Perimenopause – Carbs

I started a deep dive into women’s health and hormones around two years ago. As the world is waking up to the fact that, until now, we have barely even scratched the surface on everything there is to know about our hormonal health, I am always encouraging my fellow fitness professionals to look into these topics. I especially recommend that male Personal Trainers do some research or read what women have published as men don’t have our lived experience and therefore have little understanding organically what it feels to be a woman (in sport or otherwise).

What made me look into it all?

Most of my clients in the recent years have been women aged 45+, with many of them experiencing symptoms of perimenopause and the changes that this phase of life brings. As their Trainer, it is my duty to know how to support my clients best and understanding what they are going through is the first step to helping them reach their goals more easily.

As I had already started looking into the symptoms and scientific research to understand what exactly happens to the female body during peri- and post-menopause, you could say I was also more aware and sensitive to any changes in my body on a day to day basis. After I tried my first and last ever bulk early last year and then switched back to carb cycling, I noticed that the bodyfat I had put on was actually not shifting as quickly as it normally would have after a muscle building phase. I had also started having regular night sweats, very restless sleep, brain fog and my mood was really quite low most of the winter all the way up to May, which was not like me at all.

At this point I knew the symptoms could have been a sign of perimenopause and while I was definitely not comfortable in my body or mind, I suddenly felt such a drive to find out even more. I started reading books and following female sports scientists for latest research to support my newly found purpose and to satiate my hunger for knowledge.

When it comes to my sleeplessness, I had tried many different approaches – leaving out caffeine for a bit, I had even moved my bedroom around in hopes that a bit of feng shui would help and to figure out why I would be experiencing insulin resistance, I used a glucose tracker to ensure I don’t have some other type of health issue. (I have since written a blog post on this.)

Fast forward to my solution: it was only once I reduced starchy and processed carbs in my diet that I was able to start to feel like myself again – minimal water retention and no bloating. We’ll come back to me briefly at the end of this blog but now, let me talk you through the foundations of the topic of menopause.

What is the difference between pre-, peri- and post-menopause?

Pre-menopause – Although one might expect this to start with our first period, pre-menopause is considered our life from birth till 35-45 years of age while our oestrogen levels remain high (with normal fluctuations throughout the menstrual cycle).

Peri-menopause – the start of irregular periods, which can take anywhere from 4 to 15 years. On average, a woman arrives at menopause around 50-51 years of age. Often when menopause and its symptoms are being discussed, the actual phase in question is peri-menopause.

Menopause – Naturally, menopause is a moment in time. A single day when a woman’s periods cease entirely. Medically, menopause is announced once the woman has been period-free for 12 months. Isn’t it fascinating that, officially, one does not even find out they are in post-menopause until a year into the new phase?

Post-menopause – Our life from menopause till the end of our days.

Peri-menopause and the biggest changes

Perimenopause, which can last around four to fifteen years (depending on how early the symptoms began) is similar to the late luteal phase where our bodies’ ability to interact with insulin and carbohydrates changes. We can become more carbohydrate sensitive and insulin resistant, which, at the very least, will lead to unwanted weight gain, constant bloating and water retention.

Just like we tend to weigh more for days before our next cycle starts (some of you have reported a weight gain of up to 5kg), perimenopause can have one struggling to lose weight for years. Adding the fact that perimenopause also affects our sleep, and that lack of sleep affects our appetite and makes us crave more carbs makes it all a vicious circle. But knowledge is power and while we still have to keep going through life as fully-functioning people and fuelling our bodies, it does make it a little bit easier when you know what to avoid or which foods to steer towards.

So what to do about carbohydrates?

In short, we keep eating them but we have to manage the quantity, choose our sources more carefully and, most importantly, their intake must be timed optimally – this is what’s called carb manipulation.

Carbohydrates are the first source of energy for higher intensity exercise (muscle glycogen) and the preferred fuel for our brain (liver glycogen). In sports, carbs improve performance and delay fatigue. While a person with ample adipose tissue can utilise bodyfat as fuel and use their training to lean out, an individual with lower bodyfat absolutely must consume carbs. If they don’t, they will risk breaking down hard-earned muscle and therefore leaving themselves metabolically worse off, which is never a good idea, especially during peri-menopause.

Natural carbohydrates that humans have been eating forever (fresh fruit, vegetables, whole grains) are quality foods – these are carbs for life. When carb rich whole foods are processed and turned into something else, they become carbs for fun. Although the latter is also fine occasionally, this is really the time to reduce processed carbohydrate intake to minimise the discomfort and negative side effects of consuming such foods in this phase of life. To help, I can suggest strategies to offset the increased carbohydrate sensitivity that can happen during peri-menopause.

What you can do to minimise the discomfort of peri-menopause

Physical exercise – Especially resistance training and lifting weights that builds lean tissue. When you are physically active, you’re producing glucose transporters, which partner with insulin to regulate your blood sugar. By lifting weights and breaking muscle down to build new lean tissue, you’re also ensuring that the muscle glycogen ‘bellies’ are optimally filled, storing carbs as energy to produce force when training. In addition to that, exercise and movement in general makes it easier to manage your blood sugar in the hours after you eat.

A balanced diet – Consuming carbs with other macronutrients helps reduce the glycemic load of your meal, providing an even release of energy over longer hours after eating. This also helps you avoid ‘carb stacking’, which means having multiple sources of carbohydrates in one sitting. With no protein to slow digestion, this leads to the spiking of one’s blood sugar and then the unavoidable ‘crash’. Add protein with your carbs at every meal, especially breakfast to start the day off with steady energy.  

Fibre intake – Fibre feeds gut health by nourishing essential microbes. A study recommends that athletes aim to eat 14 grams of fibre per every 1,000 calories, which would mean 28 grams for active women on most days. Insoluble fibre helps prevent blood sugar spikes, eases digestion and keeps your digestive tract healthy. Eating more insoluble fiber means eating more vegetables and a more plant based diet in general, which research shows can dramatically improve menopause symptoms. Do remember that because fibre slows digestion, you don’t want to load up right before or after a hard workout.

Before we continue to Part 2 of this series, I will follow up this blog with more on carb manipulation to help you understand the tactics and apply these to your diet and training schedule. So, now to wrap it up…

Am I perimenopausal?

The short answer is: I don’t know, I might be. But I have to be entirely honest and say that since the very bumpy winter last year (2022/23), I haven’t really struggled with anything. I sleep well, I train hard and my diet has been largely on point. I did not experience a single day of SAD this winter and have thoroughly enjoyed life. Although the sensitivity to processed carbs remains, as long as I control their intake, I do not notice any issues with my energy levels.

The only change that got my attention lately was to my menstrual cycle. After a decade of predictably regular periods based on a consistent 26-28 day cycle, my most recent period was 5 full days late, lasted 8 days instead of the usual 5-6 and was followed by several days of spotting. The two periods before that one were also a week long. There is no discomfort or worry and I am actually curious and excited because entering into a new phase, be it considered early or not, means I could help many more women by sharing my lived experience and introducing you to many other professionals who have helpful stories and information to share. So, let’s see what the future brings!

What next?

If you also might be wondering if the irregularities in your cycle, sleep, energy levels or body composition have anything to do with perimenopause, my best advice is to keep reading more because knowledge is power. I will continue to post on the topic to bring you more in-depth views of nutrition and training in relation to perimenopause. I also highly recommend following Dr. Stacy Sims on Instagram for bite-sized pieces of the latest research.

So, let’s draw this blog to a close and I will speak to you in the next one. Before I go, I would like to thank my clients and friends who have freely indulged me in detail about their experience with menopause and the challenges it brings. Your stories will be told very soon!

As always, I hope you found this helpful. Please leave me any questions you might have and I will answer them directly and also possibly include the topics in future blogs.

Have a wonderful week,

Rahel xx