Drew Barrymore, 48, recently experienced her first perimenopausal hot flash while interviewing Jennifer Aniston and Adam Sandler live for her talk show, The Drew Barrymore Show. Drew embraced and joked about the hot flash, but how many times would this have happened to women in the middle of important meetings
The thing about perimenopause — the transition to menopause — and menopause itself, is that it’s not something we really talk about, is it? Sure, it’s used as comedy fodder in films and sitcoms, but this very serious life stage happens at some point to all people who menstruate, so why is there such a stigma? I’m 37, and I don’t know whether it’s because perimenopause could be just around the corner for me, but it’s something I have been thinking about a lot lately.
Do I need to start preparing my body — and my mind — for this life stage now? Or is it still too early? Is there anything I could be doing now to make it easier to make the transition, whenever that may be? And how do women know if they’re even in this phase at all?
“There is no medical test for it,” says Dr Ginni Mansberg, Sydney-based general practitioner, author of The M Word: How to Thrive in Menopause and founder of E.S.K Skincare.
“Menopause is the single day that happens 12 months after your last period. Except you don’t know it was your last period until it’s been 12 months since it happened.
“The three to 10 years leading up to that infamous date is called perimenopause. It’s the hormonal roller coaster that sees your ovaries sometimes step into hyperdrive only to lapse into a coma for several days to weeks afterwards, and then spring back into action. No predictable 28-day cycle for you anymore. It’s a daily freefall!”
Dr Ginni explains that perimenopause falls into two distinct phases. The first is where you might get mood swings, rage, brain fog and insomnia, your periods may be really heavy and unpredictable and your estrogen is “going up and down like a yoyo”, but progesterone — the hormone that appears after ovulation — is in short supply. This stage is officially known as STRAW –2.
STRAW –1, the second phase, can bring about hot flushes, aches and pains and night sweats as your estrogen starts to decline to match the progesterone. Your periods may also be very erratic.
“It will usually take you a while to work out what on earth is happening in your body,” she adds.
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Advertise with NZME.Twelve to 14 per cent of New Zealanders hit menopause before 45, but as many as four per cent reach menopause in their 30s, says Dr Ginni.
Naturopath, nutritionist and personal trainer Niki Loe says, “When it comes to perimenopause, education is your greatest source of empowerment throughout this new chapter of life. This is not a time to feel afraid, but rather a wonderful opportunity to learn more about the magnificence of your human body, how it works and what it needs from you.”
Niki explains that the gut is where approximately 95 per cent of the body’s serotonin, the happy hormone, is made, so nourishing the gut with prebiotics, post-biotics and probiotics, along with fermented foods is a beneficial way to help the good bacteria to thrive. Niki works with The Beauty Chef and recommends the Gut Primer powder to help support digestive health. She says 70 per cent of the body’s immune system is also regulated in the gut.
“Reduce added sugars, which can feed our unfriendly gut bacteria and power up your protein with every meal. Your needs for protein increase during this time,” she explains.
She says to aim for five to 10 servings of vegetables a day, including liver lovers such as broccoli, brussels sprouts, cauliflower and cabbage. “A rainbow-coloured range of nutrients are needed to ensure the biochemical pathways of your body and brain are working optimally.” Moving your body daily helps to improve the gut microbiome, too.
According to The North American Menopause Society, around the age of 30 we begin losing roughly one per cent of our muscle mass each year, which can lead to fat-based weight gain as muscles are crucial for burning fat. We can reverse this process and fight osteoporosis by weight training and building the major muscle groups — the legs, arms, core and butt.
Aerobic exercise is important too for heart, muscle and bone health, along with stretching to keep muscles and tendons flexible.
“But movement doesn’t always have to be serious,” stresses Niki. “A frolic in the park with your puppy, hide and seek with your kids, a boogie in the kitchen while cooking dinner. Just move as often as you can and as joyfully as you can, every single day.”
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Advertise with NZME.Where your skin is concerned, Dr Ginni says you want to hit perimenopause with as much collagen as possible in your skin, so that you can stay looking (and therefore feeling) more youthful for longer once the collagen levels start to decline when you hit menopause.
“Without the right skincare, we lose 30 per cent of our skin’s collagen in the first five years after menopause, and two per cent per year after that,” she explains. “So, sunscreen please, everybody!”
Using a broad-spectrum SPF not only helps slow down signs of premature ageing from sun damage, but it can also help preserve your collagen stores for longer.
“Remember the sun’s UV rays are divided into UVB for burning and most skin cancers, and UVA for ageing rays. UVA is there from sun up to sun down 365 days a year and they travel through glass,” says Dr Ginni.
Aside from using SPF, there is no one-size-fits-all when it comes to protecting skin before the onset of perimenopause, or dealing with symptoms once you’re in it. Dr Ginni says to be wary of marketing claims around “perimenopause-specific” skincare regimes.
“If you have sensitive skin, your needs are very different to someone with thicker, oilier skin,” she explains. “Breakout-prone skin is not the same as rosacea-prone skin. Someone who’s had a lifetime of sun exposure with pigmentation may have different priorities than someone who is battling dry, dehydrated or eczema-prone skin. That’s why we created the E.S.K Skin Quiz. Designed to get the right ingredients for your skin’s needs, not sell you a bunch of nonsense.”
She says skin changes can also depend on what is happening hormonally, for example, someone with an underlying hormonal issue like polycystic ovarian syndrome may experience more breakouts and start welcoming rogue chin hairs. Hair thinning is another symptom that may appear with the decline in estrogen, along with a compromised skin barrier which can result in dry and itchy, sensitive skin.
Knowing what to expect is an important part of being prepared in your 30s. As Dr Niki says, education is our greatest source of empowerment, and along with increasing our knowledge around the topic, taking time to invest in our mental health can help us feel more in control too. She calls it “nurturing your Zen state”.
“One of the biggest things we can do to shine bright during perimenopause is to reduce stress by having daily ‘joy practices’,” she says. “It’s always easier said than done but find what works for you; a walk in nature, a yoga class, a good book, a regular gratitude practice, journaling, meditation, or just a long, deep breath if that’s all you can manage.”
