Understanding Hormonal Shifts
During perimenopause and menopause, your body goes through a bit of a hormonal roller coaster, especially when it comes to estrogen and progesterone. Estrogen, a sex hormone often associated with youth and vitality, begins to fluctuate before it eventually drops. This can cause a slew of symptoms, including many hallmark signs of menopause, like hot flashes, night sweats, mood swings, and vaginal dryness. (1) Progesterone, a hormone involved in menstruation and pregnancy, also takes a hit during perimenopause, leading to issues like weight gain, irregular periods, and difficulty sleeping. (2, 3)
But it’s not just estrogen and progesterone that are causing a stir during this transition. In fact, cortisol (also known as the body’s main stress hormone) also plays a key role. As the balance of estrogen and progesterone shifts, cortisol can become more dominant, contributing to anxiety, depression, and surging stress levels. (4, 5, 6) Not only that, but increased cortisol can also mess with your metabolism, sleep, and energy levels, making these hormonal transitions even more tricky. (7, 8)
How Hormone Changes Affect Metabolism and Cellular Health
The hormonal fluctuations that occur during menopause and perimenopause don’t just affect how you feel; they can impact everything going on inside your body, right down to your cells. Estrogen, in particular, plays a central role in metabolic health by influencing how your body uses and stores energy. (9) As estrogen levels plummet, your metabolism slows down, your insulin sensitivity may drop, and the distribution of fat in your body might even shift, typically towards your stomach. (10) And with less progesterone, your sleep can also suffer, which may take a toll on your energy levels and metabolism. (11, 12)
At a cellular level, the drop in estrogen and progesterone can also impact the function of your mitochondria, also known as the powerhouse of the cells. Estrogen supports energy production by promoting the creation of new mitochondria and enhancing their efficiency. (13) But when estrogen levels fall, the mitochondria become less efficient, leading to lower energy levels. This process is amplified by other age-related changes, including a decline in nicotinamide adenine dinucleotide (NAD+), an enzyme involved in energy metabolism and mitochondrial function. (14)
On top of that, hormone fluctuations can also dial up inflammation. Because estrogen has powerful anti-inflammatory effects, the natural decline in estrogen levels that occurs during menopause can trigger your body’s immune system and increase inflammation. (15) Additionally, higher levels of cortisol can disrupt immune function and contribute to inflammation. (7) And while acute inflammation helps protect your body against illness and infection, sustaining high levels of inflammation long-term can actually contribute to chronic health issues, including heart disease, diabetes, and cognitive decline. (16)
Navigating the Shift: Your Hormone Health Game Plan
While tackling all of the hormonal changes tied to menopause might seem like a tall order, making a few smart shifts to your daily routine can have a big impact. Here are a few ways to help bring your hormone levels back into balance and maintain your energy levels, cognitive clarity, and metabolic health, through midlife and beyond.
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Stay active: Making exercise a regular part of your routine may help reduce symptoms of menopause. It may also improve other common issues that occur during midlife by enhancing mood, reducing bone loss, improving physical function, and increasing muscle strength. In fact, one study found that women with high or moderate levels of physical activity experienced less severe menopausal symptoms compared to inactive women. (17)
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Try adaptogenic herbs: Adaptogens are compounds that can help your body manage stress more efficiently. (18) Ashwagandha, ginseng, and maca are a few science-backed supplements that could help ease the ups and downs of menopause. (19, 20, 21)
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Increase your intake of phytoestrogens: Foods like flaxseed, tofu, and edamame contain phytoestrogens, which are natural plant compounds that support estrogen balance, especially during menopause. (22)
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Get plenty of sleep: Quality sleep can benefit almost every aspect of health, from hormone balance to heart health, cognition, mental health, and more. (23) Although menopause can definitely mess with your sleep, do your best to clock 7–9 hours per night to optimize health. (24)
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Minimize stress levels: Cortisol dysregulation is believed to worsen symptoms of menopause, including hot flashes. (25) On the other hand, stress-relieving practices like mindfulness have actually been shown to improve symptoms of menopause by preventing emotional dysregulation and rumination, or the endless loop of negative thoughts. (26)
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Consider NAD+ supplements: Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) can both boost levels of NAD+, which could help counteract some of the adverse effects of aging on metabolic health. (27) Case in point: one 10-week study found that NMN could increase insulin sensitivity in postmenopausal women with prediabetes. (28) Another study in cell cultures found that NR could reduce inflammation and oxidative stress by blocking metabolic changes and activating sirtuin 1 (SIRT1), an enzyme involved in aging and metabolism. (29)
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Soak up some sun: Getting a few minutes of sun exposure (especially right after you wake up) can help support circadian alignment, improve sleep quality, and enhance your mood. (30)
Conclusion
Even though navigating the hormonal shifts of perimenopause and menopause may feel overwhelming at times, it doesn’t have to be. Understanding how these changes impact your metabolism and cellular health is the first step in taking back control. And with plenty of sleep, physical activity, and targeted nutrient support, you can help bring back balance as you begin this new chapter.
