Almost every woman knows the signs and symptoms of menopause: the infamous hot flashes, moods that swing like a rollercoaster, your jeans suddenly not fitting for seemingly no reason, and of course, the cessation of your period. But, what about the flurry of symptoms that appear before formal menopause, like longer, heavier periods, night sweats, and insomnia? Are these simply a part of aging, or are they a different condition altogether?

Perimenopause

Research shows that these symptoms are due to “perimenopause,” sometimes referred to as “the change.” Perimenopause occurs in the time prior to menopause, where the menstrual cycle ceases completely and your body can no longer conceive.

One of the difficulties of perimenopause is that it’s known for its unpredictability. While the average length of perimenopause is four years, it can range anywhere from four months to ten years. Because of this, many women don’t realize what they’re experiencing and often end up ignoring the uncomfortable symptoms that occur.

Physical Changes and Hormonal Alterations

So, what’s happening to our bodies during perimenopause? Well, a variety of things. The physical changes to your body during this period result from hormonal alterations, specifically the level of estrogen circulating in the body. Normally, estrogen levels rise and fall quite predictably, but during perimenopause, these fluctuations become irregular. Your menstrual cycles may become longer or shorter, and there may be cycles where ovulation doesn’t occur at all.

While your cycle may no longer be the same, it’s still possible to become pregnant during perimenopause. If you wish to avoid this, it’s important to continue using contraceptives, such as birth control or other forms of protection.

Other Symptoms of Perimenopause

Along with hormone fluctuations, women may experience other symptoms, such as:

• Lower libido
• Urinary incontinence
• Memory lapses or brain fog
• Brittle nails
• Hair loss or thinning
• Unexplained weight gain and difficulty losing weight
• Fatigue
• Sleep disturbances

These fluctuations can also precipitate metabolic imbalances in our bodies. Addressing these symptoms is crucial not only to improve your quality of life, but also because we now have evidence that the hormonal changes that occur during our perimenopausal and menopausal years may be linked to disease or cognitive decline, such as Alzheimer’s.

How to Combat Symptoms of Perimenopause

While the symptoms may be uncomfortable, the good news is you don’t have to continue to suffer with them. There are a few ways to combat symptoms of perimenopause, such as:

1. Consuming less processed foods, reducing carbohydrate and sugar intake, and increasing whole foods in your diet, like:
   • Dark, leafy greens (kale, spinach, arugula, and collard greens)
   • Healthy sources of fat (avocado, walnuts, and oily fish)
   • Healthy organic proteins (grass fed beef; free range chicken breast, tofu, and low mercury seafood)
2. Stay active and focus on strength training to increase lean muscle mass and improve metabolism.
3. Increase your hydration with water and other low calorie choices.
4. Limit alcohol consumption.
5. Prioritize a good sleep schedule.
6. Take supplements that support your overall health, reduce inflammation, and balance hormonal fluctuations.
7. Consider bioidentical hormone replacement

If you begin to suspect you may be undergoing perimenopause, it’s important to consult a medical professional to ensure you can provide the best care for your body.

For many years, dementia was referred to as “the silent epidemic” – and for good reason. People were hesitant to talk about the loss of cognitive function that can ultimately interfere with a person’s daily life, even though there are nearly 10 million new cases of dementia worldwide every year. Thankfully, the topic is no longer seen as taboo, and people are much more open to discussing the reality of developing and living with dementia.

Having an open and honest discussion about the risks of dementia is especially important for women. Twice as many women suffer with dementia globally compared to their male counterparts. In this blog, we’ll break down what makes dementia different for women – from hormones to treatment to diagnosis.

Estrogen

All biological females produce a hormone known as estrogen. Many people are aware that estrogen helps control the menstrual cycle and is important for childbearing, but this hormone also affects many other body parts and systems, including our brain, liver, and heart. Some studies have even suggested that estrogen can protect brain cells.

Research has proposed that women may be less likely to develop dementia if they produce more estrogen throughout their lives. If you begin menstruating at a younger age, have at least one childbirth, or go through menopause at an older age, your risk of developing dementia may be lower.

HRT

HRT stands for Hormone Replacement Therapy. This type of therapy involves taking medication that contains female hormones to replace the estrogen that your body stops producing during menopause. HRT is typically used to help alleviate symptoms of menopause, such as anxiety and hot flashes. Some studies have shown that women who were already using HRT during menopause had a lower risk of dementia than those who were not on HRT.

In the early 2000s, doctors discovered that the risk of heart and breast cancer offset the advantages of HRT. Not surprisingly, the treatment decreased in popularity. Researchers are now trying to create more advanced and natural ways to add more estrogen to the body to reduce a woman’s risk of developing dementia.

Gender and Dementia Diagnosis

Estrogen has an impact on the brain’s growth and functionality. Research has shown that women have better memory for words and verbal items than men. These memory skills have been linked to estrogen.

To test for and diagnose dementia, medical professionals perform a verbal memory test. Women often excel in this testing method, even if they have cognitive problems. This test leads to women being underdiagnosed with dementia because they maintain memory skills even when they have brain health issues. On the other hand, men are more likely to be misdiagnosed with dementia because their verbal memory skills are not as strong.

Heart Health and Dementia

Heart health is also linked to dementia because the brain and the heart are intrinsically connected. Studies have indicated that the risk factor of poor heart health leading to dementia may also be linked to sex. High blood pressure in middle-aged women, for example, is thought to increase the risk of developing dementia. This link between high blood pressure and dementia is not the case for men.

Method of Diagnosis

In the future, we need to focus on person-centred care and diagnosis for dementia. Our methods of dementia testing need to take into account multiple factors besides just cognitive abilities. The testing needs to focus on various determinants, some of which include:

• Cultural background
• Education
• Weight
• Diet
• Sleep
• Stress levels
• And, most importantly, biological gender

The Future of Dementia Research and Treatment

Past diagnosis, research, care, and treatment for dementia should have taken into account the fact that women make up 72% of the people affected by this condition. Going forward, scientists, researchers, medical professionals, and pharmacists must develop solutions that improve the lives of both males and females. Further research is also needed to discover why women develop dementia more than men so risk factors and warning signs can be found earlier and prevention can commence.

When dementia is diagnosed early on, there are treatments and lifestyle changes that can be implemented to slow the progression of the disease and help preserve mental function. With the wealth of knowledge we now have at our disposal, there is no reason why we can’t make living with dementia more manageable for both women and men alike!

Exercise. A word that brings energy and joy to some, but can conjure negative feelings for others. I have a long, mostly loving relationship with exercise. However, it did take some time to figure out what was best for my lifestyle, and my body. For example, as much as I love the idea of going for long runs, I inevitably end up with injuries, and to be honest, get bored after a certain amount of time. By experimenting with various workouts and trying different sports, here is what I’ve learned: I love lifting weights far more than doing cardio. However, I am aware of the benefits of both, so for me, HIIT (high intensity interval training) or circuit training has proven the most motivating and fun. In the past, I was mostly motivated by how I looked as a result of exercising, and the feel-good effects were just a pleasant bonus. But, now, I am motivated by very different reasons. As I age, I am keenly aware that my muscle mass will diminish exponentially if I don’t maintain it, my brain health will falter if I don’t exercise to protect it, and my mental health noticeably deteriorates when I let weeks go by without activity.

Here are some key reasons, we all should find ways to incorporate movement, and strength building into our lifestyles:

1. Exercise has been proven to not only be beneficial for us in maintaining our physical health, but also our mental health. Evidence based research is making us aware of the neuroprotective nature of exercise.

2. After just a single session, the mood boosting effects are immediately apparent. The brain releases neurotransmitters like dopamine, serotonin and noradrenaline during a workout which give us that “feel good” high afterwards.

3. The longer term effects are where it gets interesting. Exercise can actually change the brain’s anatomy and function. It causes cell regeneration in key parts of the brain that can continue to improve mood, focus, and attention. These changes can help protect the brain. Although it might not reduce our chances of developing Alzheimer’s or other neurodegenerative diseases altogether, it very well might slow the rate at which we develop symptoms, or decrease our risk.

So, get active. It doesn’t have to be a tough, soul crushing workout (unless that’s your thing). Just aim to get your heart rate up until you feel like you’re exerting yourself more than normal. Take an extra long, fast paced walk, or take the stairs whenever you can. Incorporate some light weights into your routine, as well, to maintain muscle mass and bone health. Thirty minute workouts, 3 to 4 times in a week and that’s enough!

You got this. Your heart, body and BRAIN will thank you for it.

So, if not a vitamin, then, what is it? And why should you be concerned about your vitamin D levels?

Vitamin D is a nutrient, found predominantly in oily fish and dairy products, and also a hormone!

I’m sure you have heard the term to “get outside and get your vitamin D?” This is a fairly accurate statement, but missing some of the scientific facts. Let’s break down the actual details. UVB rays from the sun are absorbed by our skin and create a chemical reaction that produces cholecalciferol (D3). Vitamin D3 is converted to calcidiol by the liver, which is further converted into calcitriol by the kidneys. Calcitriol is the active hormone that binds to proteins in nearly every cell in our body to help regulate many body functions.

The difficulty with vitamin D is that many of us live in northern climates where we do not have year round exposure to sunlight, and when we do, it is advised to protect our skin from harmful UV rays and cover up or wear sunscreen. Without the ability of our skin to absorb UV rays, and convert vitamin D within our system, we simply cannot produce enough of the essential hormone to protect our health and brains.

So, what can you do? Dietary options are far too limited, and frequent direct sunlight exposure isn’t safe for skin health. So, daily supplementation is vital, with doses no less than 2000 IU, and often as high as 5000 IU, recommended by experts for disease prevention.

My mom’s battle with Alzheimer’s finally came to an end yesterday. I’ll never forget the date and time I got ‘the call’: July 2, 2020 at 2 am. I knew as soon as the phone rang who it was, and what it meant. My sweet Momma was finally free from this disease that had imprisoned her for so many years.

Alzheimer’s affects approximately 50 million people worldwide. That number is only growing. Due to the varying symptoms, 1 in 4 people have not even been diagnosed, but are living with dementia. We don’t have a cure, and are far from understanding the cause. These are frightening statistics, especially in the case of early onset Alzheimer’s (diagnosed prior to age 65), which has a strong genetic component.

My mom and I were best friends. We told each other everything. We lived life looking forward to every visit, every phone call, and planning all of our future adventures. She was the best mom, and the kindest, most patient, and enjoyable person I have ever met. She was smart — putting herself through medical school, while living in a tiny apartment in a poor section of Mumbai. She was a dreamer — she had declared to her parents that she would one day leave India, and she made that happen. She was compassionate — not a single scrape on my knee went without a kiss, and not a single tear went unwiped. She deserved so much better.

Alzheimer’s stole my mom far too early. Looking back, I started seeing changes in her while she was still in her 50’s. It took us years to realize that whatever “it” was, was far worse than we thought, and it was only continuing to steal pieces of her away from me. And that is the problem with early onset Alzheimer’s. It occurs in people far too young to have cognitive decline. The symptoms aren’t always what we associate with any form of dementia. In my mom’s case, she was otherwise still youthful, and vibrant. I didn’t notice any memory loss or forgetfulness. But, her personality slowly changed, and that ate away at our relationship. She seemed more argumentative, and less interested in me. I was heartbroken. I didn’t realize that her brain was slowly failing her, and causing the changes. So I withdrew from calling so often, and visiting as regularly just to avoid the little comments she would make that hurt my feelings. Over 8 years after I started noticing these changes, we finally had her diagnosed. Her MRI showed that by 65 years of age, her brain had already atrophied (or shrunk) by 50%.

That is where Alzheimer’s began to change me, as well.

I have now lived with grief. Years of watching my beloved mom lose her sparkle, her enthusiasm, and her confidence. Her ability to perform simple tasks, call me, or hold a long conversation with me like she used to, was gone. And ultimately, she lost her ability to walk, speak, or even recognize me.

I also lived with guilt. Guilt for feeling resentful towards her and the disease. I was mad that she wasn’t who she used to be. I wanted my mom — the funny, happy lady who called me every day, and remembered every detail of my life. I felt guilt for not visiting her as often as I could have because I felt SO sad seeing her like that. I felt guilt for looking at her and not feeling like she was MY mom. She looked like her, but Alzheimer’s had stolen everything about her that made her mine. And ultimately, I felt guilt for making decisions that would facilitate ending her life gracefully, and not prolonging her suffering.

And I have felt anger. Anger that she was taken too soon, and that it happened to the wrong person. Anger that her life was cut short, that she was imprisoned in her body, and forced to continue living with no quality of life. She worked so hard, and sacrificed so much for my brother, Dad and me. So much so, that she never put herself first. I’m furious at her for not being more selfish. I wish she’d had more time to live, and be with me, and enjoy her grandkids. I’m angry at Alzheimer’s for being so cruel.

But, I have also grown on this journey. I’ve learned so much about me. I’ve made positive changes in my lifestyle, am mindful of living life to the fullest, and have a special interest in brain health.

The pain in my heart is not something I regret. It’s my mom reminding me how much she loved me, how much she has impacted my life, and how she will always be with me, moving forward and continuing to live on. I am choosing not to regret any of the grief, the guilt, or the anger. All of those feelings are OKAY.

RIP sweet Momma. I will love and remember you always ♥