Hi, are you like me, wondering why your midsection is expanding and why you’re having trouble hitting performance targets? I know that I train hard, eat well and do my best to get sleep, minus a few TikTok rabbit holes every once in a while. So, what’s going on?
I decided to do some research and it appears that I’m beginning my journey through perimenopause and beyond. Taking the time to educate myself, looking at performance through the lens of perimenopause and post menopause has been absolutely fascinating and surprisingly empowering.
I always believed that when menopause became part of my story, it was the beginning of the end to my ability to perform and advance my triathlon competitive journey. Luckily, what I have discovered is, that with some interventions to my nutrition and training strategies I can enjoy a solid future of performance, strength, and health for the future to come.
Before I get into those interventions, I feel it is important to discuss the difference between perimenopause and menopause. Perimenopause this is the transition from your regular 28-day cycle to a 35 to 40-day cycle. It can start as early as 36 but usually begins around 45. This is really where you will start to see a difference in the ratio of estrogen and progesterone, noticing an estrogen dominant effect, leading to the actual cessation of your period.
Perimenopause can last up to 10 years, but for the most part, we talk about it being the four to five years before your period actually stops. This is where you start to notice changes like night sweats, putting on belly fat, losing lean mass, not feeling as strong, not hitting high intensities, and wondering why all the things that we’ve been doing up to this point now aren’t working anymore. The closer we get to the actual cessation of our period, the worse these changes can become.
Menopause on the other hand, is just one point in time when you have not had a period for 12 months. We generally talk about menopause as the time from when your period stops and beyond, but it really is just that one point in time. Post menopause then, is the rest of your life after that. As we go through our discussion, I’ll use the terms perimenopause as before the cessation of you period and menopause as the time after with the understanding that menopause is really just that one point in time. The average age to reach menopause is around 51, but this can be much earlier or later, we are all individuals. After your period had stopped is the time where diet and training interventions are super important to maintain strength, to maintain lean mass, bone support, and posture.
To understand why these changes are happening, we need to discuss the role of estrogen and progesterone. There are two types of estrogen than have the greatest impact in our perimenopause journey, estradiol (E2) and estrone. Estradiol is your normal and strongest form of estrogen and is produced from your ovaries. It is responsible for tissue growth, bone health, and blood glucose control. Estrone is the active estrogen post menopause, produced by your adrenals and has very low activity. This is why you want to focus on bone density and making body composition changes in perimenopause or before, while you still have the active version of estrogen to help drive those physiological processes. This will set you up well for an active and healthy future when it be harder, not impossible, to make those changes.
When estradiol decreases or we become estrogen-dominant there are many symptom that you may experience such as:
- Body composition changes
- Experience brain fog
- Have mood swings
- Struggle with sleepless nights
- Develop hot flashes or vasomotor symptoms
- Experience lack of adaptation to training
You might be wondering how, if we are producing less estrogen, can we be estrogen dominant. What is important is the ratio of estrogen to progesterone. While we are producing less estrogen, we are also producing less progesterone. Progesterone is produced from the corpus luteum after ovulation, and if you don’t ovulate, which is primarily the case during perimenopause, you don’t produce progesterone, but your body still produces estrogen. This is where we really want to dial in your nutrition and training strategies and start putting into place specific modalities that will help with body composition, bone density, insulin sensitivity and improving the quality of our life as you go forward.
What kind of interventions can we do?
- Menopause hormone therapy (MHT)
- Non-pharmaceutical interventions like adaptogens
Menopause hormone therapy is something you want to discuss with your GP in conjunction with your Naturopath. You will want to determine what are your individual needs, your different risk factors, if you are going to benefit from it. What are the different formulations? What kinds do you need? Do you need estrogen with progesterone, just estrogen? Have you had a hysterectomy or not? This is a very personalized and individualized conversation to have with your health provider.
We know that you want to take it for the shortest amount of time. After that, the risks might outweigh the benefits. The potential benefits of using MHT is effective as a treatment for our vasomotor symptoms, vaginal dryness, sleep issues, mood, but it is not effective for building lean mass or mitigating body fat gain. This is because exogenous hormones, from outside our body, have a different molecular structure than our endogenous hormones. There is a benefit for all our symptoms, but from a body composition standpoint, it does not help. This is why we need to focus on exercise and nutrition.
Before we move on to the types of exercise modalities and nutrition strategies, let’s chat about utilizing adaptogens as a method to balance hormone fluctuations. Adaptogens are used in herbal medicine for the stabilization of physiological processes and the promotion of homeostasis. Different adaptogens can help mitigate the response to cortisol, help balance out estrogen and progesterone and reduce the overall hormone fluctuation responses. So regardless of if you are a young athlete, a premenopausal athlete, a peri-menopausal athlete, a post-menopausal athlete, adaptogens help mitigate some of the stress responses. When trying an adaptogen, pick one, try it for a while and see how you respond.
- Reduce the fatigue that come from stress and anxiety.
- Improves cognitive function.
- Neuroprotective against toxins.
- Influences the levels of the neurotransmitters (serotonin, dopamine, and norepinephrine) by inhibiting the enzyme responsible for their degradation.
- It is a SERM (Selective Estrogen Re-uptake Modulator) that prevents, delays or mitigates menopause-related cognitive, psychological, cardiovascular and osteoporotic conditions.
- Boosts endurance, mental performance, and working capacity.
- Increases blood vessel compliance via nitric oxide as a weak phytoestrogen, modulates estrogen flux by increasing the excretion of estrogen metabolites.
- Induces oxidation in mitochondria which enhances aerobic capacity.
- Stimulates Central Nervous System CNS: enhances cognition.
- Maca is a cruciferous vegetable and therefore related to broccoli, cauliflower, cabbage and kale.
- Sex hormone support. Moderates estrogen metabolism, anti-inflammatory, regulates adrenal and thyroid function.
- Can improve symptoms of menopause, including hot flashes and disrupted sleep at night.
- Is calming; used to reduce anxiety and depression.
- Anti-microbial, immune enhancing, reduces oxidative tissue damage, modulates cortisol and improves glucose control.
- Acts as a hormonal precursor.
- Reduces blood sugar levels through its effects on insulin secretion and sensitivity.
- Helps to modulate stimulation by increasing the effect when activity is low but will block excess stimulation when activity is too high.
- Anti-stress and immunomodulatory.
- Increases natural killer cell activity and decrease markers of inflammation.
- Used to reduce cortisol, for anti-anxiety, anti-depressant, increases luteinizing hormone, and thyroid hormones T3 and T4.
So far, we’ve learned about what is going on with our bodies during perimenopause and that we have options to stay fit, healthy and be competitive athletes. How amazing is that? We still need to chat about our non-hormone interventions such nutrition, resistance training, plyometrics and periodized training for optimal recovery. I feel like I’ve been typing for a long time, and you probably feel like you’ve been reading a while. Let’s pick up this conversation in my next two posts and discuss these next strategies to nourish your performance through perimenopause and beyond.
Train well and empower yourself.
Sports Holistic Nutritionist
Strength and Conditioning Coach