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Dr Marion Gluck has gained global acclaim for her work in women’s health and bio-identical hormone balancing therapy which can help reduce menopause and perimenopause symptoms. The Marion Gluck Clinic is the UK’s leading medical clinic that pioneered the use of bio-identical hormones to restore and maintain optimal health and hormone balance for patients. Headed up by Dr. Marion Gluck herself, the clinic uses her pioneering method of bio-identical hormonal treatment to rebalance hormones to improve wellbeing, quality of life and slow down ageing.
Here, Dr Gluck breaks down what exactly is going on during perimenopause and menopause and the signs, symptoms and solutions to the processes.
Each and every woman knows about menopause and the expected age range that they may go through it, but what about perimenopause? Are women clued up enough about this stage in our lives and what should we be looking out for?
The term “perimenopause” is also called “premenopause” and refers to the time when the effects of hormonal change start to become evident. The menopausal transition phase sees the levels of reproductive hormones, estrogen, progesterone and testosterone, become more variable and the effects of these fluctuations are significant. Perimenopause can last for 10 years or more, ending one year after the last menstrual cycle – which is the official date of menopause.
Women begin to experience symptoms of the menopause transition, or perimenopause as early as the age of 35, although most don’t become aware of the transition until they reach their mid to late forties.
During perimenopause, women may miss or skip an ovulation. Progesterone is produced by the ovary after ovulation and when ovulation is missed, levels of progesterone drop by about 70%. Progesterone is the “happy hormone” and increases the levels of GABA, a neurotransmitter in the brain that has a relaxing effect on the body. This is why insomnia, anxiety and mood swings are very common features of perimenopause. Progesterone also stabilises the lining of the womb, so a deficiency causes heavy periods with clots.
Estrogen levels fluctuate widely in perimenopause and can be 20% higher so the imbalance between high estrogen and low progesterone results in estrogen dominance. This causes weight gain, worsening PMS (premenstrual syndrome), breast tenderness and headaches.
Many of these symptoms can be modified with lifestyle changes. A diet with fewer refined carbohydrates, quality proteins, good fats and a range of phytonutrients in vegetables and fruit called ‘the rainbow plate’ is a great starting point for improving wellbeing.
Women can also use exercise to reduce symptoms and even gentle activities such as walking can improve hormone metabolism and reduce stress and anxiety.
In addition to diet and exercise, many women find that meditation and yoga help immensely as these activities help to modulate the stress response. When doing yoga, certain poses can also stimulate the pelvic organs which can improve hormone balance.
One factor that can exacerbate symptoms is alcohol so keep alcoholic units to a minimum and opt for a mocktail or alcohol-free beer or wine.
For women looking to enrich their diet further, a range of supplements can enhance wellbeing and actively promote hormone balancing. Oil of evening primrose is a great supplement for modulating hormones, magnesium helps reduce anxiety, Agnus Castus can help for those experiencing breast tenderness and 5HTP aids restful sleep. Vitamin C is also a vital supplement and offers a wide range of benefits.
Bio-idential HRT is derived from plant sterols from wild yams or soya beans and is used to balance hormones in women who are experiencing perimenopausal symptoms. The chemical structure of the hormone is the same as the naturally occurring estrogen, progesterone and testosterone produced in the body. They are therefore better tolerated and have fewer side effects.
In the perimenopausal period, a natural progesterone may be prescribed which relieves the effects of progesterone deficiency and balances the estrogen dominance, which can hugely improve perimenopausal symptoms.
Menopause is a natural transition and happens to every woman. The term is generally used to encompass the entire long-lasting process that relates to the end of a woman’s fertility. There are many menopause signs and despite what many women believe, it can be easily managed.
This change is perfectly normal and a healthy body will constantly adjust to change. However, in today’s environment, a number of factors can change the body’s ability to that adaptation, including environmental toxins, poor nutrition, a lack of essential minerals and the stress of juggling work and domestic life.
Menopause is associated with the cessation of ovarian function and results in low levels of all the sex hormones, namely estrogen, progesterone, and testosterone. It is also the end of the fertile phase of a woman’s life. Hormone levels continue to drop for a number of years and some symptoms such as hot flushes may disappear but for many women, the symptoms can continue throughout their lives.
The sex hormones have a wide range of effects in the body and so we now see the menopausal period as a “chronic female hormone deficiency” and in the same way insulin is important for diabetic patients, hormone replacement is vital and has long term benefits for many areas of the body including heart, bone and brain health. It even indirectly increases life expectancy.
Estrogen works to regulate body temperature, promote healthy sleep, improve blood flow and has effects on the brain that help memory and concentration, regulate collagen production important for healthy skin and nails and maintain vaginal wall health and libido. It is also a natural anti-inflammatory so crucial for joint health.
Progesterone is the body’s natural antidepressant and vital for mood regulation and sleep. It is also a natural diuretic so reduces fluid retention. Progesterone helps protect against breast cancer and endometrial cancer and it stimulates the action of other hormones such as insulin and thyroid hormone.
Testosterone in small amounts is essential for all women. It improves energy and libido, boosts muscle mass and strength, helps motivation, concentration and memory and can even lift mood and improve wellbeing.
DHEA is a precursor to the sex hormones and is produced in the adrenal glands and brain. It naturally declines with age but can also be low after adrenal stress and burnout. Replacement if needed improves energy levels and enhances wellbeing. It boosts the immune system and has anti-ageing properties.
Pregnenolone is known as the “mother hormone”’ and is another essential precursor hormone. It is particularly helpful for women who have memory loss and difficulties with word-finding associated with menopause.
The deficiencies and imbalances of the above hormones create each individual woman’s range of symptoms and the extent that they may feel menopause is affecting their lives.
Similar to perimenopause, lifestyle changes can make a huge difference in symptoms during menopause. A healthy diet with lots of wholegrains, quality proteins, good fats and a wide range of fruit and vegetables will go a long way in helping to boost and balance hormones. Seeking advice from a nutritional therapist can help you identify foods and nutrients that will help boost certain hormones and achieve an actionable plan for you to follow.
As we age, our bone density decreases and as such, weight-bearing exercises can be used as a method of osteoporosis prevention. It is also important to take a good bone supplement containing calcium, magnesium, vitamin D, boron and manganese.
In addition to the supplements that should be taken during the perimenopausal stage, women can also look at herbal adaptogens which are non-toxic plants including soya isoflavones, red clover, black cohosh and maca. These can all help the body resist stressors of all kinds, whether physical, chemical or biological. For an extra hormone-balancing boost take a vitamin D supplement and try and spend at least 20 minutes a day outdoors in the natural light.
Due to the individuality of each and every woman, a “one size fits all” menopause treatment is not always optimal. The symptoms and severity of menopause will differ from woman to woman and the ways in which symptoms can be eased will vary too.
Bio-identical HRT with specific hormone balancing is personalised by testing the blood and sometimes the urine of each patient to ensure the treatment is unique to each deficiency. For the individual patient this can be life-changing, reducing symptoms and improving quality of life. Bio-identical hormone treatments are 100% identical to human hormones produced in the ovary and adrenal gland. BHRT can be offered in a variety of applications including transdermal creams, lozenges, tablets and vaginal creams according to individual needs and preference. Adjustments to the doses of each hormone may be made over time and through regular follow-up, the treatment can be compounded to achieve the best possible outcomes.
Over a lifetime, women experience so many phases and changes in the body, from first becoming fertile to experiencing childbirth and beyond. Menopause is not to be feared and by proactively looking ahead, introducing lifestyle changes and seeking expert medical advice, you can find the best way to approach this time.
This article was originally published in October 2021.