Navigating the Storm: Understanding Inflammation During Perimenopause and How to Find Relief

Perimenopause is the period during which a woman's body makes the transition to menopause. Menopause is the 24 hours between perimenopause and post-menopause, marking the 12-month anniversary of not having a period and the end of reproductive years. After that, it is post-menopause.  

Women start perimenopause at different ages. For some, it is in their mid-thirties, others in their 40s (this does not include induced menopause, which occurs through surgery or other medical treatments) and can last anywhere between a few months to a decade. With the hormone shift, we can feel very different and not our usual selves. Emotions can be erratic and amplified. We can feel out of control of our bodies and even quite uncomfortable in our own skin. Changes to our menstrual cycle, the irregularity of not knowing when a period will come, how heavy it will be or how long it will last can be unsettling. Gaining weight, aches in joints and muscles, sleep disturbances, hot flashes, vaginal dryness, low libido, forgetfulness, mood swings, brain fog and lack of focus are just some of the symptoms women experience. Not all women, of course, as we are each unique in our hormonal fluctuations, genetics, and lifestyle choices. However, the emerging body of research links many menopausal symptoms to inflammation. While we cannot control everything, we can make some lifestyle changes to support the reduction of inflammation and find refuge from what may be a challenging health storm.

Firstly, here is a brief explanation of inflammation. It is an immunological response to cellular injury characterised by increased white blood cells. Meaning, your body is fighting against infection, injury, and toxicity to heal itself. Your gut bacteria play an important role in the regulation of inflammation. There is both acute and chronic inflammation. Acute inflammation is when our body responds to an immediate threat, such as a fever or cut, and lasts only a few hours or days. Chronic inflammation is when our immune system doesn't switch off, and there are many reasons for this. You can read more about inflammation here if you want to dig deeper. 

The changes we experience through perimenopause occur because of hormone fluctuations, most significantly when oestrogen, progesterone, and testosterone fall out of sync.

The decline in oestrogen is known to drive a systemic inflammatory state. Oestrogen is a master regulator that functions through a network of oestrogen receptors. These are proteins that, when activated, can regulate the expression of specific genes. Oestrogen receptors play a crucial role in regulating metabolism and reproductive functions. During perimenopause, oestrogen levels fluctuate unevenly, creating irregular periods, changes in flow and duration. Declining oestrogen can lead to hot flashes, night sweats, mood swings and sleep disturbances. Oestrogen plays a crucial role in maintaining vaginal health, and its decline may lead to vaginal dryness, discomfort during intercourse and a decrease in sexual desire. Bone loss, risk of heart disease and changes in cholesterol levels are also all effects of declining oestrogen levels.

Progesterone, a natural anti-inflammatory hormone that also declines during perimenopause along with its natural inflammatory protection, can often be felt as aches and pain in joints and muscles. Lower levels of progesterone also impact mood and levels of anxiety. Through my perimenopause journey I have experienced anxiety like never before, but being aware of the cause has helped me manage those feelings. For me, it's a simple response of reframing. It goes something like this … "Oh o … progesterone is low!" Then, stopping for a moment to recognise what it is, being thankful to have the awareness, and acknowledging it is a temporary feeling. I then thank my body for the incredible miracle it is and what it has done for me and continues to do for me each day. I take a deep breath or two and do some sort of movement. If you see me randomly doing star jumps … you know why! 😂 Weight gain, sugar cravings, insomnia, and osteoporosis are all symptoms of low progesterone. Lowering progesterone levels can be accelerated through stress and a poor diet, which are both things we have options to manage.

Insulin resistance, a precursor to metabolic syndrome, increases in many menopausal women and is associated with inflammation. While this may cause weight gain, a more significant concern is the increased risk of cardiovascular disease post-menopause. We are more susceptible to inflammation with increased pro-inflammatory cytokines (small proteins) in our body and a drop in DHEA and pregnenolone. 

While what I have described may have painted a bleak picture, the story has another positive side. Research shows that many of us can make a difference in our symptoms through lifestyle choices. Relieving or eliminating them altogether! 

Here are some ways that may help you reduce the impact of hot flashes, enjoy better quality sleep, manage your mood swings, reduce inflammation, support weight loss, and experience general relief of perimenopausal symptoms: 

1. Eat a diet rich in whole real foods. Here she goes again with the whole real food. I can hear you! But yes, eat more vegetables! Vegetables and fruits are packed with micronutrients, minerals, antioxidants and phytonutrients to help fight against inflammation. Choose healthy fats such as avocado, nuts, seeds and fatty fish rich in omega-3 fatty acids. Eat whole grains, which are rich in fibre and other nutrients. These will promote healthy inflammatory responses. Eating heavily processed foods, sugary snacks, and drinks will increase inflammation. There is no way around this: as we age, what and how we eat forms part of our health care. For support in adding more whole real foods to your diet, check out my Seasonal Nutrition Resets here. 
2. Move. Exercise, building and maintaining muscle mass is essential to managing your menopausal symptoms and overall healthy ageing. Exercise will support better mood and sleep. If you were raised like me, exercise was exclusively for vanity and being thin. There was no reference to health and well-being. It made exercise a chore, and it took me a long time not to look at exercise as the enemy. Maybe there needs to be a mindset shift for you, too. One that moves you from believing that exercise is to burn off the calories you have eaten or are going to eat (or drink) to discovering what a gift it is for health, well-being and living well.
3. Relax. Managing stress and your perception of stress is crucial to control chronic inflammation. Extensive research has been done into the benefits of mindfulness, yoga, and breathing exercises in managing menopausal symptoms. Pop over to the blog here to explore mindfulness more and get some tips on bringing mindfulness into your day.
4. Nurture your sleep hygiene. Getting to sleep, staying asleep, or returning to sleep during menopause can be challenging! Disrupted sleep impacts everything from our moods, energy levels, inflammation and maintaining a healthy weight. Create a sleep routine. It is wise to choose a regular bedtime, have a 'devices down' time, enjoy the last meal of the day at least two-three hours before bedtime, refrain from stimulants such as coffee and alcohol and have a couple of go-to relaxation techniques. I have a 'devices down' policy from 7 pm, and I don't keep my phone in my bedroom (it is very rare for me to be on my phone or iPad after this time). When I have a coffee, I do so before 11 am; otherwise, I am awake until the wee hours of the morning! I don't like the television in my room, but it is a compromise I have with my husband, so we set a timer for 20 minutes, and I will read. I use relaxation techniques and listen to a Solfeggio frequencies track if my mind is racing. 
5. Reduce or eliminate alcohol. Your liver health can affect your perimenopause symptoms, particularly hot flashes and weight gain. If you drink alcohol daily, you may consider eliminating it for a while to give your liver some downtime. You may also notice you sleep better, have fewer or more mild hot flashes, and experience a better mood without daily drinks. Quite often, we crave the routine of an evening glass of wine, the association with stress relief, or enjoying someone's company rather than the wine itself. I encourage you to reflect on why you drink when you do, and if you can find a swap, do so. I have never been a daily drinker and rarely binged in excess, maybe because I always choose top shelf and it is expensive 😂. The first time I got tipsy, I was 32, and I have always been one drink-one water type of gal, too … the thought of not remembering what happened just doesn't sit well with me. However, when I discovered alcohol is poison for our bodies, and it is only because of an enzyme that our body creates that we don't die, I became even more particular about the quality of the alcohol I drink and how much I drink. It is your body and your choice to do what you want to. I just want to encourage you to explore why you do what you do and understand that those choices impact your biochemistry and, therefore, your health and well-being. There is no way around it, though: alcohol will affect your menopause symptoms negatively. You decide.

I encourage you to stay hydrated. This will help if hot flashes come on, and along with movement, being sufficiently hydrated will support your detoxification pathways. Learn about the benefits of water here. 

If you smoke, vape, or take illicit drugs, please love yourself a little more and get support to stop. They are contributing to inflammation and not supporting your health and well-being.

Maintaining a healthy weight that is right for you is vital. Obesity predisposes an inflammatory state and comes with the prospect of many health problems. I want you to be comfortable in your own skin and love yourself through change processes, especially the journey to a healthy weight. 

Supplements can reduce inflammation; some of the most effective options are Omega-3 fatty acids and vitamin D. Also, turmeric, or its compound curcumin, and pre and probiotics support good gut health, which is essential for proper immune function and reducing inflammation. Please remember the quality of the supplements is essential, and supplements create chemical reactions in your body. Therefore, please consult with your healthcare provider before starting any new supplements to ensure they are safe and appropriate for you. It would be amiss of me not to mention that hormone therapy may be something you look at to alleviate symptoms. Still, discussing the potential risks and benefits with your GP or medical professional is essential.

As with lifestyle changes, you can't do them once, and everything will change. It is what you do every day that makes the difference. Take small, consistent steps to support your health and well-being goals. 

Perimenopause is a unique experience for every woman, and taking the time to seek support and education to understand what is happening in your body and to explore options that will help you during this stage of life is important.  

Also, understanding the impact of inflammation during menopause and implementing strategies to reduce and manage it can help you find relief and improve your overall well-being. By eating whole real foods, reducing the consumption of highly processed foods, getting regular exercise, practising stress management techniques, and seeking support and education, you will navigate this stage of life with greater ease and comfort.

My heart's desire is for you to love yourself and love your body through these changes. Be kind to yourself, control what you can, and understand that you can't control it all. Seek support where you need it. You are not alone in this.

And as always, remember you are a unique miracle. You deserve to be your best self for you and those you love. If you are feeling lost with it all and want some practical support, learn more about my Love Yourself Well personalised support sessions here.

OM xx

Blog posts are not intended to provide medical advice or take the place of medical advice and treatment from your doctor. Readers are advised to consult their qualified health professionals regarding specific health questions. Ocea Marie does not take any responsibility for possible health consequences for anyone reading or following the information available on the blog. All readers, especially those taking prescription or over-the-counter medications, should consult their doctor before beginning any nutrition or supplement program.