I remember 1987. In my late 20’s, my days were full of training for the emerging triathlon scene which was part of the changing physical landscape for women, along with the emergence of Jazzercise in the fitness industry.
Working as a former nurse, I can’t believe all the training I did back then on top of my nursing shifts – I had so much energy back then! 1987 was the year that I completed the New Zealand Ironman competition.
I took a few days off work and as you did back then, put my very basic 12-speed bike, running shoes and togs in my little car and drove nearly the length of New Zealand from Dunedin to Auckland. I couldn’t afford the air-fare.
Back in those days, I had no idea how to eat or train for my hormonal cycle – it wasn’t talked about.
In fact, I didn’t know much about my menstrual cycle at all. Nobody talked about this aspect of women’s hormonal health.
There was no sport science, no sports nutrition and definitely no discussion about the type of training and nutrition to better suit the ebb and flow of our menstrual cycle.
The research linking hormonal health with exercise training didn’t exist until a few years ago, and certainly not to the perimenopause to menopause transition. But it’s great that it has emerged, because as we are the first generation of women to enter menopause in the context of being so active, we need to now apply this research to this age and stage of life.
Understanding Perimenopause
Perimenopause is an interesting stage of life for women who are regular exercisers and it differs from menopause.
Perimenopause is the time leading towards menopause when periods begin to change. This stage of life is as different from post-menopause as is chalk from cheese.
Too often women are thrown into the same ‘one-size-fits-all’ basket at this life-stage. But they shouldn’t be, because during peri-menopause, food and exercise needs differ as oestrogen and progesterone production is only beginning to decline. In healthy women, the ovaries are still producing oestrogen, but levels are beginning to decline.
As such, the levels of declining oestrogen also affects other organs and tissues around the body, including muscles.
Perimenopause refers to the years leading up to actual menopause, which is the point in time when permanent cessation of your menstruation occurs.
Globally, the average age that you enter menopause is around 51-52 years old, unless of course, you have gone into surgical menopause after a hysterectomy or after other medical interventions.
Natural peri-menopause begins around your mid-40’s. But as you learn in my online Masterclass on Menopause, this can change according to when you began puberty or due to the age you were when you had children.
Peri-menopause is usually the time when symptoms such as hot flushes/ flashes, insomnia, dry or less elastic skin, weight gain, irregular bleeding, sore joints, anxiety, dizziness and/or feelings of depression and lethargy begin.
It’s tough for many women and I had many of these symptoms too – which I found confusing and frustrating.
At the time, what I didn’t realise, was that my body was ageing and in my mid-late 40’s, I wasn’t actually in menopause, but perimenopause.
As you move through perimenopause, you enter menopause.
This is the stage when your periods end. You are generally in menopause for a year without periods, and then you enter post-menopause, where you remain for the rest of your life.
Perimenopause is the time when your hormones are fluctuating, not only within the ovaries but within your bloodstream and in other cells and tissues, including in muscles.
When your periods have stopped for a year or more, you have now transitioned into post-menopause. During these years, your oestrogen, progesterone and your pituitary hormone production has reached its lowest levels.
Your reproductive years are over.
But symptoms can persist in women who are in their post-menopause years, especially if lifestyle adaptations aren’t made to support the change in hormones.
“Regardless of popular belief, the decrease of oestrogen hormones is not the sole cause of menstrual cessation; rather, many hormones fluctuate to cause this reproductive transition or “climacteric.” (Dillaway, 2004).
For about 8-10 years, you can experience fluctuations in numerous hormones around the body. For women who experience numerous symptoms, this transition may be complex, hence, how women look after themselves during and after this transition matters to health as they age.
Understanding your Menstrual Cycle
Our female physiology is complex … and it’s riddled with fluctuations in sex hormones from one month to the next, especially in the perimenopause transition.
Even as we go into peri-menopause our pituitary hormones are still trying to get the ovaries to produce oestrogen, however, there is a dwindling pool of follicles (clusters of cells that produce ova and hormones) due to our ovarian ageing.
Some of you will have lighter periods, but some of you may have heavier periods. And it’s all to do with how quickly your levels of oestrogen and progesterone decline, unless you have had a hysterectomy.
Your menstrual cycle is typically divided into 3 phases:
- Your period is called ‘menses’ and occurs from Days 1-5 of your cycle.
- The follicular or regenerative phase follows and thickening of your endometrial lining in your uterus occurs. This is mainly achieved under the direction of your pituitary reproductive hormones, FSH and LH (follicle-stimulating hormone and luteinizing hormone).
- The last phase of the monthly cycle before your period starts again is the luteal or pregestational phase. The corpus luteum is readying itself to support a fetus and the endometrium is thickening. Some of you with endometriosis may experience more bloating and pain at this time of the month. This is when you may feel bloated and experience cravings for sugar and simple carbs, such as bread and baked products. The reason for these cravings, is that this phase is dominated by progesterone, so oestrogen is lower.
The luteal phase of your monthly cycle, when progesterone is in control, is when you may feel more emotional, bloated, lethargic and yes, you might crave certain sweet, simple foods, especially if you are exercising a lot and not managing your post-exercise blood sugar levels.
Even when you are transitioning through peri-menopause, you can still experience these mood swings, bloating and cravings, as your pituitary hormones continue to manage the monthly hormonal messages.
What to Eat During Perimenopause (Luteal + Follicular Phases)
How do you eat for your fluctuating hormones in peri-menopause?
Fortunately there is a lot more research around this area these days, and if you have a teenage daughter involved in lots of sports then plug her into the work of Exercise physiologist and nutrition scientist, Dr Stacey Sims from the University of Waikato’s Dept of Health, Sport & Human Performance (where my doctorate is from too). Stacey researches female athletes and hormonal cycles.
In the context of the ‘other-end’ of our life cycle – perimenopause, I want to share these main points from a nutritional perspective.
- Phase 1: (Your period – Menstruation) – Both oestrogen and progesterone are low in this phase, but if your periods are heavy, then eat foods high in folate, Vitamin B12, B6 and iron. Whilst we need lots of deep-green vegies in this phase, some of you might like to have more red meat in this phase, unless you are vegetarian. Whilst I don’t have a lot of meat-meals in the MyMT™ programmes, especially for women in post-menopause when they aren’t menstruating any more, for some thinner/ leaner women or those of you who are exercising, up to two meat meals a week is warranted in this phase (NZHF, 2020).
If you aren’t a meat-eater, then get healthy Omega 3 fats into you via avocado, salmon, olive oil & nuts. Ensure you also stay well hydrated.
- Phase 2: The follicular phase towards ovulation is when oestrogen dominates the hormonal environment. You may feel puffy, heavy and put on weight.
When oestrogen dominates, you may feel less bloated if you reduce your animal foods, including eggs, dairy products, chicken and soy-based foods. These foods contain natural oestrogen compounds. I talk a lot about these foods in the MyMT™ Transform Me programme because if you are putting on weight during menopause, then your fat cells can store this additional oestrogen. Fat cells also make their own form of oestrogen too. So, for women who are overweight or obese, if you eat a lot of high-oestrogen foods, your ageing liver is also working harder to clear the excess oestrogen, and saturated fats and cholesterol. As such, add more salads and lighter plant-based meals, or soups, that don’t make you feel bloated.
- Phase 3: The luteal phase is when progesterone dominates your hormonal environment. For many of you, this can be the craziest phase and it’s why millions of women both young and older, experience symptoms related to PMS (pre-menstrual syndrome), which typically includes mood swings and low blood sugar. This is why an often-reported symptom of this phase are food cravings, especially sugar cravings.
For women in peri-menopause however, when hormones throughout the body are fluctuating, this phase might also include feelings of depression, anxiety, melancholy or increasing hot flushes.
In this phase, balancing up your oestrogen and progesterone levels are important.
So, try adding more plant-based protein to your diet, such as yams, soy-based products, including edamame beans. If you aren’t overweight, then you might like to add small amounts of protein from low-fat milk or eggs.
The goal is to balance up higher amounts of progesterone with oestrogen-rich foods.
Adding zinc-rich foods such as fish and salmon is also well documented in your mid-luteal phase (and important for your immune health). Pumpkin seeds are a good source of zinc, with a 100-gram serving providing about 10.3 milligrams. Zinc is essential for various bodily functions, including immune system support.
Why is it important to drink water during the luteal phase (before your period)?
When progesterone is high, this breaks down muscle more readily, so if you are an exerciser, then include healthy vegetable carbohydrates (sweet potato or brown rice) because carbohydrates work with protein to help maintain muscle.
Research supports that this phase is when you are most likely to crave sugar, so get healthy vegie snacks ready, instead of unhealthy sugary drinks or sweets. This includes sports drinks, which are often high in sugar. Apples are a great snack for you as are carrot sticks and celery dipped in hummus. Pumpkin Seeds are also high in zinc.
Perhaps the most important factor in the luteal phase however, (before your period), is to focus on hydration.
Plasma is the watery part of your blood. When hormones, especially progesterone, are high in the luteal phase, plasma volume drops by approximately 8%, meaning that less is available for blood circulation, sweating and maintaining your blood pressure.
This is why the most important factor in the luteal phase (before your period) is to focus on hydration.
When I’ve visited Switzerland over the past few years, I love the water that flows in the troughs which is glacial-fed and high in calcium and magnesium.
Both these minerals are crucial to help reduce anxiety and improve your heart, muscle and bone health.
As you move through menopause and into post-menopause, hormone fluctuations as part of your cycle should become less intense, but only when you also adapt your lifestyle to better suit these changes. This is why I designed the 12 week MyMT™ programmes for you.
When you are ready, I hope you can join me too.
References:
Dillaway, H. (2006). When does menopause occur and how long does it last? Wrestling with age and time-based conceptualizations of reproductive aging. NWSA Journal, 18(1), Spring, 1-31.
Gorczyca, A., Sjaard, L. et al. (2015). Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women. Eur. Journal of Nutrition, Published Online 5th June, 2015: Springer.
New Zealand Heart Foundation (October, 2020). Meat and poultry: New guidelines for cardiac health. Wellington: NZHF
Sims, S. (2017). ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology. Amazon Publ.
What to Eat During Perimenopause (Luteal + Follicular Phases) FAQ
If your menstrual cycle is changing and you are experiencing heavy periods, then to help support hormonal changes during perimenopause, focus on:
- Folate-rich foods, such as spinach, kale and other green vegetables.
- Iron is important, so if you aren’t vegetarian, then have 2 red meat meals per week.
- Oranges, kiwifruit, apples and purple berries give you Vitamin C and are anti-inflammatory – an important point for those of you experiencing endometriosis.
- Low glycemic index carbohydrates will aid your energy levels and provide magnesium – oats, brown rice, quinoa and other low gluten grains.
In the follicular phase, when oestrogen dominates, reduce foods that contain natural oestrogens, especially if you are overweight or obese. Fat cells produce their own type of oestrogen, so this is when you should reduce your intake of eggs, dairy products, chicken and soy-based foods. All these foods contain naturally occurring oestrogens.
When you eat a lot of high-oestrogen foods, your liver is also working harder to clear the excess oestrogen, saturated fats and cholesterol. Don’t forget that your liver is changing during your menopause transition as it is ageing.
So, add more salads, and lighter plant-based meals and soups, that don’t make you feel bloated.
In the luteal phase, when progesterone dominates your hormonal environment, try adding more plant-based protein to your diet, such as yams and some soy-based foods, such as edamame beans.
Adding zinc-rich foods such as fish and salmon is also well documented in your mid-luteal phase (and important for your immune health), and pumpkin seeds are high in zinc too. If you are an exerciser, then include healthy vegetable carbohydrates (sweet potato or brown rice), because carbohydrates work with protein to help repair and maintain muscle.
Plasma is the watery part of your blood. When hormones are high in the luteal phase, plasma volume drops by approximately 8%, meaning that less is available for blood circulation, sweating and maintaining your blood pressure. This is why the most important factor in the luteal phase (before your period) is to focus on hydration.
