Every woman thinks she knows the signs of menopause – hot flushes, sleep disturbance, thickening waist, fatigue, moods that fluctuate wildly – but what about all those other signs of “ageing,” like low mood, poor memory, thinning hair, brittle nails, age spots and anxiety? We’ve learned it could be perimenopause, a drawn-out period of time when your body’s reproductive system slows down until you hit menopause, actually the technical term for the full-year anniversary of not having a period. We ask Dr Mary Ryan, endocrinologist, to explain exactly what’s happening, and whether it’s possible to minimise the impact on our daily lives …

“Menopause is called the Second Spring in Asia,” explains Dr Mary Ryan, consultant endocrinologist and senior lecturer at the University of Limerick. She believes menopause should be perceived as a positive chapter in every woman’s life. “How many times do I hear patients say everything was fine until puberty, because their life has been controlled by their hormones from then on?”

Hormones are generally perceived negatively, yet they control the immune system and oestrogen is a vital regulator of the immune system. As Dr Ryan explains, “Women have an enhanced capability of producing antibodies due to oestrogen. This enhanced immune reactivity helps women produce effective resistance to infection and so they are thus less susceptible to infection. When oestrogen levels lower in perimenopause and menopause, women lose this protective effect of oestrogen.”

Dr Ryan explains premenstrual syndrome as the first stage in a woman’s hormonal journey. This occurs around ovulation “when there is a luteinising hormone peak in the pituitary gland. This can cause a hormonal imbalance, peripheral nerve pain and changes in mood.”

Dr Mary Ryan

Usually at the age of about 47, women experience perimenopause. But it can occur earlier. Oestrogen levels decline in perimenopause and further in menopause as eggs are depleted and less oestrogen is produced.

Dr Ryan explains, “As eggs become depleted the FSH [follicle stimulating hormone] rises in the hormone control centre – the pituitary – and as a result there are knock-on hormonal effects.” These side-effects range from muscle pain, insomnia, fatigue, anxiety, sweating, flushing and vaginal dryness. During perimenopause, studies have likewise shown that cortisol levels increase, which in turn impact and affect sleep cycles and eating habits.

Dr Ryan says, “Before menopause, we have a great way of buffering stress because we have optimal levels of progesterone. Once progesterone starts to lower in peimenopause and menopause, due to reduced ovulation, the effect of cortisol weakens. A lot of women can feel very hormonal but not depressed. Depression is over-diagnosed in women. If there is a hormone imbalance then this can be treated.“

Dr Ryan emphasises it is very important for women to pace themselves during perimenopause. “In order for your body to deal with the hormone imbalance and chaotic circadian rhythms, the body must rest and recharge.” Dr Ryan indicates some of the physiological effects: “Reduction in oestrogen contributes to osteoporosis, changes in the arteries and an increase in atherosclerosis plaque, putting women at risk of heart disease post menopause.”

Top tip: Take a natural supplement such as Cleanmarine MenoMin – an all-in-one Omega 3, phytonutrient and vitamin blend specifically formulated to give nutritional support to perimenopausal and menopausal women.

While she admits a few women sail though menopause, when periods cease completely, the majority do get autonomic effects such as sweating, flushing, insomnia and severe fatigue, due to low oestrogen production which also disturbs sleep and causes brain fog. One study has shown that 60 per cent of women will likely suffer from brain fog during menopause.

Dr Ryan describes brain fog as “a term used to describe when patients find that their brains are excessively tired. This causes forgetfulness and can occur in women postpartum after having a baby, at perimenopause and menopause.”

To counteract brain fog, Dr Ryan believes sleep hygiene is a priority, especially limiting blue light exposure before going to bed, which disrupts the natural circadian rhythm. “The blue wavelengths reduce your natural melatonin or sleep hormone that is essential for deep REM sleep. Both REM and non-REM sleep are necessary to consolidate your memory for the day ahead. The hours of 10pm – 2am are when the body detoxifies most, so remaining in an active state during this time disrupts the body’s natural process.”

The most important message for every woman to remember is that there is help available for all of stages of women’s hormonal journey. “The best advice I can give any women is to understand your body: know when you are perimenopausal and menopausal,” says Dr Ryan. “Do not suffer as there are lots of treatments to help the hormone imbalance.”

Dr Ryan’s Tips to Minimise Menopausal Misery:

-Empower yourself with knowledge so that you can help yourself. Recognise when you are perimenopausal and menopausal. Talk to your GP.

-Have a healthy diet and “eat the rainbow” with plenty of fresh fruit and vegetables.

-Reduce sugar and caffeine intake.

-Get plenty of rest.

-Get treatment for vaginal dryness, and peripheral nerve pain.

-Get a DEXA – a bone density scan.

-Keep a check on your lipids and blood pressure at this time.

-Try a natural supplement such as Cleanmarine MenoMin – an all-in-one Omega 3, phytonutrient and vitamin blend specifically formulated to give nutritional support to perimenopausal and menopausal women. Cleanmarine MenoMin is available at pharmacies and health stores nationwide, learn more at www.cleanmarine.ie.

-Download The Essential Guide To Female Hormones, available at www.cleanmarine.ie.

Need to Know: Each capsule of Cleanmarine MenoMin contains Omega-3, Biotin, Rosemary Extract, Soy Isoflavones with B Vitamins and Vitamin D3 to provide nutritional support aged 40+. Vitamin B6 helps regulate hormonal activity and along with Vitamins B1 and B12 it contributes to normal psychological function. Vitamin D helps maintain healthy normal bones and supports the normal function of the immune system. Cleanmarine MenoMin’s synergistic formulation is ideal for women in perimenopause and menopause who want to feel good every day. Cleanmarine MenoMin is available at pharmacies and health stores nationwide, learn more at www.cleanmarine.ie.