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Journalism of Courage
Just when you hit mid-40s, you know you have to hit menopause at some stage till you reach mid-50s. But you are not sure how to navigate the confusion that happens in between simply because you do not understand your body as you get irregular periods, hot flashes, mood sings, sleep and bladder problems and palpitations. Your hormones swing and dance and you get thrown about in conditions you never had, like higher levels of cholesterol. This is what is called perimenopause, meaning “around menopause.” It refers to the time during which your body makes the natural transition to menopause, marking the end of your reproductive years.
Women start their perimenopause phase at different ages. Usually, the changes begin in your 40s but some women are now noticing changes as early as their mid-30s. In fact, several hormonal changes during perimenopause not only impact women’s bodies but also mental health. Well-known Mumbai gynaecologist Dr Nozer Sheriar and macrobiotic nutritionist Shonali Sabherwal have written a book, “Finding your Balance- Your 360° Guide to Perimenopause and Beyond” that addresses the issues related to perimenopause with a holistic focus on dietary, lifestyle and therapeutic solutions.
Why should a woman care about her perimenopause?
Dr Nozer Sheriar: Menopause has always been an integral part of women’s lives. With women living longer than witnessed at any time in human history, a third of their lives will be spent in perimenopause. Symptoms associated with perimenopause can be disruptive to a woman’s personal and professional life. Thankfully, we live in a time when physiological and hormonal changes related to menopause have been demystified. So women can opt for preventable treatments and manage associated problems.
What kind of queries do you get from your patients going through perimenopause?
Dr Nozer Sheriar: The symptoms of perimenopause may vary from one individual to another. Some may have a smooth transition, while others may complain of gaining weight despite being on diets and watching their food. Yet others may feel blue inexplicably and be irritable even around their closest families. I remember how my mother suffered. On bad days, she would use up three packets of sanitary pads in a day because of heavy bleeding and passing of clots. She complained of severe pain and was irritable and moody as well. Also, we get a lot of queries about cancer as the chances of developing uterine and ovarian cancers increase post-menopause.
Shonali Sabherwal: Symptoms such as hot flushes, sweating, palpitations and even chills are among the earliest and most dramatic symptoms that women experience in perimenopause.
How can a diet help a woman ride out her perimenopause?
Shonali Sabherwal: Everything you do starts with the way you eat. The food you choose impacts your gut health, hormones and cardiovascular systems. Moderate sugar, avoid an overload of dairy, processed and refined foods. Avoid alcohol and caffeine as they weaken the adrenaline glands. So women must eat well and adopt a healthy lifestyle as early as her 20s. This is critical. If women take control of their lives and medical conditions at a younger age, they will be spared a difficult perimenopause journey. You should also choose the right exercise, focussing mostly on your pelvic health, which women neglect. All of this will prepare you for a smooth transition in your 40s. Nobody can delay menopause but simple interventions early on can help you transit through bodily changes effortlessly. Remember, today’s women have to deal with lifestyle and environmental stressors and a bit of advance prep could ease them through the troughs.
What motivated you to write the guidebook on perimenopause?
Dr Nozer Sheriar: The idea to write the book came from Shonali. The reason it struck a chord immediately was that unlike several books on pregnancy, fertility and menopause, there wasn’t one on perimenopause. This is one area which is largely being overlooked by women, society and medical professionals. So myths and misconceptions abound. We have incorporated a lot of real-life stories of patients and experiences. Every chapter has two stories.
Using this book as a guide, we hope that women will be able to draw individual benefits as they negotiate their life-changing situations.
How is the book different in terms of story-telling?
Dr Nozer Sheriar: The book gives two voices—a medical voice and a nutrition-lifestyle perspective. The first part concerns preparing for menopause so that women can understand about their own hormones. The second part deals with medical conditions. We have tried to be more evidence-based. And the third part suggests tips, tricks and exercises that women can follow.
Shonali Sabherwal: For instance, women often complain about hot flush which is related to a disturbed temperature-control mechanism in the perimenopausal stage. So we have given a diagrammatic snapshot of lifestyle and diet management. We have suggested how performing yoga, wearing cotton clothes, getting eight hours of sleep, lying down on a gel mattress, minimising alcohol, spicy foods, caffeinated drinks among others can help a woman sail through her difficult phase.
Dr Nozer Sheriar: Sometimes, women also talk about emotional health and suffer anxiety. So we want men to read this book as well. We want men to be involved in their partners’ health.
Can you give an insight into hormone replacement therapy?
Dr Nozer Sheriar: It is also called menopause hormone therapy (MHT). It can be administered by oral and non-oral routes, depending on your age, symptoms, medical profile and to what extent your estrogen levels have dropped. We have also mentioned associated risks of hormone therapy when it comes to their impact on blood clotting and heart health.
