What are periods like during menopause? As with so many things in these hormonally turbulent years, the answer is, periods are different for every woman. From what happens to your periods in perimenopause, to menopause and the post-menopause years, there are many variations and fluctuations, as Le’Nise Brothers explains.
Le’Nise is a registered nutritionist, mBANT, mCNHC and yoga teacher. She specialises in women’s health, hormones and the menstrual cycle. She’s also the host of the Period Story podcast, which aims to break taboos around menstrual health and hormones. In other words, when it comes to menopause and periods, there is nothing she doesn’t know.
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Le’Nise has helped hundreds of women improve their menstrual and hormone health through her private practice and group programmes, talks and workshops for the likes of Stylist, Channel 4, Ebay and TikTok and her Instagram page. We asked her to answer some of your most commonly asked questions about your periods in menopause and beyond.
What is happening to our menstrual cycle in the perimenopause and menopause years?
Let’s start with perimenopause. This can start as early as our late 30s, but typically starts in our mid 40s. The average length of perimenopause is four years, however some might have a short journey of just a few months, while for others it can last for up to 10 years.
Physically, we may start to notice that our menstrual cycles start to change, becoming longer or shorter. This can also mean changes to our periods, with some becoming very light and some much heavier.
As we move into our mid 40s, we have fewer follicles that grow into the mature ovum, so we don’t ovulate every menstrual cycle. This reduces the amount of progesterone, our calming, anti-inflammatory hormone, our body makes, which can then impact our moods. Think more easily irritated, less tolerant and quicker to snap at others. Less progesterone also affects the quality of our sleep, breast tissue, blood pressure, thyroid function and more.
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This is all building up to menopause. This is simply the day when you haven’t had a period for 12 months. Then we move into the post-menopausal phase of life: no more periods and no more menstrual cycle.
Contrary to what you may have heard, we still produce hormones! In our menstruating years, we produce a powerful form of estrogen called estradiol. In our post-menopausal years, we produce a less potent from of estrogen called estrone from our adrenals, the tiny glands on top of our kidneys.
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In all of this, there is a mental and physical transition that we need to prepare ourselves for. We’re shifting into a new phase of life and with that comes a fantastic power and sense of renewal. It’s valuable to understand that your physical and mental wellbeing needn’t completely fall apart and that there’s a lot that can be done to support.
What sort of symptoms might women notice?
In perimenopause, you might start to notice issues with your energy and mood first. Maybe you’re struggling to wake up and get going in the morning. Or maybe you’re relying more on coffee for a morning boost. Maybe you notice yourself responding more harshly to your kids or partner. Maybe it’s brain fog that makes it hard to focus on the task at hand or even to remember what you’ve walked into the room for.
Then there are the changes to your period: You might experience a much heavier flow, perhaps a much lighter flow or even more frequent periods. For those with regular menstrual cycles and periods, these changes can be disconcerting. As you may have seen on And Just Like That, perimenopausal Charlotte experienced a flash period, which is a sudden period that occurs with irregular menstrual cycles.
How long can these changes go on for?
How long these changes last really varies. For some, they happen gradually and culminate in the menopause. For others, they can last for a long time – through perimenopause and past menopause.
Once we get past menopause, we can see an increase in symptoms affecting temperature regulation: Hot flashes during the day, night sweats of varying degrees, from slightly hotter to completely drenching the bed.
Got a perimenopause or menopause question?
The lack of estradiol can affect other areas of the body, including lubrication of the vagina, bone strength, frequency of urination and skin health. It’s not all bad news. Estrone, the less potent form of estrogen we produce in our post-menopausal years, helps to counteract some of these symptoms. As well as our adrenals, we also produce estrone in our adipose (fat) tissue. I know many of us bemoan that slight increase in weight around the middle that can happen, but it does play an important role for supporting hormone production.
What can women do to help with these symptoms?
There’s a lot that we can do to support our health during perimenopause and beyond.
During perimenopause, it’s important to make sure you’re covering all the basics that support great health. Are you getting enough high quality sleep, going to bed before midnight and sleeping for at least seven hours? Are you eating enough, eating at least three meals a day with lots of greens, fibre, high quality protein and healthy fats?
Do you have a handle on the stressors in your life – physical and emotional? Do you intersperse moments of calm throughout your day to help manage your cortisol and stress levels? What about sugar, caffeine, and alcohol? Could you take a more mindful approach to each of these, noticing if you’re relying on them to prop up your energy levels or mood.
Post-menopause, we need to keep going with the great habits we’ve established during perimenopause. This includes eating enough whole foods, which give our body nutrients like B vitamins, vitamin C, zinc, selenium, iodine, B12 and magnesium, which we need to make estrone and other hormones.
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It’s not just what we eat, it’s also how we eat. Eating slowly and with intention helps us properly digest our food and absorb the nutrients effectively, so we can then use them to continue making enough estrone, testosterone, thyroid hormone and more. These nutrients also support the health of our bones, skin, hair and brain. Calmer mealtimes and better chewing can also reduce the bloating that some of us experience. Bloating is also a sign that we need to support our gut health, with more fibre, greens, water, and daily bowel movements.
Can women still get sporadic bleeding or spotting, even after their regular periods have stopped?
In short, yes. If this is happening for you, please speak to your doctor. There could be a number of reasons for this sporadic bleeding / spotting, including new medications, friction during sex against thinner vaginal walls or polyps.
READ MORE You Can Have A Better Period by Le’Nise Brothers is published on March 8 2022.