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If you’re in your 40s you may have noticed that your periods have started to get heavier, last for longer, and could also be more painful.
You might have also noticed difficulty sleeping, brain fog, and anxiety, even with no prior history. For some women it has a big impact on their ability to function at work and home.
This can be largely attributed to the decline of the hormones oestrogen and progesterone, which naturally occurs as we enter perimenopause and menopause.
Progesterone is produced by the adrenal glands and the ovaries. It has a calming effect on the nervous system, helps to stabilise mood, and facilitate sleep.
Oestrogen is a fabulous hormone, and its effects are felt and loved by cells all over your body. One of its many functions is to thicken the lining of your uterus in preparation for supporting a pregnancy.
Progesterone is the yin to your oestrogen's yang, and the balance between these two hormones is important. While oestrogen's job is to encourage the cells in your uterus to multiply, progesterone has the opposite effect, inhibiting the growth of the uterine lining as well as causing it to thin.
Since your menstrual period is the result of the uterine lining shedding, a thicker uterine lining means a heavier period.
By inhibiting the growth of uterine lining, progesterone serves to make your period lighter.
Progesterone levels start to decline in perimenopause while at the same time your oestrogen levels can fluctuate wildly between between high and low during this time.
It's these high oestrogen states (or even regular oestrogen states) coupled with lower progesterone that result in a heavier period.
Supporting progesterone production is really important during perimenopause, not just to help manage heavy periods but also to facilitate sleep and stabilise mood.
Here are the top 3 things you can do to support your body producing enough progesterone (and this goes for any woman still getting a period. Low progesterone is one of the most common menstrual issues I see in the clinic and not just in the peri group).
The best part? They don’t cost a cent.
1. Get 8+ hours of quality sleep.
And since the hours between 8pm and 12am are the most restorative, if you can put the light out anywhere between 9-10pm you’re tapping into one of the most powerful health hacks on earth - good quality sleep.
If your sleep is a mess, you can download my free guide all about how to get the best sleep of your life (it's based on the findings of leading sleep researchers and is full of actionable steps you can take straight away - get your hands on it here).
2. Reduce / manage stress.
When we are stressed our body ramps up production of the hormone cortisol. Cortisol is an important hormone to help us deal with stressful situations, but we aren’t meant to be exposed to high levels of it for sustained periods of time.
Unfortunately our modern lives tend to have us running around with elevated cortisol levels. Progesterone is what we call a ‘precursor’ to cortisol, meaning the body uses progesterone to make cortisol.
When we don’t manage our stress and our cortisol levels increase, our body effectively “steals” progesterone to make more cortisol. As cortisol levels increase, progesterone levels decline.
See here for more information on cortisol and how to keep it in check.
3. Eat breakfast before 10am.
Skipping breakfast increases your cortisol levels. See above. Also avoid coffee on an empty stomach, instead drink it with or after your breakfast.
Period expert Lara Briden also recommends avoiding cow's dairy products that are likely to contain higher amounts of the A1 protein. The good news is that you can still have butter (thank all that is holy), cream and ricotta cheese as these contain relatively lower levels of A1. You can also eat cheeses and yoghurts made from sheep and goat milk (mmmm, spanakopita 🤤).
If you’ve addressed the above and you’re still noticing signs of low progesterone (including but not limited to: sore breasts, PMS with irritability and anxiety, difficulty sleeping, heavy and long periods) then you might find benefits from adding in supplements like magnesium and Vitex.
If you're still experiencing heavy bleeding, you can ask your doctor whether ibuprofen might be a suitable option for you. 200mg of over-the-counter ibuprofen taken with meals on heavy flow days can reduce bleeding by up to 25-30%. If you'd like some information to take with you to show your doctor, you can download the For Healthcare Providers: Managing Menorrhagia without Surgery document available on the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) website.
If you've implemented all of the above and are still dealing with heavy periods you may be a candidate for MHT - Menopausal Hormone Therapy. Unlike the HRT of the past, MHT uses hormones that look exactly the same as your own, natural hormones. This means they're not only safer but can deliver health benefits their synthetic counterparts cannot.
As with everything, MHT is not a magic bullet nor is it suitable for everyone. If you have questions about your best plan of attack, or you're interested in working together to get your symptoms in check Contact me here and let’s get you on the path to feeling and living at your best!
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