When you're not ok.
What's the link between perimenopause and anxiety? Simple ways to support your liver health and a Matcha & Almond Energy Ball recipe
When someone asks how you’re doing, it’s so easy to respond with ‘yeah, fine’, as if on auto-pilot. But sometimes, you’re just not ok. In some ways, it may feel slightly self-indulgent to launch into a monologue about how you’re honestly feeling when actually there’s so much to feel grateful for. A survey report from the Fawcett society (May 2022), based on data from the largest ever survey of menopausal and perimenopausal women in the UK, reported that 69% of women experience difficulties with anxiety and depression due to menopause. But often women don’t make the link between feelings of anxiety and perimenopause and don’t realise that there are many strategies that may help — whether that’s through diet, lifestyle, supplements, HRT, medication or therapy. In this month’s Midlife Bites, I explain what may be causing this common symptom of anxiety and look at what we can do to help with these sometimes debilitating feelings.
This month’s habits are focused on what we can do to support our liver health. Your liver has so many critical roles — including managing hormonal balance, detoxification and overall metabolism — and there are some simple changes that you can adopt to make sure you’re not putting it through any additional stress. By maintaining a healthy liver, you can also help manage the symptoms of perimenopause more effectively, not to mention benefitting your overall health.
Matcha is a great ingredient to include in your diet as it’s rich in beneficial polyphenols called catechins (antioxidants that help prevent cell damage), as well as helping to support liver health, reduce inflammation, improve brain function, reduce the risk of heart disease and support healthy metabolism. The recipe this month is Matcha & Almond Energy Balls (if you’re experiencing anxiety, choose a decaffeinated matcha) — a super nutritious snack to have in the fridge in case you feel peckish.
For paid subscribers, I take a look at whether collagen supplements are really worth the hype, or are they just another wellness fad? Plus, if you do want to try a collagen supplement, I share my tips for picking out a quality product.
For all readers, if you’d like to discuss your health goals — whether that’s how to ease your perimenopause symptoms, or how to improve your gut health, or to generally support your overall health for the long term, go ahead and book a free 1-to-1 chat — I’m here for you!
Is perimenopause making you anxious?
Anxiety is a common symptom of perimenopause that may hit you suddenly or creep up gradually, leaving you feeling overwhelmed and stressed. For some women, anxiety is the first symptom they experience, even if they don’t have a history of mental health issues. If you’ve been feeling irritable, worried, have trouble relaxing, concentrating or falling asleep, or have been experiencing panic attacks, these can all be symptoms of perimenopause anxiety. But what causes these mental and emotional changes?
When we talk about the hormone fluctuations in perimenopause, we’re usually referring to the reproductive hormones, oestrogen and progesterone. But it’s important to also note that all hormones are part of a complex ecosystem, where many of them influence the production of others. There are oestrogen and progesterone receptors throughout the body, so with the dramatic hormonal peaks and troughs of perimenopause, every area with receptors may be affected, including the structure and functions of the brain, leading to these feelings of heightened anxiety. Research has shown that oestrogen is linked to levels of serotonin (the ‘happy hormone’) in the brain, as well as the stress hormone, cortisol. Experiencing anxiety particularly in the morning is another common symptom as cortisol levels naturally peak at this time to wake you up, but too much and you may be left feeling anxious.
The physical symptoms of perimenopause can also affect our anxiety levels, especially if issues such as weight gain, hot flushes, night sweats and sleep disturbances are affecting your day to day. All of this coupled with family responsibilities and work stress, there’s a lot going on that has the potential to make us feel anxious.
So what can we do to help with these feelings? Getting enough sleep, exercise and eating a healthy balanced diet, limiting sugar and processed food may all have a positive impact on your wellbeing. Cutting down on alcohol will also help with reducing anxiety — have you ever woken in the middle of the night after one too many glasses of wine only to not get back to sleep because your mind is racing imagining impending doom? Relaxation techniques such as meditation, mindfulness and yoga have been shown to be helpful ways to offset anxiety. Exercising in the morning, when cortisol levels are higher, may help improve cognitive function and reduce stress levels throughout the day.
There are also a number of key nutrients that may be useful to include as part of your diet if you’re feeling anxious:
Magnesium is often known as ‘nature’s tranquiliser’. It’s vital for many aspects of health, from energy production, muscle function, sleep and the ability to cope with stress, to bone, cardiovascular, nervous system and hormonal health. Research has shown that higher dietary magnesium intake is related to better brain health, particularly in peri-and post-menopausal women. Good sources of magnesium are: green leafy veg; avocados; black beans; wholegrains; flaxseeds; chia seeds; and dark chocolate.
Zinc is also essential for supporting our health — it improves hormonal balance and encourages progesterone production, as well as supporting immunity, reducing inflammation, promoting healthy skin and wound healing. Zinc also supports the hippocampus, the part of the brain that dials down cortisol and the stress response. Sources of zinc include meat, poultry, cheese, shellfish (eg oysters, crab and mussels), pumpkin seeds, lentils and chickpeas.
L-Theanine is a compound found in matcha and green tea that aids relaxation and supports mental wellbeing. It helps increase levels of neurotransmitters like GABA, serotonin, and dopamine, which are crucial for regulating mood, alertness and sleep.
Taurine is a semi-essential amino acid (a building block of protein) that your body uses for a wide variety of processes; it’s structurally similar to GABA, so has similar actions when it comes to reducing stress, anxiety and promoting sleep. Oestrogen plays a role in regulating taurine levels in the body, and as oestrogen levels decline during menopause, so does taurine. As taurine declines with age, it’s important to make sure that you’re including enough in your diet (or consider supplementation, if appropriate). Food sources include shellfish (especially scallops, mussels and clams) and dark turkey and chicken meat.
There’s a lot we can do to support our mental health through diet and lifestyle changes, but if anxiety is becoming too challenging for you, do get in touch for a chat. Also, don’t be afraid to speak to your GP for help.
To support your liver
What has your liver got to do with perimenopause? In fact, with over 500 different functions, looking after your liver health is something that we shouldn’t overlook during midlife. The liver works to filter and clean the blood, support blood sugar balance and store energy, balance hormones (especially important during perimenopause!), store vitamins and minerals (including A, D, K, B12 and iron) and help with digestion. Oestrogen also supports liver health, so as this hormone fluctuates and declines, overall liver function may also decline.
But does supporting our liver mean going on the latest 7-day juice cleanse, or jumping on a new liver detox fad? Absolutely not. It’s important to remember that the liver is the body’s natural detoxifier and to make sure it’s functioning at its best, we want to be packing our diets full of plenty of nutrient-rich wholegrains, cruciferous vegetables and protein, as well as protecting it against stress, such as potential environmental toxins. Here are three simple ways to support your liver during perimenopause:
Eat a wide range of colourful fruit and veg: Aiming for 30 different plants a week is a great way to introduce antioxidant-rich and fibre-dense foods into your diet. Cruciferous vegetables such as kale, cauliflower, broccoli, Brussels sprouts and cabbage are particularly important as they support liver detoxification processes.
Cut down on alcohol: While your liver is busy detoxing alcohol, it can’t detox hormones, which is so important when we’re dealing with fluctuating oestrogen. Try to include a few alcohol-free days every week and choose low-alcohol or alcohol-free versions of your usual drinks.
Reduce the amount of toxins you’re exposed to: The average woman is exposed to hundreds of chemicals every day (eg skincare, cleaning products, cookware), all of which her liver needs to process. So trying to eat organic foods (where possible) or changing your cosmetics and cleaning products to chemical-free versions, puts less strain on your liver.
Matcha & Almond Energy Balls
Makes: 15 balls | Time: 15 minutes
With a healthy balanced diet, three meals a day should be enough to ensure our bodies are well nourished. However, this is real life so there will be occasions when having a snack is needed — a meeting overran and there’s no time to grab lunch, you’re having a particularly hungry day, or your circumstances or lifestyle require a higher calorie intake, or you just fancy it! Think of a snack as a mini meal and try to combine fibre and protein to maintain energy levels until your next meal. Simple, nourishing ideas include: an apple with a tablespoon of almond butter or a handful of nuts; carrot sticks and a tablespoon of hummus or a boiled egg; or oatcakes and cottage cheese.
These energy balls with matcha and almonds are full of fibre, protein and healthy fats and are a great snack to batch make and keep in the fridge. Matcha which is abundant in L-theanine, supports relaxation, reduces LDL cholesterol (the ‘bad’ type), enhances focus, memory, and overall cognitive function, plus it provides sustained energy (without the jitters that you may get from coffee). Hemp seeds are also packed with essential fatty acids, complete proteins and vital minerals. They can support heart health and promote skin and digestive wellbeing, as well as alleviating symptoms during perimenopause.
INGREDIENTS
10 pitted Medjool dates (soaked in hot water for 10 minutes)
80g (1 cup) rolled oats
45g (½ cup) ground almonds
1 tablespoon matcha powder
120g (½ cup) almond butter
2 tablespoons hemp seeds
1 teaspoon cinnamon
2 tablespoons unsweetened shredded coconut (optional)
METHOD
In a food processor, blend the soaked dates until they form a smooth paste, scraping down the sides of the blender if needed. Add the rolled oats and blitz until they’re finely chopped. Add the ground almonds, matcha powder, almond butter, hemp seeds and cinnamon.
Process until the mixture comes together in a sticky dough. With wet hands, roll the mixture into small balls, about 2cm in diameter; then toss the balls in the shredded coconut (if using). Arrange the balls on a parchment-lined tray and place in the fridge for at least 30 minutes to firm up. Store in an airtight container in the fridge.
If you’re interested in working with me on a 1-to-1 basis, why not book a complimentary chat to find out more about how I can support you through perimenopause. And if you’re on Instagram, come and say hi.
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