The perimenopause stage, which lasts for at least 5-10 years, brings with it dry skin, irregular periods that may be lighter or heavier, mood swings and trouble sleeping. 

Most women experience menopause ,which is when the ovaries stop producing eggs and monthly periods stop,  between 45 and 60. The average age of menopause is 51. Menopause is an event which lasts for one day which is when 12 consecutive months without a single period have passed.  Then the woman is considered post-menopausal.

Common symptoms during perimenopause and menopause

• irregular menstrual cycles
• mood changes
• sleep disturbances
• hot flushes and night sweats
• vaginal and urinary symptoms 
• muscle and joint pain
• headaches and migraine
• forgetfulness
• lack of self-esteem
• fatigue 
• reduced libido 

Tips to Manage Menopause

• Nutritious diet – choose a wide variety of plant foods, whole grains, lean meat, fish or chicken. Include foods rich in phytoestrogens such as soy, tofu, whole grains and legumes. Phytoestrogens may mimic the action of oestrogen in some women which may assist with managing symptoms.
• Regular exercise – to support heart, adrenal and thyroid health. Aim for 30-45 minutes per day and include weight bearing exercises to decrease the risk of osteoporosis. Some studies have suggested that exercise can reduce hot flushes.
• Relaxation and managing stress levels – this may help to improve hot flushes as well as mood and sleep imbalances. Try mindfulness exercises and connecting with nature on a regular basis.
• Prioritising sleep – use light-weight sleepwear and bedding to assist with night sweats. Ensure a dark and cool temperature to promote restful sleep.
• Manage weight – women who are overweight may have more hot flushes than women in a healthy weight range.
• Avoid hot flush triggers such as spicy food, caffeine and alcohol.
• Quit smoking – those who smoke may experience an earlier menopause with increased adverse symptoms.

During the perimenopause stage, start taking Chaste Tree to keep your cycle regular and support progesterone levels. It is important to support DHEA levels, a steroid hormone produced by the adrenals.  DHEA converts into testosterone and testosterone is converted into oestrogen via an enzyme called aromatase. 

For the last 6 years, I myself was taking bioidentical DHEA but my oestrogen levels were far too high as a result of taking that and I have now switched to tribulus leaf.  To keep oestrogen levels in check, you can take herbs to assist oestrogen clearance alongside Prometrium (bioidentical progesterone available on prescription from your GP) from days 15 to 25 of my cycle.

If sleep is an issue you can take sleep herbs, boost memory and concentration with the herbs ginkgo biloba and bacopa and keep irritability under control with this "PMS Power Pack" PMS Support & Antioxidant, Stress & Sleep PM Formula, Calcium & Magnesium Plus K2 & D3 and Detox & Liver Support.

When oestrogen levels start to decline, this is usually when menopausal symptoms such as hot flushes and night sweats commence.  There are a lot of theories around why some women are more prone to hot flushes than others.  Serotonin is closely linked with oestrogen and that is one theory behind why SSRI's (antidepressants) are a successful treatment for hot flushes.  The health of the adrenals are another theory linking high stress levels and caffeine consumption with an increased tendency to hot flushes.

As naturopaths and herbalists, we take all of this into consideration when treating someone holistically.  The best herbs I have found for supporting serotonin are St John's Wort and Saffron with plenty of clinical evidence behind both herbs.  Rehmannia is my favourite adrenal tonic for during the day for menopausal women, and Withania my favourite PM adrenal herb to help combat the effects of stress on the body and reduce cortisol levels. 

Hot flushes are accompanied by a sharp rise in luteinising hormone (LH) levels and this is one of the theories behind the prescription of black cohosh which is known to reduce LH levels.  Black cohosh is also a selective oestrogen receptor modulator, helping to bind to oestrogen receptors and mimic the effect of oestrogen.

Night sweats can be debilitating.  Women have told me that they were so bad their sheets were saturated, and they would have to get up in the middle of the night to change them.  Sage and zizyphus are renowned herbs to reduce night sweats with the added benefit of zizyphus assisting sleep.  Valerian and hops are well-known herbs to help you drop off to sleep, with hops having the additional benefit of being oestrogenic.  If you are suffering from mild insomnia, I recommend the combination of Stress & Sleep PM Formula one hour before bed, followed by Sleep & OestroSupport PM Formula at bedtime.

By: Nikki Warren, Naturopath and Founder of NaturoBest

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