What is Perimenopause?
Perimenopause is when the body begins preparation for the stage in life where child bearing will not be the biological focus. This usually happens in a woman’s 40s and is a gradual build-up to menopause, when the menstrual cycle ceases completely. Perimenopause starts with a gradual decline in progesterone and can cause some of the following symptoms:
- Weight gain
- Cracked, dry or loose skin (caused by less collagen)
- Low sex drive and/or more difficulty reaching orgasm
- Tearfulness (especially week before period)
- Restless sleep
- Increased menstrual cramps
- Night sweats 
These uncomfortable symptoms are because the body is trying to adjust to the relative oestrogen excess.
Not only do the sex hormones (oestrogen and progesterone) have to make the transition, so do other hormones. For example, cortisol levels (a stress hormone) will increase, and insulin resistance can be more common. Because of this, it is vitally important to eat a healthy, balanced diet and to find ways of managing and/or coping with stress.
Before menopause, the ovaries are the major oestrogen secretors. However, as they become less active during perimenopause and menopause, the balance shifts until finally around half of the body’s oestrogen and progesterone is made in the adrenal glands. If stress levels are high, the adrenal glands will always prioritise the secretion of the stress hormones over the creation of sex hormones. Thus, finding ways of lowering stress will ensure the adequate amount of sex hormones is produced in a woman’s body in her 40s and beyond, maintaining balance.
In addition, the body might look elsewhere for oestrogen once the ovaries start to slow down. This could easily lead to weight gain because fat cells are a key source of oestrogen storage. Furthermore, if a woman is already obese before menopause then the fat cells may create too much oestrogen in comparison to progesterone, leading to increased oestrogen dominance. 
Oestrogen dominance is also likely during prolonged periods of stress. This is because the stress hormone cortisol competes with progesterone. Thus progesterone levels decrease, inducing an imbalance of oestrogen and progesterone.  Signs of decreased progesterone, and oestrogen dominance, are:
- Decreased sex drive
- Irregular or otherwise absent periods
- Breast swelling and tenderness
- Mood swings (irritability and/or depression)
- Weight gain (particularly abdomen and hips)
- Cold hands and feet
- Headaches, especially pre-menstrual 
How to cope
Find ways of managing/coping with stress that work for you. Ideas: regular reflexology or massage treatments, daily meditation, regular exercise, better time management, spending more time outdoors, spending time with animals/nature, keeping a diary or journal.
Eat a healthy balanced diet. Try to avoid white, refined carbohydrates such as pasta, bread, cake and biscuits. Make a switch to fresh vegetables, white meat and fish, pulses and whole grains.
Switch to organic. Eating organically can be expensive; if you cannot afford to go completely organic, try to avoid the Environmental Working Group’s (EWG) “Dirty Dozen”. This means if nothing else, always buy the following as organic produce (or avoid altogether): apples, celery, cherry tomatoes, cucumber, grapes, hot peppers, nectarines, peaches, potatoes, spinach, strawberries, peppers, kale and courgettes. The EWG’s “Clean 15” is a list which can be classed as “safe non-organic”: asparagus, avocados, cabbage, melon, sweetcorn, aubergine, grapefruit, kiwi, mango, mushrooms, onions, papaya, pineapple, frozen peas, sweet potatoes. 
Reduce use of stimulants such as caffeine and alcohol. Stimulants send the body’s hormones on a roller-coaster ride of high peaks followed by low drops creating a multitude of problems including cravings and fatigue.
Don’t be too hard on yourself. Don’t eliminate everything from your diet and make yourself miserable. Allow yourself that morning coffee; enjoy a piece of cake once a week; switch to a darker variety of chocolate with less sugar; enjoy a weekend glass of wine.
 Is it me or my hormones? by Marcelle Pick 2013
 The Optimum Nutrition Bible by Patrick Holford 2004
 The Wisdom of Menopause by Dr. Christiane Northrup 2009
 Environmental Working Group http://www.ewg.org/foodnews/
Jackie Marsden MAR is a qualified reflexologist and independent consultant (Team Leader) for Neal’s Yard Remedies Organic. Jackie leads and mentors a growing team of consultants (many of whom are therapists integrating organic products into their existing businesses) via the NYRO social selling channel, holding regular team meetings, one-to-one coaching via phone and facetime, and a closed facebook group. All views are my own.
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