Is it perimenopause or depression/ anxiety? A naturopathic apporach to a hormonal shift

The fastest growing group being prescribed anti-depressants is women of perimenopausal age.

I see this time and again as a naturopath woman between the ages of 40 and 50, and yes, we do see the hormones begin to shift for many women at age 40. They begin experiencing mood and emotional changes which are completely out of character for them.

It’s generally put down to stress- many of my clients have been to their GP several times only to have their pathology testing come back ‘normal.’ Some of them are being told they are suffering from mild to moderate depression and should seek support for that.

One can’t help but wonder if there is a misidentification of mental-psychological imbalance for what is essentially a large hormonal transition impacting the brain.

So, if this is you- understand that your ovarian hormones progesterone and estradiol (estrogen) start to decline or shift around perimenopause, and these hormones have significant impacts on your brain!

Progesterone decline in perimenpause:

Progesterone c interacts with neurotransmitter systems in the brain, including gamma-aminobutyric acid (GABA) receptors. GABA is an inhibitory neurotransmitter that has a calming effect on the brain. Progesterone's interaction with GABA receptors may contribute to its anxiolytic (anxiety-reducing) and mood-stabilising effects.

Some studies suggest that progesterone may have a positive impact on cognitive function. It has been investigated for its potential role in enhancing memory and learning. Additionally, researchers have explored its effects on conditions such as Alzheimer's disease, where hormone-related changes may play a role in cognitive decline.

Have your hormones started to shift? Are you entering perimenopause?

The best way to determine this is to have the blood test done- Day two or three of your bleeding is essential as this is where we can identify how contentious the communication is between your brain and ovaries and if indeed your brain has started increasing FSH secretion essentially screaming at your ovaries to make more hormones.

Wait, let me guess… you’ve had your hormones tested, and they came back ‘normal’ helpful to understand that if it’s outside this specified collection window of day 2 or 3, you are only likely to identify perimenopause when you’re at the end of your journey.

Other ways to identify perimenopause…

Not all women experience these; however, if you have mood changes accompanied by any of the following, it’s a nudge to have your hormones tested.

Irregular Menstrual Cycles:

One of the earliest signs of perimenopause is changes in your menstrual cycle. Your periods may become irregular – shorter, longer, heavier (very common to bleed through or have to change often), or lighter periods in some. Keep track of your menstrual patterns on a calendar to identify any emerging irregularities, as these fluctuations are often a clear signal that perimenopause has begun.

Hot Flushes and Night Sweats:

Fluctuations in estrogen levels can lead to hot flashes and night sweats, common symptoms during perimenopause. These sudden, intense feelings of heat, often accompanied by sweating, can be disruptive but are a normal part of this transition. If you find yourself experiencing these symptoms frequently, it may be indicative of perimenopause.

Changes in Sleep Patterns:

Many women going through perimenopause report disruptions in their sleep patterns. Insomnia or difficulty staying asleep can be attributed to hormonal changes. If you notice a shift in your sleep quality or find yourself waking up frequently during the night, it could be a sign that perimenopause is underway.

Brain Fog- Concentration Issues:

Hormonal fluctuations can impact neurotransmitters in the brain, leading to mood swings and emotional changes as we’ve discussed. It can also lead to a decrease in cognitive performance and issues with short-term memory. So if you’ve been losing the keys, forgetting names and dates and losing words it could be perimenopause.

Changes in Libido:

Hormonal shifts can also influence sexual desire and arousal. Some women may experience a decrease in libido during perimenopause due to changes in estrogen levels. If you observe a shift in your sexual appetite that seems unrelated to other factors, it might be worth exploring the possibility of perimenopause.

Vaginal Changes:

As estrogen levels decrease, perimenopausal women may experience changes in vaginal health, such as dryness and thinning of the vaginal walls. These changes can lead to discomfort during intercourse. If you notice these symptoms, it's advisable to consult with a healthcare professional for guidance and potential solutions.

As a naturopath, I’m often asked about HRT (hormone replacement therapy) and if it’s a good option for women who have started perimenopause. The research shows for many women bio-identical hormones can be helpful in reducing the severity of symptoms.

As a first step you might want to consider engaging with both your GP and your naturopath so that you’re able to make informed decisions, have the appropriate testing and develop a plan you’re comfortable with that will prevent further issues down the track.

Naturopaths will often work to uncover the cause of your symptoms and early identification of perimenopause can get you into a better footing to avoid many of the other health complications that can develop for a woman post this phase of life.

If you have any questions please feel free to book a complementary call to better understand how we work to support individuals on their journey to better hormone balance.