Three essential perimenopause facts you need to know

Over the past weeks, we've explored perimenopause, a natural life phase marked by significant hormonal shifts that can begin as early as age 35 and last up to a decade. We've covered its definition, symptoms and associated health concerns. We’ve also discussed dietary changes that can help ease symptoms and optimise health. Additionally, we've examined the impact of perimenopause on our brain and mental health, and strategies to address these effects. In this final piece, we'll discuss three key points: the relationship between perimenopause and our gut microbiome, some important considerations around blood sugar levels and insulin resistance and finally, the essential role of exercise in maintaining health during perimenopause and beyond.

1. Support your gut microbial diversity

Scientists have discovered that a thriving, diverse gut microbiome is connected to many aspects of our health. A much lesser known change during perimenopause and menopause, is the alteration of the gut microbiota. Indeed, the estrobolome (gut microbes supporting oestrogen metabolism) influences our oestrogen levels and as such, lower oestrogen levels during perimenopause and menopause can reduce gut microbial diversity and create an imbalance of bacteria. Moreover, reduced oestrogen and progesterone during perimenopause might increase gut permeability, which could be linked to food intolerances, IBS and digestive issues. Consuming a minimum of 25g of fibre daily and eating a variety of colourful vegetables, fruits (with the skin on), whole grains, legumes, nuts and seeds can support the microbiome. Maintaining gut diversity can help alleviate perimenopausal and menopausal symptoms and support overall health.

2. Keep an eye on your blood sugar levels

As oestrogen levels start to fall during perimenopause, your body may become less responsive to insulin. This may cause insulin resistance, a condition when the body's cells don't respond well to insulin, a hormone that helps control blood sugar levels. This can result in higher blood sugar levels and/or increased HbA1c (also known as glycated haemoglobin levels, indicating your average blood sugar levels over the past two to three months) and may increase the risk of developing type 2 diabetes. Research shows that insulin resistance can also lead to high blood pressure, abnormal lipid levels, high uric acid, increased inflammation, poor blood vessel function and a higher risk of blood clots. Regular check-ups with your GP are important, especially if type 2 diabetes runs in your family. Optimising your diet and exercise routine (see below) to increase muscle mass is vital, as increased muscle mass has been shown to protect against insulin resistance and metabolic syndrome in both diabetics and non-diabetics.

Optimise your exercise routine

Research shows that perimenopause may be the ideal time for lifestyle interventions, as this is when women begin to experience negative changes in body composition and metabolism. It concluded that perimenopausal women could prevent negative metabolic changes by engaging in activities that maintain muscle mass and enhance fat-burning capacity, such as resistance training and HIIT (high- intensity interval training). During perimenopause, oestrogen levels decline, reducing the regeneration of muscle stem cells (satellite cells) by up to 60%. Resistance training, especially lifting heavy weights, is crucial during this time as it boosts muscle-building cells. Increased muscle mass enhances metabolic rate, that may help postmenopausal women burn more fat during exercise. Additionally, heavy resistance training builds stronger bones, which is vital since women can lose up to 20% of their bone density during menopause. Furthermore, resistance training improves insulin sensitivity, lowers blood pressure, reduces visceral fat and boosts immunity, thus enhancing cardiovascular and overall health.

Incorporating this information into your daily routine can transform your health journey through perimenopause and beyond. Embracing smart food choices, maintaining good blood glucose control, and committing to a regular exercise routine with a focus on resistance training are key to navigating this period. By taking these steps and building a team of health practitioners to guide you, you will transition through this phase of your life with strength and confidence. Wishing you all the best as you embark on this journey!

Disclaimer: This article is intended for educational purposes. The information, or comments herein, does not amount to, or replace, professional advice and should not be relied upon as or substitute for professional or medical advice from a qualified professional.