Hot flushes, mood swings, sleepless nights, weight gain and low libido.
Just some of the joys associated with the hormonal roller-coaster that hits women during menopause – and in the time leading up to it, perimenopause.
Author and naturopath Lara Briden, who’s been helping women with hormone-related issues for more than 20 years, has written a new book, Hormone Repair Manual, on how to deal with these changes in our bodies.
(Happily, we have three copies of this fine book to give away to Starfish readers; details at the end of our interview.)
Why did you write it?
Hormone Repair Manual is my message to 40-something women that everything is going to be okay. Symptoms that arise during the ten-year transition to menopause are temporary, treatable, and not as scary as they sound.
What is perimenopause?
Perimenopause, or second puberty, is the two to twelve years before the final period. It’s different from menopause, which is the life phase that begins one year after the final period. Most symptoms (if there are symptoms) occur during perimenopause, not menopause, and therefore start as young as 35 when periods are still regular.
What are the most common problems perimenopausal women complain about? What kind of symptoms could you experience?
Common symptoms of perimenopause include heavy periods, painful breasts, weight gain, night sweats, insomnia, premenstrual mood swings, and more frequent migraine headaches. The sweats, insomnia, migraines, and mood symptoms are all part of the “brain recalibration” process described in the book.
Do you think many women still don’t really understand what’s happening to their bodies when menopause approaches?
There’s a mistaken belief that perimenopause is a time of lower estrogen; when in fact it’s a time of high, fluctuating estrogen and low progesterone. That’s why perimenopausal symptoms often respond better to progesterone (brand name Prometrium) than to estrogen or the pill.
Why do some women cope with menopause so much better than others?
Women are at greater risk of strong symptoms if they reach their final period before age 45 or undergo surgical or medical menopause. Women who reach menopause at the normal age of 45 to 55 have about a one in four chance of strong symptoms, which is the result of genetics, general health, and the state of periods leading up to perimenopause.
If you can generalise here, if there was one thing women could do to make it easier on themselves, what would it be?
My top tip is to take magnesium, which can help with sleep, night sweats, and migraine prevention. I also recommend reducing or even quitting alcohol, in part because alcohol depletes the body of magnesium.
Do you think society prepares us women enough for this phase of our lives? Should we all be talking about this stuff more?
Most women feel decidedly unprepared for perimenopause because they imagined it to be off in the distant future when in reality, it’s just around the corner. For example, anyone born before 1984 is in the territory of second puberty or perimenopause, which really emphasises the message that perimenopause is about hormonal change — not aging.
As a naturopath with a scientific background, what are your thoughts on hormonal replacement therapy? Should we try other remedies first?
The modern term is menopausal hormone therapy, not replacement therapy because it’s normal to have low estrogen in menopause. That said, hormone therapy can be incredibly helpful for symptoms and, in some cases, for reducing the risk of osteoporosis. Most of my patients use a combination of nutritional supplements and body-identical hormone therapy, which means hormones that are identical to the body’s own hormones. Modern body identical products are available from any doctor and pharmacy and are widely regarded as safer than non-body identical hormone therapy.
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You say in your book that many women come out of the other side of perimenopause and menopause happier and more content than ever before. Why is this, do you think?
Most women reach their mid-fifties and find their mood and energy to be at least as good as when they were younger, and maybe even better. That’s according to several lines of evidence, including research from the University of Melbourne, which concluded that the majority of women over 60 report feeling “pretty fantastic”, and the observations of US psychologist Mary Pipher, who says that “a woman in her seventies is likely to be the happiest she’s ever been.” Canadian endocrinology professor Jerilynn Prior (who helped with the book) says women need to know that “perimenopause ends in a kinder and calmer phase of life called menopause.”
How will your book better equip women for this life-changing time of our lives?
The book is a practical guide to feeling better, whether that’s with lifestyle, supplements, hormone therapy — or a combination of all three. It also demystifies the process with simple explanations, real-life patients stories, and practical “how to speak with your doctor” sections to assist with testing and treatment.
To win a copy of Hormone Repair Manual, (Pan Macmillan) just email us at email@example.com telling us why you’d like the book. Be sure to also include your postal address. Good luck!