Health Hotline Magazine | May 2024

(and progesterone) production. It’s a time in which your monthly period can become unpredictable, sometimes not happening at all, and other times coming like a 100-year flood. Every woman’s perimenopausal experience is as unique as she is, and symptoms are far-ranging and some are even surprising. Here is a (non-exhaustive) list, in no particular order: heart palpitations, itchy, crawling skin, insomnia, anxiety, depression, joint pain, vaginal dry ness, urinary incontinence, weight gain, especially in the belly, mood swings, loss of libido, brain fog, hair loss/hair thinning, memory loss, vertigo, night sweats, hot flashes, dry mouth, and bleeding gums. As you can see, it’s not just hot flashes; in fact, a survey of perimenopausal women found that the top three symptom complaints were mood swings, brain fog, and fatigue. It turns out that estrogen affects nearly every part of our bodies, and with its decline, we start experiencing (sometimes weird) symptoms. In addition to the more acute symptoms, long-term effects of estrogen loss—especially if there is no management of symptoms—include muscle loss, bone loss, and a higher risk for insulin resistance and other metabolic dysfunction, dementia, and cardiovascular disease. But there are ways to counteract this, and the perimenopausal years are the perfect window of opportuni ty for healthy interventions. Shi ing how you eat must become a priority When it comes to diet, one thing becomes crystal clear during perimenopause: what may have worked for years just doesn’t anymore. Sixty to 70 percent of women report gaining weight during the menopausal transition, particularly in the belly, and this weight gain can be a risk factor for cardiovascular disease. Perimenopause leads to reduced metabolic flexibility, or the ability to switch between burning carbs and fat for fuel, changes our body composition, with a significant increase in fat mass and a reduction in lean muscle mass, and changes where fat is distributed in our bodies (looking at you, belly fat), making it imperative to adjust how we eat. Lean into a low-in ammatory diet. Estrogen plays an important role in modulating inflammation in our bodies, so as estrogen decreases, inflam mation increases. Inflammation can increase the severity of menopausal symptoms and the risk of a number of degenerative diseases. Now is the time to lean into a low-inflammatory diet. What does that look like? The main things to avoid (or at least strictly limit) include sugars, refined carbohydrates and processed grains, fried foods, high omega-6 vegetable oils, and alcohol, as they are all drivers of inflammation. Instead, fill your plate with quality protein, healthy fats, and loads of fiber-rich vegetables. Take inspiration from the Mediterranean diet, which comes out on top in research for promoting health through perimenopause and beyond, including reducing cardiovascular risk, maintaining bone mineral density and a healthy weight, preventing cognitive decline, improv ing mood, decreasing hot flashes, and reducing the risk of all-cause mortality. This way of eating is based on a foundation of anti-inflammatory and antioxidant-rich foods: seafood, olive oil, pastured dairy and meat, nuts and

legumes, vegetables, and an array of spices. Learn to prioritize protein.

During the menopausal transition, protein breakdown increases and protein synthesis declines. To counteract the loss of lean muscle mass, it is imperative to eat enough protein. Experts recommend 1.2 grams of protein per kilogram of body weight for perimenopausal women; converted to pounds, that would be 81.6 grams of protein per day for a 150-pound person. If you are very physically active, especially if you are strength training (a must for peri- and post-menopausal women!), those requirements can increase to 2 grams per kilogram of body weight

daily. One study found that post-menopausal women who consumed at least 1.1 g/kg body weight daily had lower fat mass and better upper and lower body strength compared to those in the low protein group (less than .8g/kg/body weight/day). Good protein sources include grassfed or regeneratively raised beef, bison, pork, chicken, and eggs;

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