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Menopause Prep 101: Getting Ready for the Next Chapter

Love it or hate it, there’s nothing women can do to stop menopause from inevitably arriving. However, there are things you can do to prepare yourself for menopause and ease your transition instead of feeling like you are aging rapidly without a plan.

The perimenopause time is when you can do some significant interventions to prevent many of the negative changes associated with menopause - like weight gain, insomnia, and mood swings. In this blog, we’ll explain why perimenopause prepping is so important and how to do it.

Recap on menopause:

Before discussing how you can prepare for perimenopause, let’s recap what menopause actually is. Menopause marks the official end of a woman’s menstrual cycle. The average age for a woman to go through menopause is 51, but it can happen throughout your 40s and 50s.

Menopause occurs over three different stages:

  • Perimenopause: In the first stage of menopause, most women experience irregular period cycles. Some women might also experience some symptoms like hot flashes and chills. This typically happens around age 47. The average duration of perimenopause is 4 years, but for some women, it can last as long as 10 years.

  • Menopause: Menopause marks the day you have your last menstrual period. But you will not be sure it has happened until 1 year has passed without a period.

  • Post-menopause: The final stage occurs when you hit the year mark without a single period. This stage actually lasts for the rest of a woman’s life.

To learn more about how to master menopause, click here!

What’s happening with your hormones during perimenopause:

Starting in a woman’s late 30s, hormones will start changing. This means that your 40s is a time of adjustment and further hormonal fluctuations. The main hormonal change that women experience during perimenopause is variations in the level of estrogen in circulation and a drop in progesterone. Estradiol (Estrogen)is the main sex hormone produced by the ovaries and serves many roles throughout the body, including protection against heart disease, promotion of healthy bone development, growth and development of the reproductive anatomy, and significant effects on brain structure and communication. Progesterone is necessary to not only balance estradiol but also for glucose control, bone growth, sleep and feeling calm.

During peak reproductive years, the amount of circulating estrogen rises and falls predictably throughout the menstrual cycle.

However, when a woman enters perimenopause, ovarian production of estrogen varies dramatically until finally slowing substantially.

During perimenopause hormones start to decrease and ratios become out of balance. Symptoms can be diverse and different for every female. What is important to realize is that estradiol and progesterone affect every system in our body - including our brain.

Our microbiome is also affected by our hormones and may affect the diversity causing many GI symptoms that are common for women in their 40's and 50's.

What kind of symptoms should I expect?

Leading up to menopause, a woman’s hormones are rapidly fluctuating, which will inevitably have a significant impact on a woman’s entire body.

Some of the many symptoms women experience during perimenopause include:

  • Hot flashes

  • Night sweats

  • Mood swings and irritability

  • Fatigue

  • Vaginal dryness

  • increased stress and decreased ability to recover from stress

  • Weight gain especially abdominal weight

  • Joint and muscle pain

  • Irregular periods

  • Difficulty losing weight

  • Memory loss

  • Painful intercourse

  • Skin and hair changes

  • Difficulty falling asleep and waking up at 3am

  • Depression and anxiety

  • Tender breasts

  • IBS symptoms: bloating, constipation, diarrhea and reflux

  • Changes in hair and skin

  • Decrease in muscle tone and strength

What can you do to mitigate symptoms?

Luckily, there are steps you can take to help mitigate your future symptoms of menopause. And you don’t have to wait to start till you’re in your late 40s, there’s no reason you can’t start prepping for menopause today!

The number one factor that influences most of the hormonal symptoms of menopause is stress. Stress is not only psychosocial stress but any negative influences such as high sugar and processed foods, gut issues, excess alcohol, decreased sleep, too much or too little exercise, work/life balance, relationships, environmental toxins, etc. And the hormonal instability experienced during perimenopause itself significantly strains the body, nudging women towards a predominantly sympathetic state. This circumstance can exacerbate hormonal dysfunction and precipitate an earlier depletion of progesterone. The key to health is knowing what are your contributing stresses and learning how to effectively manage them.

Here are some other simple lifestyle changes you can integrate to make your transition to menopause as easy as possible.

Maintain a moderate weight:

Unfortunately, it’s very common to gain weight leading up to menopause, you might have already noticed the extra body fat springing up in your abdomen. This is due to dropping estrogen levels causing fat to build up around the midsection. Fat around the abdomen is also known as visceral fat, which has been linked to an increased risk of developing diseases like heart disease and diabetes.

Further, excess body weight has also been linked to worsened symptoms of menopause. Several studies have found that obese women are more likely to experience severe menopausal symptoms. This is especially true for symptoms like hot flashes, night sweats, muscle and joint problems, and bladder issues.

Prioritize foods with calcium and vitamin D:

Older women are at a heightened risk for osteoporosis because the hormonal changes experienced during menopause cause bones to weaken. And, both calcium and vitamin D have been linked to good bone health, so getting enough of these nutrients is vital to women as they enter menopause.

You can find calcium in many foods, such as dairy products, kale and other leafy greens, tofu, beans, and sardines. Unfortunately, as you age, getting sufficient vitamin D becomes a little harder. This is because your skin progressively gets less efficient at making it. Thus, you might need to take a vitamin D supplement to get enough of the essential nutrient.

Eat a healthy diet:

While eating a healthy diet is a good idea for everyone, it’s especially true for women nearing menopause. Several studies have found that women who consume a diet rich in vegetables and fruits were less likely to have menopausal symptoms than women who consume a diet containing more fatty foods and sweets. Overall, eating a healthy diet can help to lessen the severity of menopausal symptoms like hot flashes, mood swings, bloating, exhaustion, and weight gain.

Prioritizing protein is also vital for women nearing menopause. Eating protein throughout the day with each meal has been found to slow down aging-related muscle loss and boost bone health. Research has also found that eating protein can also keep your metabolism functioning properly and help to mitigate some symptoms of menopause.

You might also want to include more foods that contain phytoestrogens, a naturally occurring plant compound that can mimic the effects of estrogen in the body. These foods include soybean, tofu, tempeh, flaxseeds, sesame seeds, and beans. One study found that diets high in soy were associated with reduced severity of night sweats and hot flashes for perimenopausal women in the study. The high intake of phytoestrogens in Asian countries is thought to be the reason why women living there tend to rarely experience hot flashes.

Avoid trigger foods:

Unfortunately, some (otherwise delicious) foods have been linked to worsening symptoms of menopause. Such foods include:

  • Fatty foods: Fatty foods can increase your risk for heart disease, a condition that postmenopausal women are already at a heightened risk for. Moreover, fatty foods tend to promote weight gain, which will worsen menopausal symptoms as well.

  • Spicy foods: Unfortunately, spicy foods have been found to trigger sweating, flushing, and hot flashes. Best to shelve the hot sauce for now.

  • Processed foods: You may find yourself craving cookies or potato chips while going through menopause, but it’s better to avoid them. These foods are high in sodium and added sugars, both of which can worsen symptoms like bloating.

  • Sugary foods: As we know, the more sugary foods we consume, the higher our blood sugar spikes. This is especially true for menopausal women, who have to work harder to mitigate blood sugar due to dropping estrogen and progesterone. High blood pressure has been linked to hot flashes and other symptoms of menopause.

  • Alcohol: During menopause, that evening glass of wine can actually worsen menopausal symptoms. This is especially true for symptoms like hot flashes and insomnia- both of which have been found to be more severe when paired with alcohol. Moreover, alcohol can potentially increase the likelihood of conditions like heart disease, stroke, and osteoporosis that menopausal women are already at a heightened risk of.

Don’t forget to drink enough water!

During menopause, many women experience dryness throughout their body. Again, this is likely due to the dropping levels of estrogen. You should aim to drink 8-12 glasses water per day to help mitigate the dryness. Drinking water can also help to get rid of symptoms like bloating!

Consider hormone replacement therapy:

With the help of your medical provider, hormone replacement therapy (HRT) could be a great way to prevent negative symptoms of menopause before they even begin. But it is very important that hormones are given in a bioequivalent method by a physician who specializes in Menopausal Women.

Currently, due to the sensationalized findings of the 1993 Women’s Health Initiative study on HRT, many doctors are not prescribing hormone replacement. To read more about the problems in the Women’s Health Initiative’s study, click here. The true findings of many researchers after the 1993 study prove that HRT has been demonstrated to:

  • Alleviate menopausal symptoms.

  • Lower risk of death by 39% for women who started HRT before menopause.

  • Improve sleep, muscle aches, and pains in menopausal women.

  • Reduce the incidence of coronary heart disease by 50%, if started within 10 years of menopause.

  • Help prevent osteoporosis and associated injuries.

  • Decrease the risk of heart disease.

  • Slow the progression of atherosclerotic plaques, which lead to heart attacks and cardiac death.

  • Improve symptoms related to vaginal atrophy.

  • Help alleviate depressive symptoms.

  • Increase skin collagen content, thickness, elasticity, and hydration.

  • Help reduce belly fat.

Most importantly, consider seeing a functional health doctor who specializes in Women's Health:

As you just read, a lot is happening to women approaching and going through menopause- hormones are fluctuating, weight is changing, sleeping is difficult, and mental health can be worsening.

Functional medicine treatment encompasses various important aspects, including addressing gut health issues, which are closely linked to the brain and can contribute to symptoms like anxiety, depression, and sleep disturbances experienced by women in their 40s. Recommendations from functional medicine doctors may involve dietary changes, probiotics, and supplements to enhance gut health.

Additionally, they can help identify and address nutrient deficiencies through testing and suggest appropriate supplements. Moreover, functional medicine doctors collaborate with patients to reduce stress through lifestyle modifications, counseling, and stress management techniques. By focusing on these areas, they aim to enhance overall health and well-being for women dealing with perimenopause symptoms.

But all women and especially those who are over 40 need a physician who specializes in women's health using a holistic, functional approach. Women are not small men and therapies uniquely suited for women are necessary for long-term health.

The bottom line:

Menopause is a challenging time for many women. Your body will inevitably change in many ways, but it’s important to not feel defeated! There are ways to tackle this unfortunate effect of menopause.

At the Johnson Center for Health, we specialize in peri-menopausal, menopausal, and post-menopausal women. We work with our patients to develop a personalized weight loss plan using a detailed personal history, bloodwork, microbiome analysis, genetic testing, and hormone testing. We can work together to tackle menopausal weight gain and get you on the path to optimal health.

To learn more about the Johnson's Center's approach to menopause, click here to contact us! If you have any more questions about your path to optimal health, email our office at or call 276-235-3205.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!


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