She told me all people who work through the perimenopause and menopause “would need HRT”. The main problem with the NHS approach is the decision “that they don’t want GPS measuring hormones,” Wendy told me. “It’s a cost issue, and hormones vary, but that doesn’t mean you shouldn’t measure them.”
GPs are prescribing hormones based on symptoms, but the years of perimenopause are a rollercoaster. Testosterone tends to dip first, then progesterone. When low oestrogen hits, you get the hot flushes and night sweats. But that comes and goes, for a couple of years. If women take extra oestrogen through this cycle, their levels can end up sky-high. The second problem, she said, was the one-size-fits-all approach. We are generally told they can have five years of HRT max, because of cancer risks. But they are not screened for particularities.
My DUTCH test revealed oestrogen and free cortisol levels off the charts but rock-bottom progesterone. Caught in a high cortisol, high oestrogen cycle, my weight was rocketing. The 4-OH estradiol result was also high – a cancer-inducing pathway.
Wendy was frank. First I needed to lose adipose tissue. Oestrogen loves to live in fat cells, so I needed to reduce them, but I needed to de-stress or it would be mighty hard. Aerobic exercise helps to metabolise oestrogen. “Whatever you are doing, double it,” she instructed. My progesterone being rock bottom was age-appropriate, but also, when the body is in a period of prolonged stress, it will make cortisol the priority over progesterone – it’s called the “cortisol steal”. Low progesterone causes bad sleep, bad mood and fatigue. She put me on a bioidentical progesterone made from yams to be applied for half the month.
She also put me on a resveratrol supplement (a plant compound found in red wine and in the skins and seeds of grapes and berries), which hampers the body’s ability to metabolise estradiol down the 4-hydroxy pathway. She told me to do “whatever it takes” to sort out work-life balance, then said my dopamine was on the floor. “Do things that make you happy,” she said. “You need joy.” I had a lot to absorb – and almost no bandwidth. But I started on progesterone, resveratrol and on ashwagandha for sleep and stress.
Website: thehealthdoctors.co.uk
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How nutrition can impact the perimenopause
HealthMatters Group, Marylebone and Zoe Science and Nutrition
Sue Camp is Clinical Director of Nutrition Service at the HealthMatters Group, a whole ecosystem of integrative health solutions with teams working across nutrition, stress management, sleep disorders and functional medicine. Sue, a gentle and patient sort, sensed that I was in a state where incremental rather than radical change was best. She told me to eat protein with each meal and choose nutrient-dense foods – fruits, vegetables, whole grains, lean proteins, healthy fats, and phytoestrogen-rich foods to balance the hormones.
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