis; fibrosis, cirrhosis.

Pancreas: causes toxic substances to be produced that can lead to pancreatitis and impairs its ability to make enzymes and hormones for proper digestion.

Cancer: alcohol is a known human carcinogen. There is a strong scientific consensus that alcohol drinking can cause several types of cancer: head and neck cancer, including oral cavity, pharynx, and larynx cancers; esophageal cancer, particularly esophageal squamous cell carcinoma; liver cancer; breast cancer; colorectal cancer.

Immune System: Drinking too much can weaken your immune system, making your body a much easier target for disease. Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk. (5)

Learn more

• Read: How I Quit Coffee (and other things I did to fix my high cortisol levels) here
• Listen: Whole View ep 57, The Women Who Quit (alcohol) here

Caffeine Causes

Caffeine stimulates the central nervous system—that’s the jittery feeling—which can lead to agitation. (8) And yet, it is the most widely consumed psychoactive substance in the world. Many people start every day with caffeine in one form or another to help them feel more alert, energized and focused. While that may not have been a problem when your health is good it can exacerbate a lot of health conditions (which overlap with perimenopause):

• Having trouble sleeping
• Anxiety, restlessness or irritability
• Experiencing stomach and digestive issues, or heartburn
• Dizziness, shakiness, or tremors
• Sweating
• Rapid heartbeat or your heart beating unevenly
• Can make medical conditions like heart problems, diabetes, osteoporosis, and others worse
• Makes your heart work harder and raises your blood pressure
• Contributes to panic attacks
• Raises blood sugar levels (which we know then in turn affects cortisol and other hormones)
• Blocks calcium absorption and leads to spinal bone loss
• Increases stomach acidity, irritates the gut, reduces iron absorption
• Can make some medications and dietary supplements less effective.
• Increases urination frequency and can lead to dehydration, urinary urgency or incontinence.
• Headache – from both dehydration and withdrawal (7)

Why does high cortisol matter?

Cortisol is the body’s primary stress hormone. It increases sugars (glucose) in the bloodstream, enhances your brain’s use of glucose and increases the availability of substances that repair tissues. Cortisol also curbs functions that would be nonessential or harmful in a fight-or-flight situation. It is a steroid hormone that regulates a wide range of vital processes throughout the body, including metabolism and the immune response.

All the effort we make towards health really can’t have an impact if our bodies are literally unable to prioritize immune support, since it’s in flight or fight mode. Having elevated cortisol is literally limiting your body’s ability to function properly. Immune and metabolism are sacrificed as your body is in a constant state of “chasing wild beasts.”

Caffeine in dietary doses increases both adrenocorticotropin and cortisol secretion in humans. Caffeine’s effect on glucocorticoid regulation therefore has the potential to alter circadian rhythms and to interact with stress reactions. (4)

Learn more

• Read: How I Quit Coffee (and other things I did to fix my high cortisol levels) here
• Listen: Whole View ep 58, Cortisol, Caffeine, and Long Covid here

It might feel impossible, but I’d love to help it feel feasible. In removing both of these I saw physical health improvements that improve my perimenopause symptoms. I’m actually running a free an “accountability group” of folk looking some support to make this switch.

Tips: what to do

Here’s two science-based things you can add to your life to improve perimenopause symptoms.

4: Do not skip breakfast.

I know Intermittent Fasting is all the rage. But did you know most of the things shared about are a) tested on men, and b) not a full picture? In fact, the science ise very clear: it is essential that women do not skip breakfast!

Researchers analyzed data from 10,575 adults who participated in the National Health and Nutrition Examination Survey. What they discovered instead was that eating breakfast early reduced insulin resistance, and feeding window didn’t matter.

People who start eating before 8:30 am had lower blood sugar levels and less insulin resistance. And in a different study it shows it doesn’t even really matter what you’re eating – even regular breakfast cereal consumption is associated with lower stress levels and reports of better physical and mental health. (10)

Another study showed female breakfast-skippers display a disrupted cortisol rhythm and elevated blood pressure. (11)

Learn more

• Listen: Whole View ep 479 Stress, Coffee, and Breakfast here
• Listen: Whole View ep 453 Should We Eat Breakfast Before 8:30AM? here

MY RECOMMENDATIONS

Have a smoothie or soup within an hour of waking in the morning. I know, it’s a weird thing to start with. But, when I first switched from what most of us drink – just a cup of coffee – it took my body a while to get used to digesting food that early. You’ll need to “wake back up” your digestive track to produce enough stomach acid and enzymes. That’s why already partially-digested food can be really helpful – and why hospitals say things like eat a “soft diet” when your body is recovering.

Recipes:

• Green Smoothies: 3 Versions with Healthier Fats, Protein and Fiber-Rich Veggies
• A ton of smoothies & smoothie bowls at Fed & Fit

I strongly recommend LifeShake as the base of your smoothie. It not only has complete protein, but also added pre and probiotics to help with digestion, as well as a lot of fiber and essential nutrients added. I have found in switching from a beef isolate protein powder to LifeShake (I’ve tried both the pea and soy versions), I have more sustained energy after.

If smoothies aren’t for you, soups are another way to get in lots of nourishing nutrients in an easily digestible form. A couple of recipes I love:

• Danielle Walker’s Leftover Roast Chicken Soup with Roasted Vegetables
• Egg Drop Soup is an easy breakfast win
• Fed & Fits Creamy White Chicken Chili
• Or Fed & Fits’s Chicken Soup with Ginger and Tumeric adds extra anti-inflammatory benefits

MY EXPERIENCE WITH THIS

It sounds sad, and impossible – but trust me, you can do this (if you want or need to). It was easier than I thought, and I felt SO much better once my body adapted. Here’s what happened:

• Since I’m not making my coffee with collagen and cream anymore, I got hungry. I’m now eating a nourishing breakfast.
• Instead of forcing myself to wind down at midnight, I am now putting myself to bed easily and energetic throughout the day.
• I’m finding my energy to be more stable which leads me to be more intentional with my movement and making time for exercise and self care.
• My moods are more stable which let’s be honest is best for everyone!

So with this ONE intentional change, a lot naturally changed for me! Listen, I didn’t want to let go either. But if you’re suffering from fatigue, insomnia, sleep issues, cravings, mood swings, anxiety or general weirdness, I encourage you to consider trying, and not giving in to crutches.

5: Support Your Body Through Perimenopause with Added Nutrients

Supporting your body with habits that nourish and fuel, as well as prioritizing sleep was noted above as having an impact on what you can do at home. Reminder, they were:

• Eat lots of fruits, vegetables, whole grains, lean protein and healthy fats.
  smoothies & soups, I’m telling you – once it’s your first meal of the day you’re all set!
• Perform weight-bearing exercises like walking, hiking or strength training.
  with energy from an early breakfast you will desire to move your body in a joyous way, but beware of intense cardio exercise which may exacerbate symtoms
• Improve sleep hygiene by avoiding screens and doing relaxing activities before bed.
  the Rest & Rewind tea below is a game changer
• Quit and limit smoking, alcohol and caffeine.
  see above
• Practice meditation or other stress management techniques.
  a tons of resources on the science of this here
• Ensure a balanced system with probiotics
  the flora & flow ones below have been a huge help to those I’ve heard from that have tried them so far
  

Protein and Menopause

In addition to the added micronutrients we need to fuel our cells, protein (a macro nutrient) is essential for long-term wellness as we age. Dr. Lyon says that getting enough high quality dietary protein, with the 9 essenital amino acids, is critical. She is the author of the book Forever Strong, A New, Science-Based Strategy for Aging Well has worked in geriatric medical facilities and learned that the biggest factor for long-term health is skeletal muscle. That if we prioritize enough protein and movement through peri and menopause that we can beat some of the statistics.

In fact, a 2005 study (which incidentally controlled for gender, age, and smoking, which many other studies before that time did not do) found overweight individuals had lower mortality rates than people in the normal weight category. (12) This is because their bodies were stronger to withstand falls, sickness, etc. Which is why it’s SO important to prioritize muscle health as we age!

And, this study found that about 25% of healthy, older postmenopausal women consumed less than the RDA average of protein. And that it physically impaired in those who under-consumed protein.

Before you tell me those things won’t help, not only do you have my personal experience and the dozen plus scientific reference I’m sharing, but here are some testimonials from others who have tried adding some of these:

What I’m personally using (and the testimonials above are referring to):

• Collagen 9, the most complete collagen product – all of the 9 amino acids Dr. Lyon refers to
• Vivix, anti-aging at the cellular level (liquid or gummy form)
• Flora & Flow, easy-to-take capsules for vaginal and urinary tract health
• Rest & Rewind tea, relaxing mint tea for restful sleep and anti-aging*
• of course LifeShake for added protein
• and maybe some Cheer Up & Chill Out gummies wouldn’t hurt

Shop all my recommendations here.

my personal experience is that the Rest & Rewind tea was one of the best tools I could use, beyond all the other changes – even though I was no longer having night sweats or many of the other symptoms anymore, I was still having restless sleep, difficulty falling asleep, and both anxiety and depression. In taking this tea 2-3x a week I was feeling so much more rested and clear headed that I have weaned  off of both my SSRI and antidepressants! -stacy

pro tip: grab a number of these together in bundles for additional savings, and in June 2024 they’re another 15% off with code BUNDLE15

Additional Resources:

• The Whole View Ep 51: Rebranding Menopause with Dr. Mary Claire Haver, listen here
• The Whole View Ep 29: Menopause & Symptom Relief with Esther Blum, listen here
• TPV Podcast Ep 369: Let’s Talk About Menopause, listen here
• The Whole View Ep 78: Forever Strong, How Muscles help us Age Well with Dr. Gabby Lyon, listen here
• TWV Podcast Ep 491: Skin Care FAQ Part 2, listen here

Sources

1. An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause, PMID: 35758176
2. BCPP.org’s Hormones in Personal Care Products with the following cited sources:
   1. Rudel, Ruthann A et al. “Chemicals causing mammary gland tumors in animals signal new directions for epidemiology, chemicals testing, and risk assessment for breast cancer prevention.” Cancer 109, 12 (2007): 2635-66. doi:10.1002/cncr.22653.
   2. Tiwary, C M. “Premature sexual development in children following the use of estrogen- or placenta-containing hair products.” Clinical Pediatrics 37, 12 (1998): 733-9. doi:10.1177/000992289803701204.
   3. Olson, Adrienne C et al. “Breast cancer patients unknowingly dosing themselves with estrogen by using topical moisturizers.” Journal of Clinical Oncology 27, 26 (2009): e103-4. doi:10.1200/JCO.2009.23.1225.
   4. Draelos, Zoe Diana. “Topical and oral estrogens revisited for antiaging purposes.” Fertility and Sterility 84, 2 (2005): 291-2; discussion 295. doi:10.1016/j.fertnstert.2005.03.033.
   5. Doisneau-Sixou, S F et al. “Estrogen and antiestrogen regulation of cell cycle progression in breast cancer cells.” Endocrine-Related Cancer 10, 2 (2003): 179-86. doi:10.1677/erc.0.0100179.
   6. Moral, Raquel et al. “Effect of prenatal exposure to the endocrine disruptor bisphenol A on mammary gland morphology and gene expression signature.” The Journal of Endocrinology 196, 1 (2008): 101-12. doi:10.1677/JOE-07-0056.
   7. Tiwary, C M. “Premature sexual development in children following the use of estrogen- or placenta-containing hair products.” Clinical Pediatrics 37, 12 (1998): 733-9. doi:10.1177/000992289803701204.
   8. Li ST et al. “Hormone-Containing Hair Product Use in Prepubertal Children.” Archives of Pediatrics and Adolescent Medicine 156,1 (2002): 85–86. doi:10.1001/archpedi.156.1.85.
   9. Tiwary, Chandra M, and John A Ward. “Use of hair products containing hormone or placenta by US military personnel.” Journal of Pediatric Endocrinology & Metabolism 16, 7 (2003): 1025-32. doi:10.1515/jpem.2003.16.7.1025.
   10. Hsieh, C C et al. “Age at menarche, age at menopause, height and obesity as risk factors for breast cancer: associations and interactions in an international case-control study.” International Journal of Cancer 46, 5 (1990): 796-800. doi:10.1002/ijc.2910460508.
   11. Donovan, Maryann et al. “Personal care products that contain estrogens or xenoestrogens may increase breast cancer risk.” Medical Hypotheses 68, 4 (2007): 756-66. doi:10.1016/j.mehy.2006.09.039.
   12. James-Todd, Tamarra et al. “Racial/ethnic differences in hormonally-active hair product use: a plausible risk factor for health disparities.” Journal of Immigrant and Minority Health 14, 3 (2012): 506-11. doi:10.1007/s10903-011-9482-5.
   13. Myers, Sharon L et al. “Estrogenic and anti-estrogenic activity of off-the-shelf hair and skin care products.” Journal of Exposure Science and Environmental Epidemiology 25, 3 (2015): 271-7. doi:10.1038/jes.2014.32.
3. Potentially Toxic Chemicals Plummet in Teens After Switching to Safer Cosmetics, EWG.org
4. How I Quit Coffee and Other Things I Did to Fix My High Cortisol, RealEverything.com
5. Alcohol Effects on the Body, NIAAA.NIH.gov
6. Caffeine intake and anxiety: a meta-analysis, PMID: 38362247
7. Caffeine’s side effects, AuroraHealthCare.org
8. The Dangers of Caffeine, healthcare.utah.edu
9. Perimenopause, Cleveland Clinic
10. Stress, breakfast cereal consumption and cortisol, PMID: 12000084
11. Female breakfast skippers display a disrupted cortisol rhythm and elevated blood pressure, PMID: 25545767
12. Excess deaths associated with underweight, overweight, and obesity, PMID: 15840860
13. Adequate Dietary Protein is Associated with Better Physical Performance Among Post Menopausal Women, PMID: 24522467
14. Exercise beyond menopause: Dos and Don’ts, PMID: 22408332

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