My menopause Toolkit
I'll be 50 years old in November. Like so many of you, it feels like my 50th has come out of nowhere. Perhaps this is because I had my children in my late 30s and am still very much in 'raising a family' mode. It's also only in the past five years that I started to build Penn Smith Skincare online. Maybe you could call me a 'late bloomer', but for sure I feel like I'm still very much nurturing a family while building a skincare community.
And for me this is amazing. We women have so many choices: we can choose whether to have children early, late or not at all. We can choose to work outside the home, stay home raising a family, or have our own businesses. And importantly, we can (largely) choose how we age and how we prepare for and navigate through one of the most important changes that happens to us in our lives - menopause.
While I still have a regular period, there is no questioning as to whether or not I'm in periomenopause (the handful of years that lead up to the cessation of our last period.) Do I need a test to tell me this? I have learned that I do not. All women who are over 45 are in perimenopause to some degree or another. The best (and only reliable) way to gauge where you are in this process is through your age and your symptoms. But we won't go into that here - because I have other content that will go through the nitty-gritty.
Nutrition (and supplementation)
This is such a fascinating area to me. I'm nearly finished reading Dr .Haver's book The Galveston Diet. There are two main premises.
Eat an anti-inflammatory diet
Consider intermittent fasting
What's compelling to me isn't that anti-inflammatory diet is generally good for us - I think most of us know that 🙃. Until recently it hadn't occurred to me that both estrogen and progesterone (but particularly estrogen) protects me from disease, thanks partly to their anti-inflammatory properties. So when we we have our last period at menopause, we lose these key allies that have been protecting so many of our organs from inflammation for all of our adult lives.
From brain fog, to bone fragility, joint pain and belly fat - all of these menopause symptoms have rooting in inflammation. We know that HRT can bring estrogen levels back up and help address inflammation, which is amazing. But from where I sit, it makes so much sense to also ensure that my other lifestyle habits are anti-inflammatory - starting with the thing I have the very most control over - what I feed myself.
I can't recommend strongly enough Dr. Haver's book, The Galveston Diet. If you're looking for a higher touch option, Dr. Haver has a comprehensive online program to guide women through the process and offer lots of support.
Personally, I'm not rigid - I'm a firm believer in the 70/30 rule (ok I know that's supposed to be 80/20 but I meant it when I said I am not rigid LOL). I try to pack my diet with vegetables, make sure I get enough fiber and focus on lean proteins such as chicken, eggs, fish and greek yogurt. But a few times a week I'm likely to go out to dinner or even have Taco Bell with my family - because life is for living!
While I don't formally do 'intermittent fasting', I do generally stop eating at about 7/8pm and typically don't have my first meal until about 12-1pm the next day. But I love creme in my coffee first thing in the morning (breaks the fast), and I'm not prepared to give it up!!
I make sure I hydrate a LOT (usually a few 32oz water jugs a day). And I always add an electrolyte powder (Mango chili is my fave) to my first large glass of water of the day. I'm still doing research in this area but supplementing with minerals in the form of electrolytes is said not only to help restore critical elements that we lose every day by sweating and urinating, but it also helps us retain the water we drink, rather than having it pass right through. I also find that I enjoy my water so much more with a little flavor so I am much more likely to drink it (which is key :).
I've also significantly reduced my alcohol consumption since the beginning of 2023. I may go 8 weeks without alcohol and while I do still enjoy the occasional glass of wine, regular drinking just isn't conducive to the health outcomes I'm after 🙂.
The supplements I'm taking
Sparkle collagen (on Amazon) https://amzn.to/3Demmqv
Vitamin C liposomal Cymbiotika or Pique https://www.shareasale.com/r.cfm?b=1321242&u=2430463&m=8634
Magnesium Cymbiotika https://www.shareasale.com/r.cfm?b=1321242&u=2430463&m=8634
Creatine Cymbiotika lyposomal. 4mg (this is only when I lift weights)
https://www.shareasale.com/r.cfm?b=1321242&u=2430463&m=8634
I do take a Vitamin D3 with K2 but I have fluctuated brands....I don't think I have found the right one yet. I like eazy melts because they're melt-aways but I am not 100% sure of their efficacy. The search goes on (suggestions welcome!).
I take digestive enzymes and also probiotics. (I like Bye bye boat (recommended by one of you! And also Seed probiotics).
I am probably forgetting something...I will update when this peri-menpausal brain fog lifts :)
HRT - Estrogen/Progesterone
A lot of my discussion with Dr. Haver focused on why it makes sense for most women to supplement with estrogen and progesterone (for those who have a uterus.)
I recently had a consult with MyAlloy, the online service that offers science-based solutions for women over 40 who want to address symptoms of menopause. I've been using the MyAlloy M4 cream and testing it on my friend Ange - more soon).
I absolutely love the idea of the MyAlloy service. As Dr. Haver mentioned in her video, one of the biggest roadblocks to getting women the care they need for peri/menopause is the lack of practitioners trained specifically on menopause - and with all of the very latest understanding of how menopause impacts our body, and what we can do about it. MyAlloy's entire reason-for-being is to just that; connect women who have symptoms/questions/concerns about menopause directly with their team of highly qualified menopause doctors who are trained on the very latest findings on how menopause impacts our bodies, and what we can do about it.
While I only have a few obvious symptoms (occasional brain fog, NEW anxiety I never experienced before, DRY SKIN, itching ears, some fatigue that's new etc) of menopause, due to my age, I know I'm in perimenopause. And because of all the things I've learned in the past year about peri/menopause, I wanted to make sure I'm doing all I can to protect my brain/bones/heart etc, even if I'm relatively symptomless. So, after an online consult, the doctor at MyAlloy prescribed me a low-dose birth control pill.
*MyAlloy - what's in their HRT options:
Estradiol Patch: FDA-approved, plant-based, bio-identical hormone treatment
This is the one I'll go on when it's time. It's handy (needs to be reapplied twice a week) and also avoids the major risks associated with taking estrogen in a pill form (so better for people who are smokers, overweight, have vein issues or a risk of diabetes) - but it is more expensive than the pill.
Estradiol Pill: FDA-approved, plant-based, bio-identical hormone treatment
(if you don't have a uterus you'll receive oral progesterone with both of the above)
*You can use code penn20 for $20 off your first purchase of any product from their site. I encourage you to sign up for their information, and at least familiarize yourself with everything they offer educationally. Aside from the skincare option the other information on their site is INVALUABLE.
🇬🇧 NOTE FOR UK RESIDENTS: MyAlloy isn't available outside of the UK, but UK residents have HRT available on the NHS. From 1 April 2023, the Department of Health and Social Care announced they are introducing the HRT PPC to reduce the cost of HRT prescriptions. The HRT PPC costs £19.30 for 12 months. It will cover all your eligible HRT prescriptions for that period, no matter how many different medicines you need. Many forms of estrogen and progesterone are covered as are a few other things (I'm told its best to order your HRT separately to other medications so you can use the exemption certificate without any problems 🙂)
Exercise
My weekly exercise program consists of daily long walks with my dog and/or with a human that I Iove) and, critically, lifting heavy weights 3-4 times per week. These things are non-negotiable for me and have been for years.
There is so much data on how critical strength training is for women at all ages, but especially when we're approaching menopause. We must maintain our muscle mass as we grow if we want to age well. Lifting heavy weights has scores of benefits including protecting our bones, increasing our metabolism (so we burn more at rest), enhancing our brain function, and so many more. I plan on talking about this more in the future, but for now I so encourage you to explore this amazing form of exercise
This from the article "Resistance Training is Medicine"
"Inactive adults experience a 3% to 8% loss of muscle mass per decade, accompanied by resting metabolic rate reduction and fat accumulation. Ten weeks of resistance training may increase lean weight by 1.4 kg, increase resting metabolic rate by 7%, and reduce fat weight by 1.8 kg. "
Sleep
Sleep is perhaps the best medicine in the world. It's when we 'recreate' ourselves for the next day. But I hear from so many women who are in peri/menopause that sleep eludes them. The term 'sleep hygiene' is relatively new and was developed, I imagine, to help us escape from so many of our modern temptations (can you imagine your grandmother hearing you talk about 'sleep hygiene' 😂)
But lack of sleep is no laughing matter!! For me, my routine starts first thing in the morning when I go out to get morning sun in my eyes (a suggestion from Andrew Huberman in his handy Sleep Toolkit. I also make sure I don't consume caffeine after 1pm. But I'm not an expert on sleep so I rely on people like Huberman
Stress reduction
Honestly, looking after my sleep, nutrition and exercise all contributes to helping me manage my stress. in addition, having wonderful and supportive friends and family and handy pets can be amazing when the pressure is high and I need to ground myself.
In addition, these are some of the top things I do when I feel stressed:
Setting boundaries - knowing how to say no (even to myself and opportunities that I really wish I could pursue!!)
Breathing (you don't need an App, but there are some nice ones like Breathwrk if you like the support)
Meditation. There are some great free options on YouTube!
Organizing my space. I do this every few days. I tend to create 'little messes' when I'm working on content. But interesting enough, I find it so soothing to take an hour or so just to methodically put things away when the cyclone has passed 😂
Take a walk in nature. I cannot emphasise enough how helpful this can be.
Focus on routine and habits. I adore Atomic Habits by James Clear
PEMF - stress management ... overwhelmed and tired (I wake up at 5am). Mika (my pup) lays on mat with me. 15 mins. stepping away and taking a moment to be quiet. Time out.
Hypnosis. I've recently heard about the Aura App from a friend who absolutely swears by it for helping her sleep and get into a better state when she feels ruffled (and when breathing and meditation seem not to be enough).
Finally, I think the ability to take proper vacations and really escape from our routine and 'life' is vital. We are so plugged in and switched on these days. I'll admit to having difficulty resisting the urge to check my phone constantly while on vacation. But the times when I allow myself to be completely present (with nature, family, friends, myself) pays such amazing rewards. I return to the 'real world' feeling 'recreated' (which is what recreation is meant to do!!)
Skin
I'll soon be creating more content about how to support peri/menopausal skin. But everything we've ever talked about on the topic of 'collagen induction' is so appropriate here - microneedling, RF etc. As is retinoid and derivatives, AHAs, etc. Keep posted for my update on MyAlloy's M4 topical estriol for the skin:
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