Perimenopause and Healthy Aging
Now that we understand the role of hormones during our reproductive years, let's explore their function during perimenopause. After all, it is National Perimenopause Awareness Month. In this blog, we will discuss tips for healthy aging that align with our events this month. The events are pelvic-informed pilates and yoga for improved sleep. Trusted pilates instructor Alyssa Dawn will be guiding us in the pilates class. Our in-house yogi, Teeana, will guide us through a restorative flow, while Healing with Zen performs ear seeds for sleep, and Jennie provides sleepy-time tea.
Understanding Perimenopause and Healthy Aging:
Perimenopausal symptoms do not appear all at once; they can slowly develop over time. Additionally, this occurs during a life stage when many people are busy with work and raising children, so symptoms may be mistaken for stress or busyness rather than a hormonal shift. Menopause symptoms can begin long before periods stop, primarily due to changes in estrogen and progesterone levels during perimenopause. During this hormonal transition, our bodies produce less progesterone while estrogen remains relatively high. Remember, after ovulation, progesterone helps transform the uterine lining into a nutrient-rich, implantation-ready state , and when it decreases before your period, the lining breaks down and sheds. If progesterone isn’t present to do this, estrogen can cause the uterine lining to build up more, leading to heavier periods. Additionally, as these hormones decline, some women are more prone to hot flashes and night sweats, which are common symptoms of perimenopause.
While I know that hot flashes are a hot topic regarding perimenopause (which usually resolve over time), we also need to highlight that over 70% of women going through menopause will experience musculoskeletal symptoms. These are among the most severe complaints in women within this age group. Unlike vasomotor symptoms like hot flashes, musculoskeletal issues are not something we can expect to stop later in life. As your friendly pelvic physical therapist, I want to emphasize the importance of caring for your musculoskeletal health.
As you can imagine, most studies have been conducted on male bodies; however, these findings do not always apply to females. For example, males typically begin losing muscle mass at age 55, while females start this process at age 31. Therefore, females need to engage in strength training. In the previous blog, we discussed how estrogen influences muscle health. When estrogen levels decrease, your speed, agility, and strength can suffer, ultimately leading to sarcopenia (muscle loss). If movement has never been your thing, it remains vital to incorporate movement into your routine because estrogen not only supports muscle performance but also improves insulin sensitivity and promotes the production of myokines. These anti-inflammatory compounds help reduce aches and pains. With the decline in estrogen—which also affects insulin resistance—it's important to look beyond MHT (menopausal hormone therapy) to maintain overall health.
Since we’re focusing on pelvic health, I need to explain how decreased estrogen and testosterone impact the pelvic floor. However, we've already written a blog about this, and during National Menopause Awareness Month in October, we’ll definitely address it more.
As we mentioned in our previous blog, there are a large number of cortisol receptors in the abdomen. People in midlife may notice more belly fat because of this, and it is highly inflammatory. Furthermore, one can enter an awful feedback loop: stress can boost sugar and fat cravings, potentially making things worse.
So what can we do about all of this?
First, I want to acknowledge how unfair this all feels. Why are females the only ones who have to go through this? No matter your age, it's helpful to remember that overall health, including biopsychosocial factors, can support you through it. It may seem, or actually is, like a burden at first, but once you establish a healthy lifestyle, you might start feeling significantly better.
Quality sleep: Getting quality sleep is essential for many reasons. First, it supports hormones that regulate feelings of fullness and hunger, leading to healthier eating habits. I’m not sharing this just for aesthetics. Belly fat, in particular, can increase inflammation in the body, which can cause more unwanted symptoms. There are so many benefits to sleep. It can also reduce stress, clear your mind of past concerns, and boost your creativity for the next day. Additionally, it helps prevent illness.
Movement: You probably saw this coming. As discussed, females begin to lose muscle mass around age 31, and muscle is crucial for both mobility and reducing insulin resistance. Maintaining muscle can help keep you mobile and lower the risk of falls later in life (hello osteoporosis). We also want to avoid breaking bones, since there's a link between age, fractures, and mortality. Additionally, as estrogen declines and we lose some cardioprotective benefits, adding cardio exercise can promote healthy aging. As your local movement experts, we have plenty of strategies to help optimize this!
Eating well for your body: Perimenopause can be tough on your body, and nourishing yourself is key to feeling your best. For example, decreased estrogen levels can affect insulin sensitivity, making a balanced diet important. As stated, cortisol receptors in the belly can increase abdominal fat, so managing the nervous system and eating well can help reduce this. Bone health is crucial in midlife and beyond, so eating foods that keep bones dense and strong is essential. Lastly, supporting heart health is important because, as estrogen declines, you lose some of the cardioprotective benefits you had during your reproductive years.
Regulating the nervous system: Regulating the nervous system is essential for health. If you’ve attended pelvic therapy at The Pelvic Model, you’ve likely heard us say that your nervous system plays a key role in pelvic health. It is also central to aging gracefully. The better you manage your stress, the more resilient you become to illness. When hormones fluctuate and decline during perimenopause, it stresses the body (remember, estrogen is in every cell of your body!); therefore, having tools to regulate your nervous system in midlife can be very helpful.
It's impossible to summarize all of this in just one bullet point each, so I hope this offers a clearer picture of the considerations for healthy aging. Since this is a topic we care deeply about, please follow us for more updates. We will host more events on this subject, and of course, we treat pelvic dysfunction related to perimenopause and menopause. We’re always here to support you on your health journey!
