The perimenopause acts as a critical opportunity for your health and to correct any imbalances before your transition into menopause. The Dutch Plus test can help you to make informed decision about your hormonal health.
Understand Different Menopause Stages and the Symptoms
Professor Prior a Professor of Endocrinology (the study of hormones) often talks about the four stages of a woman’s hormonal journey throughout the menopausal phases and is commonly described in the context of reproductive ageing;
Pre menopause.
The reproductive phase before any noticeable hormonal changes associated with menopause occur. This is typically characterised by regular menstrual cycles, stable levels of oestrogen and progesterone. Normal fertility and hormonal balance would be expected and this typically lasts until late 30s or early 40s.
Perimenopause
The transitional phase leading up to menopause, where hormone levels (especially oestrogen) fluctuate. This can be characterised by irregular periods (may become longer, shorter, heavier, or lighter). Symptoms like hot flashes, night sweats, mood swings, and sleep disturbances can be present. Begins with noticeable cycle changes and ends 12 months after the last menstrual period. Typically lasts 4-10 years but can vary widely.
Menopause
The point when a woman has gone 12 consecutive months without a menstrual period. Officially marks the end of ovarian function and fertility. Symptoms like hot flushes, vaginal dryness, and mood changes may continue or intensify. Hormone levels will have reduced with progesterone finishing and oestrogen remaining at a low level . Typically happens between 45-55 years.
Post menopause
The phase following menopause, lasting for the rest of a woman’s life. Symptoms of menopause (like hot flashes) may persist for several years but generally diminish over time. Increased risks for health issues such as osteoporosis, cardiovascular disease, and urinary tract changes due to low oestrogen levels. Focus shifts to long-term health and managing age-related risks.
Menopause Risk Factors
Menopause is a natural phase of life, but it comes with several health-related risk factors due to the hormonal changes that occur, particularly the decline in oestrogen. Understanding these risks can help guide preventive strategies and management. Below are some of the risk factors associated with menopause:
Osteoporosis and Bone Health Risks
Declining oestrogen levels accelerate bone loss, reducing bone density. This increases the risk of fractures but also the likelihood of developing osteoporosis. The bones also can hold certain toxins, such as lead, and as we lose bones this is then released and can cause further complications.
Cardiovascular Disease
Oestrogen plays a significant protective role in the cardiovascular system, which is why the risk of cardiovascular disease (CVD) increases in women after menopause when oestrogen levels decline. Oestrogen helps to regulate cholesterol and promotes HDL (good cholesterol) over LDL, which is considered the worst cholesterol due to the build p of plaques. Oestrogen also acts as an anti-inflammatory, antioxidant and promotes te production of nitric oxide, that is essential for blood vessel health.
Weight Gain and Metabolic Changes
Hormonal shifts can slow metabolism and promote fat redistribution, particularly around the abdomen. Oestrogen improves insulin sensitivity and glucose metabolism, as we lose oestrogen insulin resistance can become more common. Insulin resistance is the condition of having chronically elevated levels of insulin, while the cells have lost the ability to respond to this. Insulin then keeps rising as the cells aren’t responding and is linked with type 2 diabetes
Mental Health Concerns
As we mentioned above perimenopause can start with the reduction in progesterone and initially fluctuating oestrogen. As you reach menopause oestrogen levels will also have dropped. Losing both oestrogen and progesterone can be quite destabilising for both your brain and nervous system. Hormonal fluctuations can affect mood-regulating neurotransmitters. This can cause a higher risk for depression and anxiety or cognitive decline or memory issues (sometimes referred to as “brain fog”). Building the health of these areas and managing stress and the adrenal glands is imperative for managing mood problems later in life.
Sleep Disturbances
Hot flushes, night sweats, and hormonal changes disrupt sleep patterns. Chronic sleep deprivation can exacerbate mental health issues, weight gain, and fatigue.
Testing hormone levels to help guide the best steps to help your hormone health
Testing hormone levels before introducing any hormonal therapy such as HRT or supplementation is essential to ensure safety, efficacy, and tailored treatment. Testing provides a clear picture of hormone levels (e.g., oestrogen, progesterone, testosterone and cortisol) and helps identify specific imbalances. In addition the DUTCH test also looks at the ratios between the 3 oestrogens and the pathways that are used to remove excess oestrogen – showing if you are removing oestrogens down the safer pathways. It also means any underlying conditions can be ruled out. Symptoms like fatigue, mood swings, or hot flashes may mimic other conditions such as thyroid dysfunction, adrenal fatigue, or other health issues. Hormone levels vary greatly between individuals. Testing ensures treatments are customised to your unique needs.
Ideally, we want to check levels of hormones first and you can do this with our DUTCH tests. Understanding which pathways need support is the quickest way to optimise your hormones, energy and mood.
Which test Should I Choose to tell if my hormones are out of balance?
Advanced tests like the DUTCH test can reveal how hormones are metabolised, indicating potential issues with detoxification pathways or risks. We have a wide range of DUTCH Tests and I wanted to differentiate as to when you might use these. The DUTCH test is broken down and has up to 4 sections included, that are listed below:
- DUTCH Sex Hormones
- DUTCH Adrenal
- DUTCH Organic Acid Tests
- DUTCH Cortisol Awakening Response
The DUTCH Plus is the most comprehensive and that includes all 4 sections above. The DUTCH Complete covers the top 3 (Sex hormones, adrenals and organic acids). If you do not have a regular cycle then all of the tests have the cycle mapping option which tracks hormone levels over a cycle. .Without a regular cycle or if you are struggling with infertility or have no menstrual bleed then a one-day sample will not suffice. The cycle mapping option looks at nine measurements across the follicular, ovulatory and luteal phases of the cycle.
If you are retesting and just want to look at the Sex hormones then there is a stand alone test for that (DUTCH SEX HORMONE Panel For Women). This can be useful for monitoring Hormone Replacement Therapy.
Managing hormones during menopause involves addressing the symptoms of hormonal decline and imbalance while monitoring overall health. Proper testing ensures tailored interventions that improve quality of life while minimising risks.
Finally, if you are concerned about your hormone levels or stress, we also have a team of fully qualified Functional Medicine practitioners, Nutritional Therapists and GP’s on hand that we can refer you to to help.