Super Bowl LVII had plenty of things to be excited about: two well-matched teams, Patrick Mahomes at the top of his game, and, unexpectedly, hot flash awareness. The organization What’s VMS? sought to make perimenopause a “hot” topic this year and raise awareness for vasomotor symptoms–the scientific name for the hot flashes and night sweats that classically characterize perimenopause–all during their Super Bowl ad! Their website features a helpful FAQ page and resources aimed at addressing menopause-related stigma. Astellas, What’s VMS?’s parent company, is developing a non-hormonal medication to treat hot flashes. But women should know that there are also options for managing perimenopause naturally.
First of all, what is perimenopause?
Perimenopause is the time between normal, regular cycling and menopause. Menopause is the absence of menstrual cycles for longer than one year. The first symptoms of perimenopause start with the advent of long or irregular cycles. This change in the hormonal status-quo in your body prompts a variety of symptoms. These can begin around the time of your final menstrual cycle, or even up to 10 years before menopause.
Symptoms
According to this continuing education course for registered nurses, symptoms of perimenopause include:
- hot flashes and night sweats
- cognitive symptoms such as anxiety, depression, irritability, and insomnia
- Tiredness
- bone loss
- joint pain
- Incontinence
- low libido
- vaginal dryness
What about HRT for perimenopause symptoms?
For some women, perimenopause symptoms disrupt sleep and daily activities. It’s understandable that these women may be interested in hormone replacement therapy (HRT) to ease symptoms.
However, HRT has its own risks and side effects. According to the American College of Obstetricians and Gynecologists (ACOG), HRT increases your risk for endometrial cancer, breast cancer, heart attack (for older women), blood clots, and gallbladder disease, especially if family or personal medical history indicate that you are at a higher risk for these complications to begin with. However, there are ways to ease discomfort without supplementing hormones during this natural transition phase.
Natural solutions for managing perimenopause
Chart your cycle
In some ways, perimenopause is a similar stage in life as puberty. When teens first begin ovulating, cycles can feel random and stressful and come with a host of symptoms ranging from uncomfortable to debilitating. In perimenopause, as fertility dwindles, new symptoms appear and cycles are again irregular. In both situations, charting helps to manage feelings of powerlessness when you can track biomarkers that help you to understand which hormones are dominant when, and when a period might be approaching. Including notes about when symptoms like hot flashes occur can also help you to identify associations between different points in your cycle (irregular as it may be) and how your body responds at these different points.
Manage hot flashes
Common triggers for hot flashes include alcohol, tobacco, caffeine, and spicy foods. In a hot flash, the change in your body’s usual balance of hormones mistakenly sends a signal to your body that you’re too hot. The result, a hot flash, is actually your body’s attempt to cool down by prompting cooling behavior like sweating. Try wearing layered outfits that can transition from winter wear to summer wear easily.
Another way to reduce hot flashes is by exercising, since women “who lead sedentary lives seem to experience more hot flashes” according to the Cleveland Clinic. There are also devices on the market like the Embr Wave, which, although pricey, has been shown in studies to help with hot flashes and night sweats by making the inside of the wrist cold and helping the brain realize you are not too hot.
Support bone health
Supplementing calcium and vitamin D can help support bone health later in life, as calcium is needed to maintain bone density and vitamin D is needed for the small intestine to absorb calcium. Exercise is also thought to slow bone density loss and help prevent osteoporosis.
Support healthy weight and muscle mass
This step is not all about losing weight. While menopause is associated with weight gain due to slower metabolism, muscle density often decreases with age and can contribute to the muscle weakness and balance issues associated with old age. Prioritizing protein at meals can help to support muscle mass, keep you feeling full for longer (thus, less snacking), and help to manage blood sugar levels. Exercise, especially activities that strengthen muscles, is important for managing weight, improving muscle mass, and supporting energy levels and good balance.
Support mental health and good sleep
At the risk of becoming repetitive, I’m just going to say it one more time–exercise! Moderate exercise is known to improve mood, decrease anxiety, and—since it has the added bonus of easing the other symptoms of perimenopause—it can lower your overall discomfort.
Other forms of stress management include meditation and mindfulness, deep breathing exercises, journaling, and intentionally choosing to do something each day solely because you enjoy it, whether it be going out for a (decaf) coffee, spending time outside, calling a friend, or whatever brings you joy.
It can also be helpful to find a support group or bring together a group of friends who are also experiencing perimenopause with whom can commiserate about VMS “tropical moments,” hear and express encouragement, and offer advice or try new ideas (bonus points if you get together to do something active!). This can be particularly beneficial for women who feel uncomfortable talking about perimenopause at work for fear of age and/or gender related stigma.
What about supplements, herbs, and special foods?
Many women wonder, can you manage perimenopause naturally with food? Certain foods contain isoflavones, which are compounds that are similar in structure to estrogen and thus can create either weak estrogenic or anti-estrogenic effects in the body. The most well known isoflavone is soy, which is a complete protein and is high in fiber, but there are many other plants with hormone effects (see our previous perimenopause guide here). Harvard Health notes that the debate about whether soy helps with certain health conditions is ongoing.
For most people, increasing fruits and vegetables and opting for foods with lots of vitamins and antioxidants is a great way to support overall health and potentially help with some perimenopause symptoms with little risk of side effects.
Keep in mind that many herbs can interact with different medicines and are not regulated by the Food and Drug Administration (FDA). It pays to run these by your healthcare provider before trying any supplements for perimenopausal symptoms.
The bottom line on managing perimenopause naturally
Perimenopause is an important transition stage in which the body is finding a new hormonal balance and preparing for life without periods. Some hormones will be lower, while other hormones, particularly estrogen, may actually be higher than normal at times. This is due to the body attempting ovulation with the limited number of remaining follicles. Managing perimenopause naturally can give you clues on how best to help your body through this transition and support your own health and wellbeing into menopause. Who knows? Perimenopause symptoms could provide the motivation to be in better shape than ever before!
Additional Reading:
The benefits of charting into Perimenopause
Fertility awareness can reduce perimenopause dread
