The Hormonal Shifts of Menopause

Let’s start with defining menopause! Menopause is confirmed when you don’t have a period for 12 months. This lack of periods means that ovulation is not occurring and that you are no longer making progesterone or estrogen (other than the small amount coming from your adrenal glands). This is why menopause is a low hormone state. The time leading up to this, perimenopause, is when you typically have irregular cycles and a lot more symptoms like hot flashes, insomnia, low libido, vaginal dryness, mood changes, etc.

What’s actually happening when the body transitions to menopause? The ovaries gradually start to produce less hormones and then eventually stop releasing eggs and cycling all together.

Quick Summary:

  • Peri-menopause= hormonal chaos
  • Menopause= low hormone levels, less chaos

Estrogen Dominance & Menopause

One of the big topics that I discussed with Maria and Kristin and wanted to get across to midlife women is that your typical estrogen dominance is often not the issue during the transition to menopause. Can you be in an estrogen dominant state during this time? Yes, absolutely, but that doesn’t mean you want to lower estrogen. For example, one of the most common reasons for estrogen dominant symptoms during this time is low progesterone. As we age, the amount we are ovulating and the amount of progesterone we make decreases. If progesterone drops below estrogen, then you have what is called relative estrogen dominance. This means estrogen is higher than progesterone, but overall, but hormones are low. I see this in pre-menopausal women too.

Why is this an important concept to grasp for midlife women? It’s easy to Google your symptoms and come up with estrogen dominance. When you are a midlife woman, you have to keep in mind that the issue likely is not that you have too much estrogen but that you lack adequate progesterone. Honestly, this goes for all women. I often see the focus on reducing estrogen when we should be focusing on increasing progesterone in reality. Can we increase progesterone naturally midlife? The answer for peri-menopausal women is no. You can talk with your doctor about testing your hormones and adding bioidentical progesterone to help. I also see vitamin E as being incredibly helpful for these women and especially for hot flashes.

If you’re a midlife woman and think estrogen is your issue, I would think twice before you try to take supplements that lower estrogen. That will most likely make your symptoms worse.

Strength Training & Menopause

I cannot emphasize enough how helpful and supportive strength training is for midlife women. Ideally, you’ve been strength training before this transition, but it is truly never too late to get started. Strength training supports women in menopause for a few specific reasons:

  • Improves Insulin Sensitivity: As estrogen decreases during this time, so can insulin sensitivity. This can make it difficult to eat nourishing foods that provide micronutrients but also contain carbs. Strength training and muscle mass in general increases insulin sensitivity and can reduce insulin resistance.
  • Improves Bone Density: Strength training helps to reduce bone loss and can even improve bone density. Bone loss happens as we age, likely related to excess iron and a reduction in estrogen, which is why it’s such a crucial time to include strength training.
  • Less Stressful On The Body: If you are a cardio queen and a midlife woman struggling with hormones, you may want to rethink your exercise routine. Cardio leads to unwanted cortisol release and eats away at muscle tissue when strength training does the opposite.
  • Increases Metabolism: The more muscle you have, the more robust your metabolism is and the more energy your body will use. Strength training is the best way to put build muscle mass.

If you want to get started with strength training, my friend Adina Rubin is a great resource and has a free download on her website where you can get started. I also want to remind anyone reading this that our body weight also counts as a weight for strength training.

Iron & Menopause

Bone loss is a significant concern for midlife women. The focus is typically on estrogen, which does impact bone loss, but I think we are missing an important piece of this puzzle: iron accumulation. Excess iron in the bone inhibits osteoblasts and leads to bone loss. Iron accumulates more during menopause because you are no longer bleeding every month. The amount of iron you absorb doesn’t increase, but the amount your body gets rid of does. This leads to iron accumulation and creates more oxidative stress, AKA inflammation, and aging in the body.

This is why donating blood 2-3 times a year can be a helpful tool during menopause to help get rid of excess iron.

How To Optimize The Peri-Menopause Transition

This was one of the most common questions I got when I put up the question box for peri and post-menopause, which was encouraging. I’m so happy so many of you are thinking this way and want to prepare to support your body in the future. The secret is….everything I talk about all the time! The key is supporting strong ovulation, healthy progesterone levels, and minimizing outside stressors on the body. This doesn’t mean you have to have zero stress to transition into menopause gracefully. That’s not real life, but something I do think is realistic is learning how to nourish your body and doing that to the best of your ability before, during, and after the transition. Entering menopause in a state of undereating and undernourishment is only going to exacerbate your symptoms. We talk about how to do this in this episode of the Are You Menstrual? Podcast. 

The other big piece of the puzzle is iron. You want to make sure you’re getting enough copper and vitamin A in your diet in order to keep iron in motion and minimize accumulation. Learn more in this iron and copper podcast episode.

Here are two other helpful podcast episode on menopause that you might enjoy:

reminder: i’m currently taking on 1:1 clients. if you’d like to explore what it would be like to work together and if we are a good fit, fill out this form to get more details!​

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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