Most women who enter peri-menopause expect hot flashes, night sweats, and the occasional mood swing. Many are surprised when they begin to experience significant changes in mood (sometimes diagnosed as anxiety or depression), often many years before the onset of menopause. As I’ve written about here, the peri-menopausal years can be full of unexpected changes due to fluctuating levels of the hormones estrogen and progesterone.
Getting to the root
The peri-menopausal years are usually characterized by sub-optimal levels of progesterone (that can fluctuate month-to-month) and normal levels of estrogen. This “hormonal picture” is the most common culprit for mood changes, especially around ovulation or in the days leading up to your period. Some women also notice that they may experience hot flashes and night sweats in the immediate pre-menstrual period. So, while most of us associate menopause with lower estrogen levels, that isn’t the most common root cause of peri-menopausal anxiety and depression.
1. Take charge of stress levels. An increased demand for the stress hormone cortisol can lead to a drop in progesterone levels, making symptoms such as insomnia and anxiety worse. As you can see in the image below, cortisol can be made form progesterone if needed. Changes in these hormones are often at the root of perimenopausal symptoms.
2. Get enough sleep. Lack of sleep increases the demand for cortisol, resulting in further declines in progesterone. And, as we all know, we can’t feel our best if we’re tired! Sleep onset and sleep maintenance insomnia can occur due to changes in hormones and are often the starting point in treatment.
3. Enjoy healthy fats. Don’t fear fats! Many fats, especially saturated fats and cholesterol are necessary for the production of all steroid hormones including estrogen, progesterone and testosterone. Work on improving testosterone health. Enjoy a variety of health fats from a variety of plant and animal sources.
And, if that doesn’t help see a Naturopathic Doctor who can help you choose the best herbal medicines based on your symptoms. Many herbs have hormonal actions, or can support hormonal pathways. Wondering about bio-identical hormones? They have their place, but many women don’t need them once the root causes of their symptoms have been found.
Dr. Jenn RD ND maintains a family-centered Naturopathic and Dietetic practice in Dartmouth, NS. and enjoys working with people of all ages. As a non-diet dietitian, she uses the principles of Intuitive Eating to help nurture a healthy relationship with food and health.