Other than knowing that it will ‘happen at some point’, what conversations are we having about perimenopause and menopause? Where are the dinner party table discussions that go beyond hot flashes and low sex drive? Emma Bardwell’s work is here to change that, normalising conversations about menopause so it doesn’t feel like this big and scary transition. We spoke to Emma about her journey into women’s health, why it’s so important and what we can be doing to learn more and prepare ourselves for perimenopause and menopause.
What pushed you towards focusing on perimenopause and menopause in your practice?
I decided to specialise in the menopause transition around 10 years ago. At the time it wasn’t really talked about much. Clearly a lot has happened in the last few years with celebs and numerous documentaries and books and podcasts throwing a spotlight on the subject, which has been welcomed by all. But back in 2016, when I was entering perimenopause myself in my early 40s, I couldn’t get the support and evidence-based information I needed.
Women’s health is woefully under researched and misunderstood. Lots of women simply aren’t getting the answers they need, which means they’re vulnerable to the misinformation and pseudoscience that’s so prevalent right now. I’ve set about bridging that gap with evidence-backed strategies that get results and through my social media, books, events and media work.
What are the most common misconceptions about perimenopause and menopause and why do you think they still exist?
The biggest misnomer is that it’s something you experience when you’re ‘old’. My youngest client was just 14 when she went into full blown menopause. This goes to show that you’re never too young to be menopausal, despite what many medical professionals tell you.
It’s also important to recognise that perimenopause can start 10-12 years before menopause, which means lots of women start to feel changes in their late 30s. Again this isn’t often recognised when they visit their GPs and many are made to feel they’re going crazy or that their symptoms aren’t real.
And finally no one is talking about the fact that some ethnicities go through it earlier than others. For example the average age of menopause for Black and South East Asian women has been shown to be around 5-7 years earlier than that of white women. This is important information, why is no-one highlighting it?
Historically there’s been a real lack in both funding and research into women’s health; what’s the best and safest way for women to learn more about their bodies and the changes they’re going through?
Don’t rely on social media! Seriously, there’s so much pseudoscience and menowashing on there, it’s hard for women to know what and who to trust. Check people’s credentials. If someone’s shilling supplements, give them a wide berth. If anyone talks about hormone balancing diets, or talks in blanket statements without nuance, or makes you feel fearful around food or HRT (taking it or not taking it), I’d say avoid them. Same goes for people operating outside their scope of practice – personal trainers, for example talking about nutrition when they’re not qualified to do so.
The local societies – BMS (British Menopause Society), NAMS (North American Menopause Society), AMS (Australasian Menopause Society) all have patient arms on their website which are good sources of information.
I obviously also have to mention my book The Perimenopause Solution which is evidence-based and covers everything you need to know – from pharmaceutical interventions, to sleep strategies, to weight management and lots more. It regularly gets recommended by GPs.
For a great impartial doctor, look out for endocrinologist Annie Mukherjee who is brilliant on podcasts, has experience of breast cancer herself and always has a wonderfully positive outlook.
How can our diet affect how we experience perimenopause and menopause?
Food is fundamental to our physical and emotional wellbeing. It powers us through a busy day, helps us think straight and staves off illness. Thanks to the immense body of scientific research linking nutrition to health outcomes, we know that what we eat matters during menopause. And it’s not just about managing symptoms here and now, it’s about thinking further ahead too. We want to make sure our health span, not just our life span, is optimised. We want the post-menopause chapter to be vital and robust. Nutrition and exercise are essentials to future-proofing your heart, bones, brain and energy levels.
And what lifestyle changes can help manage the common symptoms of menopause?
Now’s the time to embark on a health audit. Get your thyroid, B12, folate, iron, vitamin D levels checked. Deficiencies in these can mimic symptoms of perimenopause but equally the two can co-exist alongside each other. I see lots of women with hair loss, palpitations, itchy skin and restless legs who have suboptimal iron levels. It’s a relatively easy fix but you need to know your numbers.
While you’re there get your LDL, hba1c and triglyceride levels checked as they’re the biomarkers to know in order to prevent future risk of diabetes and heart disease.
And start finding a form of exercise/movement that you enjoy, ideally one that helps you build muscle. We lose muscle as we age and as we head into menopause and it’s vital for so many things, including metabolism, energy, blood sugar regulation and weight management.
What are some specific ingredients that we should be incorporating into our diet to help us prepare for perimenopause and menopause? And what about when we’re experiencing them?
Focus on eating a good source of protein with each meal, alongside lots of plants and some healthy fats. This gives you the building blocks and the energy you need to fuel you through the day.
Phytoestrogens are plant based foods that contain oestrogen-like compounds. Some research suggests they can be helpful at alleviating hot flushes, although the evidence is mixed. Either way, it’s worth including them in your diet as they taste good and have other benefits such as lowering cholesterol. Heavy hitters include soya based products like tofu, tempeh and edamame beans, plus chickpeas, flaxseeds, sesame seeds and green and black tea.
Try to minimise snacking and alcohol as much as possible, minimise ultra processed foods and aim for three calcium sources a day: dairy, fortified plant milks, sardines, broccoli, tofu, almonds, kale, spinach, white beans and oranges are all good sources.
Supplements are highly individual and most are not necessary (beware of meno washing!) but everyone who lives in the northern hemisphere needs vitamin D from October - March. The RDA is 10-25mcg a day but it’s very personalised. I advise getting your levels checked with your GP and taking it from there. If you decide to supplement, choose a vitamin D3 variety combined with vitamin K2 as this helps strengthen bones and teeth, as well as helping immunity, mood, skin, muscle and metabolism. It’s a real all-rounder.
Creatine monohydrate is also very helpful for menopausal women (all women in fact!). It helps with muscle building, stamina and recent research is now linking it with brain benefits. Magnesium glycine may help with anxiety, sleep and restless legs and a B complex could be helpful for fatigue.
And if you’re not eating 2 portions of oily fish a week, get a good fish oil (or algae oil if you’re vegan) for the omega 3 fatty acids that they contain. Vital for heart, skin, brain and metabolism. Try them for 12 weeks. If you don’t feel they’re making any difference don’t bother re-purchasing. As always, please check with a healthcare provider before starting any new supplement.
Sign up to Emma’s high protein/high fibre 2 week meal plan here.