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Writer's pictureTula Nutrition

Perimenopause episode 4 - Your questions


Since I started the perimenopause series I have received so many questions so I thought I'd answer them all in this episode.

It's shocking that there isn't more information out there. I really feel that women are given a bad deal with the lack of support available and can sometimes be made to feel like we should "just get on with it" when in reality it can be extremely challenging for many.

So here I've compilled the most common questions and answered them in as much detail as possible.


  • I'm so low on energy, is there anything I can do to boost it?

The number one cause for low energy is poor sleep.

A good sleep routine can leave you feeling more energized. Try to go to bed and wake up around the same time every day, even on the weekends. Avoid caffeine and alcohol close to bedtime as well as putting down your phone or any other electrical device at least one hour before bed.

Of course this is all well and good but if hot flashes are keeping you awake due to a dip in estrogen and progesteron is also low this can play havoc with your sleep pattern.

There are some natural supplements that may help such as valerian root, tart cherry juice concentrate, melatonin and magnesium. As well as a cool, dark bedroom with cotton bedding.


Are you having heavy periods that last a long time?

This is a common symptom of perimenopause and can mean that you are low in iron. Low iron will make you feel extremely fatigued so should be ruled out by a simple test with your GP.


Are you reaching for quick convenience foods?

Our bodies crave quick release carbohydrates when we are low on energy, the trouble is this creates a vicious circle of blood sugars dipping and rising which makes us crave them even more. Try and keep your diet fairly clean, full of protein, complex carbs and healthy fats. A good rule of thumb is to actullay use your hand to portion out your plate.

The guide is as follows-


Protein-A flat palm size , such as chicken or turkey breast, lean red meats, tofu, tempeh, cottage cheese e.t.c...


Starchy carbs- a cupped handful, such as rice, quinoa, potatoes, pasta e.t.c...


Fat- a thumb size such as butter, nut butter, fat on meat, avocado e.t.c...


The rest of the plate made up of non-starch carbs such as leafy greens, brocolli, salad items e.t.c...


Drink plenty of water -being dehydrated really affects our energy levels and try to cut down on teas and coffees as these will have a duretic effect in the body as well as the crash from caffeine.


  • I seem to be putting fat on my belly, how can I lose it.

The reason for fat depositing in your belly area when it didn't before is a shift in hormones.

With the fluctuation of dipping of Progesterone and fluctuation of estrogen, testosterone can actually become much higher in ratio leading to a change in more of a male pattern of fat deposits. Another reason is low estrogen, this affects your ability to cope with stress . If you are constantly in a state of stress you will produce more cortisol which can lead to becoming less insulin sensitive. This means for insuline in the body leading to weight gain especially in your mid section.

Unfortunately we can't spot reduce fat but sticking to a energy balanced, healthy diet will help. Don't go too mad the last thing you need to do is a 1200 calorie diet plan but a small deficit of round 10% under your maintenance calories will be sufficient. You can use a calorie calculator for this or simply be mindful of portions, hunger, energy and cravings.

The other biggy is stress management. Flipping yourself out of fight or flight can have a real impact on your belly area. Find ways that help you de-stress. Yoga and meditation have shown profound affects on stress levels and body composition in countless studies. Yoga is so powerful it's shown to reduce symptoms of IBS without a change in diet moving the body into rest and digest.


Move your body

Now is not the time for an iron man comp. Find ways to exercise that you enjoy and don't stress you out, be it walking, strength training, swimming, cyccling etc.. exercise is also a great way of diposing of excess estrogen.


  • I think I'm in perimenopause, how do I approach my doctor

It's important to see your GP if symptoms of perimenopause or suspected perimenopause are troubling you. It's best to go prepared and write down a list of all the questions you wish to ask along with your symptoms. and period history. I know when I've had an appointment before I've forgotten half of what I wanted to say.

  • Do your research beforehand

  • If your doctor suspects perimenopause he/she may arrange a hormonal blood test

  • What are the treatments available for perimenopause

  • If you don't feel like you have been listened to ask for another appointment with a different GP

  • There is also the option of a private functional medicine practitioner if you'd like to go down the holistic route.


  • What options are there for hormone therapy


  • There are a few different approaches for Hormone therapy. However I am not a medical professional so please take expert advice.


  • The first and most controversial is HRT (hormone replacement therapy), a study was conducted that suggested it caused breast cancer but has now been debunked, the risk was not statistically significantly compared with known lifestyle risk factors such as smoking and obesity. But many women would rather still suffer in silence which is a shame as many have reported life changing effects for the better.


  • Bioidentical hormones

Bioidentical hormone replacement therapy, also known as bioidentical hormone therapy or natural hormone therapy, is the use of hormones that are identical on a molecular level with endogenous hormones in hormone replacement therapy. This comes in cream form in either progesterone, estrogen or a mixture of both. Again, many women find them to be benficial, however make sure you get professional advice as these are not as regulated as HRT and guidance is a must.


  • Alternative/complementary remedies

Herbal remedies can also be beneficial. Adaptogens (natural substances which help the body to adapt to stress and exert a normalizing effect on bodily functions)

The most common for perimenopause are Ashwagandha, Maca, and Schisandra. These can help with cognitive issues, hot flashes, fatigue and anxiety. Again please be mindful and ideally get some professional advice and guidance if this is the route you'd like to take.


  • Other complimentary therapies

Therapies such as acupuncture, reflexology and reiki can also have positive benefits when implemented regularly and can really compliment other approaches.


Hopefully thats answered the most common questions from my previous blogs.

If you are going through perimenopause and need help with nutrition and lifestyle do reach out I'm here to help.


Much Love


Coach Tula xx






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