Life cycle

From PMS to menopause, YHL takes a look at the main menstrual health issues experienced by women at all stages of life

Teenage years

“The onset of menstrual periods is defined as ‘menarche’, and it is an important milestone in a woman’s life,” explains Dr Monica Lascar, specialist in BHRT and functional medicine at The Marion Gluck Clinic (www.mariongluckclinic.com). “The age when the first menstrual periods begin can vary between 10 and 16 years of age and it seems to occur at an increasingly younger age in Europe and the USA. Oestrogen increases at puberty and is the hormone that peaks just before ovulation and leads to an increase of the lining of the womb (the endometrium). This then sheds if the egg is not being fertilised. Oestrogen also helps to keep our bones and muscles healthy as well as have an efficient metabolism, a sharp brain, good mood and energy levels. Progesterone is a hormone we only make when we ovulate, and it peaks at day 21 of the cycle. It is known as the pro-gestation hormone that supports pregnancy but has many other benefits, such as help with inflammation. Too much oestrogen and not enough progesterone can lead to heavy and/or painful periods, breast tenderness, bloating and water retention.”

The main hormonal issues in teenage years include heavy and painful periods, irregular periods or infrequent/lack of periods.

Dr Monica Lascar says: “You can support your body by having a balanced diet and taking anti-inflammatories (non-steroidals or turmeric/curcumin is a powerful natural anti-inflammatory). Avoiding dairy (especially cow’s milk) may be beneficial and you could consider taking iron supplements as required. Oral combined contraceptives can be a good albeit temporary solution, but it is important to understand that ‘the pill’ works by fully suppressing ovulation (putting your ovaries to ‘sleep’) and replacing your hormones with synthetic alternatives. Progesterone can also help. See your doctor who may sometimes offer additional investigations/tests as necessary, including thyroid function, blood count and iron levels. When periods are lighter or absent, a more detailed hormone profile can help distinguish between different hormonal problems and help find more specific ways to rebalance hormones.”

20s & 30s

“Entering her twenties, a woman’s hormones and menstrual cycle should start to settle into a regular pattern and she will learn what’s normal for her (cycles are usually an average of 28 days),” says Louise Lewis, DipCNM mBANT rCNHC, a qualified nutritionist specialising in women’s mental wellness (louise-lewis.com). “Many women go on to some form of hormonal contraception at this time such as the pill, implant, or injection, which can mean changes to her menstrual cycle such as lighter, irregular or no bleeds. The twenties and thirties are also when we might see some menstrual irregularities. Many women suffer from PMS, period pain, heavy periods or amenorrhoea (no periods) in this age group, and menstrual-related conditions such as PCOS, fibroids and endometriosis. These are often hard to diagnose and can cause significant upset to women affected.

Diet and lifestyle play a part in the menstrual cycle in this group. In their twenties and thirties, women are often trying to establish a career, leading a busy social life, or juggling family life around it all, which can lead to stress. Stress has a wide-ranging effect on the body and can affect the balance of a woman’s sex hormones and thus her menstrual cycle. Too much or too little exercise feeds into this, as well as poor nutrition and blood sugar balance. And lack of the right nutrients can exacerbate things like PMS symptoms.

This is also the time at which women might start planning to have a family. Coming off hormonal contraception can cause menstrual changes and she may start tracking things like ovulation. There may be fertility challenges which can involve treatments affecting her menstrual cycle. And then there is pregnancy itself and the return of periods afterwards, which can be up to six weeks. Women may notice changes to their cycle after giving birth.”

40s

“In your forties you are officially entering perimenopause, where your ovaries are running out of eggs and your hormones start to change,” explains Nicki Williams, award-winning nutritionist and founder of Happy Hormones for Life (happyhormonesforlife.com). “Progesterone levels fall as ovulation becomes less frequent while oestrogen can fluctuate between high and low. Stress hormones may be high as a result of this and extra stresses in midlife. The list of potential symptoms in peri-menopause is long, and can vary considerably between women. Common ones include fatigue, mood swings, anxiety, brain fog, poor sleep, irregular or heavy/painful periods, PMS, low libido, joint pain, weight gain and hot flushes or night sweats. It’s incredibly important to balance your hormones as much as possible during peri-menopause and, thankfully, there are many natural ways to do this.

Here are my four steps that I think are vital for hormone balance:

Eat: Hormones need a variety of nutrients to function properly, so it’s important to eat whole, nutrient-dense foods including protein, healthy fats and complex carbohydrates. Lots of vegetables at each meal will help to crowd out not so healthy foods, and supply plant nutrients and fibre. Healthy fats (including avocado, oily fish, olive oil, nuts and seeds) will help to keep your blood sugar stable and you feeling full between meals.

Rest: Managing stress hormones is vital for hormone balance. Factor in 15 to 20 minutes per day of relaxation or doing what you love.

Cleanse: Certain chemicals that we are exposed to in our food and everyday products can disrupt our hormones, especially oestrogen. Avoid pesticides, plastics and synthetic fragrances as these are some of the worst.

Move: Staying active is key to hormone balance, but it’s important to find a balance that’s right for you. Yoga, Pilates and walking are all very good for your hormones!”

50+

“Defined as a woman’s last menstrual period, the menopause occurs because the ovaries’ supply of eggs, known as the ovarian reserve, has depleted,” explains Aliza Marogy, Founder of Inessa, Registered Nutritional Therapist and Functional Medicine Practitioner (www.inessawellness.com). “Common effects include night sweats, hot flushes, insomnia and joint pain. It’s worth pointing out that many women experience only mild symptoms. According to a survey by the British Menopause Society, 50 per cent of women aged 45 to 55 who have gone through the menopause in the last 10 years have not had to seek help from a healthcare provider.

There’s evidence that phyto oestrogens (plant oestrogens that act in a similar way to human oestrogen in the body) can relieve some symptoms, including hot flushes. Soya and linseeds are good sources, as well as chickpeas, lentils, fennel and dried apricots. B vitamins, as well as being key for optimal energy production, are known to help regulate mood, and play a role in the production of the happy hormone, serotonin.

As both heart health and energy levels can suffer as a result of menopause, supplementing with CoQ10 – a nutrient that is essential for good cardiovascular health and energy production but is hard to get from food – can benefit women. Studies also suggest that taking CoQ10 can help slow cognitive decline in postmenopausal women and can be important for those taking hormone replacement therapy, statin or thyroid medications, all of which can deplete our CoQ10 levels. Vitamin D3 and K2 are key nutrients for supporting bone health. Calcium and magnesium may also be required by some women in addition, though it’s best to seek the advice of a nutritional professional or GP before taking supplemental calcium. A quality multivitamin and mineral should contain all the aforementioned as well as a spectrum of micronutrients including vitamin E and zinc, which have also been shown to improve menopausal symptoms, benefit overall wellbeing, lift mood, boost energy and support hormonal balance.”

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