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Perimenopause: what, when, why and how to deal with it

Perimenopause, a quieter process preceding menopause, can have a significant impact on your body. Here is how you can manage it

Resistance training helps slow down the inevitable loss of muscle during perimenopause
Resistance training helps slow down the inevitable loss of muscle during perimenopause (Pexels)

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Do you remember the exact moment when you felt like an adult? Perhaps it was when you found yourself paying taxes or instinctively acted like your mother before stopping dead in your tracks. It's happened. You've become an adult. Ageing is forever a process, not a final destination, and there is no universal way to realize we've become an adult, but we certainly know it once we get there.

For women, menopause can seem like the most significant indication of ageing, but people rarely know about its warm-up act, perimenopause. According to the Mayo Clinic, the average age that a woman experiences menopause is approximately 51 years old. However, our bodies don't one day say, "you know what? That's enough estrogen production from me; I quit." 

A quieter process happens long before, ranging from four to even fifteen years before menopause starts, which means perimenopause can start as early as your late 30s. The Mayo Clinic calls it the "menopausal transition" period, and you never know when it will begin.

Also read: Why women should avoid fasted cardio

But no, don't panic. Hear me out, first. In a book titled Perimenopause Power, the author, Maisie Hill,  states, "some people will have a positive experience of perimenopause. After all, it's a life event, not a disease or disorder." 

The problem often is that most women aren't aware that this transition period exists when their body starts acting erratically. Her body can feel like malfunctioning software, spurting, and spitting flames, leaving a woman confused in the wake of a lifetime of relative physical predictability. I recently asked a doctor in Canada if women can at least get a blood test to indicate whether or not they are in perimenopause. Unfortunately, her answer was, "no, you just have to watch for the signs." 

Hill agrees. You have to remember that this isn't a time when estrogen levels may be low (a hallmark of menopause); testing is therefore redundant. Instead, women need to identify "experience changes" around their cycles. 

Each woman will experience a different reality as she transitions through perimenopause, so there is not one blueprint we can point to and say, "this is your roadmap." You may suddenly lie awake at night for hours, unable to sleep. Your menstrual cycle may become erratic, or your flow and pain associated with it can peak or wane each month. You may even endure night sweats around your period, lumpy or swollen breasts, or experience mood swings that could make a lion cower in his cage. You may experience no symptoms, one symptom, many, or all.

One of the significant symptoms for women is their stubborn weight gain. It doesn't seem to matter how much they try, but they cannot shake the weight off. Even where women put on extra fat may also change during this time. According to Estrogen Deficiency and the Origin of Obesity during Menopause, decreases in a woman's estrogen may affect where her fat is stored. She may lose fat located just under the skin and instead, gain it on her belly - much to the chagrin of my female clients. 

On top of all the other confusing changes in her body, adding a negative body image is one that I would like for women to avoid, which is why I need to talk about perimenopause in a way that can empower and encourage women to be proactive about their health.


During perimenopause, a few things encourage weight gain, even if you didn't change your diet and workout plan. Even though we may not be estrogen deficient, the production of it may be irregular, and it can sometimes be high and sometimes decrease. 

Estrogen is a term that embodies many different types of estrogen, one of which is called estradiol, and estradiol is intrinsically linked with our hunger hormone, ghrelin. In an article called Does Hunger Affect Hormones,  Hellen Kollias writes that the more estradiol we produce, the less ghrelin we release, and the less hungry we are. That means the less estradiol we produce, the more ghrelin we have, and our hunger signals increase.

All of a sudden, you're hungrier than usual and likely eating more. You can keep a hunger journal and rate your hunger throughout the day on a scale of 1-10. Do you notice that your appetite is slightly increasing? 

One way to improve this is to eat high-protein and high-fibre whole foods, which help fill you up without the added calories. Refocus your diet away from processed or confectionary foods that are high in calories and don't leave you satiated. It may also mean ditching dramatic diets which have you eating very little as these can exacerbate your hunger signals. Instead, fuelling your body with natural, whole foods which will leave you feeling and looking your best. Don't forget to include protein, colourful fruits and vegetables, complex carbohydrates, and essential fats.


There is also a phenomenon happening to both men and women called sarcopenia, the process in which we naturally lose muscle. Muscle burns more calories than fat at rest, keeping our metabolism running faster. The more muscle you have, the more calories you will burn. However, each decade after 30 years of age, we lose a smaller percentage of this muscle, which inevitably means we burn fewer calories. Sadly, a decline in estrogen can also make it harder to maintain muscle mass.

Continuing or starting a well-thought-out resistance training program in the gym will do wonders for maintaining or building muscle mass, allowing us to burn more calories even at rest. 

There is another unexpected benefit to this as well. As your estrogen levels begin to deplete as your progress through menopause, your bone density may suffer. Strength training strengthens your muscles and other support tissues and helps keep your bones strong, decreasing your risk of osteoporosis and osteoporosis

Also read: How to train through your menstrual cycle


Decreased sleep can dramatically impact your waistline. Even one night of disrupted sleep can alter your metabolism by up to 20% the following day, meaning you burn fewer calories and create the perfect conditions to increase your hunger. A good night's sleep begins when you wake up by limiting the amount of coffee you drink throughout the day. It also depends on the activity you engage in, and the food and alcohol choices you make at night. 

Start by setting your alarm for the following morning, and determine your bedtime by allowing yourself to sleep 8 hours. Then, start powering down blue lights, turn off your emails and text messages, and make your room dark, warm, and inviting 30 minutes before bed, to help enable the perfect sleep.


According to Perimenopause Power, the intricate balance of our hormones can also be linked to pain and inflammation. As we enter perimenopause, we may notice more muscle aches and stiffness, as well as arthritis and joint pain. Not only are pain and inflammation in the body uncomfortable, but they can also hold us back from leading an active life, which, as we know, will dramatically benefit our weight loss.

You can also improve your inflammation by choosing foods that are higher in Omega 3s. Examples of foods that contain Omega 3 are fatty fish, nuts, seeds, and some oils. Another way to reduce the inflammation in your body is to consume whole foods rather than processed ones and minimize your trigger foods (gluten, dairy, caffeine, alcohol, etc.) that may cause it to flare.

Jen Thomas is a Chennai-based weight-loss coach

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