10 most common triggers exacerbating perimenopause symptoms

here are an estimated 3 million women currently going through perimenopause in the UK, and although symptoms are primarily due to falling sex hormone levels, many of these women are unaware of the way mental health, lifestyle and diet choices can trigger the frequency and severity of their perimenopause symptoms.

The UK’s No.1 perimenopause brand*, Health & Her (www.healthandher.com) conducted research with women going through perimenopause and found that 80% reported at least one trigger of perimenopause symptoms, with stress at work, caffeine and stressful events being the top three most common[1]

Dr Rebeccah Tomlinson, GP menopause specialist at Health & Her comments: “It’s not surprising to me that stress features twice in the top three and is a major cause of amplifying symptoms felt by women during this time.” 

“Stress is a natural physical and psychological reaction to life experiences. In small doses, stress is fine, but when it revs up especially during work, the body goes into fight or flight mode.   Your brain signals the release of the stress hormones, cortisol and adrenaline, which prepares your body for action.”

“The reason stress at work is cited so frequently by women is because oestrogen helps maintain cortisol levels, so when oestrogen levels start to drop things go out of balance. It then becomes a vicious circle. the more you stress the more you experience mind, mood and sleep problems. However, all the triggers in the top ten can be easily managed by tracking, so that you can understand how they connect to your symptoms. In doing this you can then start to make changes to your lifestyle, diet, and outlook accordingly.” 

Health & Her and Dr Rebeccah Tomlinson goes onto explain the top ten triggers in the UK to help women understand what exactly is going on. 

  1. Stress at Work 

Just over half (54%) of the women reported that stress at work is a major trigger for them. Examples of work stressors might be meeting a tight deadline, presenting in front of clients, attending performance reviews and even company social events. Our research found stress of this nature is most highly correlated to mind and mood symptoms of perimenopause including anxiety, low mood, poor concentration, brain fog and memory loss. With 4.4 million[2] perimenopausal or menopausal women currently in the workplace, finding ways to help them manage stress to minimise triggering symptoms is important to keep women in the workforce, and it’s not surprising that 1 in 10 leave the workplace [3].

  1. Stressful Event 

These are an unavoidable part of life and research confirms an association between stressful events and worse menopause symptoms[4]. It is not necessarily the event that exacerbates symptoms but how a woman responds to that event. Time and energy spent over-thinking before or after and event can wind up the stress levels, which then has an impact.  Just under half (47%) of the women in our research reported this as trigger alongside anxiety, poor concentration, memory loss and even heart palpitations.

  1. Caffeine 

2 in 5 women reported they started to experience more sensitivity to caffeine as they progressed through perimenopause. Dr Rebeccah explains why “typically found in tea, coffee and energy drinks, caffeine accelerates your nervous system, increases alertness, and interferes with the absorption of vitamins and minerals.  Whilst it might seem like a good pick me up after a bad night’s sleep, caffeine can also have a detrimental effect on sleep, causing insomnia which is one of the most common symptoms of perimenopause.”

  1. Alcohol 

4 in 10 women found that they experienced an issue with alcohol tolerance. Alcohol causes the blood vessels to dilate and raise the internal body temperature. Combine this with depleting hormones already disrupting the body’s internal thermostat, and this will lead to more hot flushes and night sweats. Alcohol has also been shown to raise cortisol levels, interrupt sleep, worsen depression, cause mood swings and increase dehydration.

  1. Sugar 

Sugar posed a moderate issue for one third of the women. Sugary snacks are known to cause rapid high spikes in blood sugar levels. High blood sugar, insulin resistance and metabolic syndrome are linked to hot flushes in perimenopausal women[5].  Dips in blood sugar can impact energy and mood levels. These spikes and dips can all lead to a cycle of snacking on quick fix foods that can exacerbate menopausal weight gain. Other symptoms women reported around this issue were bloating, digestive issues and memory loss.

  1. Hot Weather 

In the research, 34% of women reported hot weather as a severe trigger. Fluctuating hormone levels can make women more sensitive to heat[6]. The hypothalamus is a gland in the brain that helps to regulate our internal temperature, and because of falling oestrogen levels, this regulation can go into turmoil during perimenopause. Hot weather can also interfere with sleep and increase sweating which in turn can cause dehydration which further stresses the body, and stress is the number one trigger to more symptoms! It all becomes a negative cycle of triggers and symptoms.

  1. Cold Weather 

One third of women found cold weather a trigger, setting off symptoms of joint aches, skin changes, dizziness and digestive issues. Melatonin, also known as the ‘sleep hormone’ has an effect on temperature regulation too. It is very reactive to the light and darkness cues we get during the day and night. The longer hours of darkness also tend to mean we are less active in winter which can have also impact on hormone production and hormone balance. Plus, the shorter days can often exacerbate low mood as limited exposure to sunlight may impact vitamin D production. Cold weather can also affect the immune system, making us more prone to sickness.

  1. Fatty Food 

The research found fatty foods were reported as moderate trigger for just under one third (29%) of the women. It has been shown that women who consume a high fat diet (high levels of fats, snacks, oils and sweets) prior to the menopause have higher oestrogen levels than other women with lower fat diets, but their menopause symptoms are much more marked when their internal oestrogen levels drop at the time of the menopause. Conversely, a diet rich in fruits and vegetables can have a positive effect on perceived menopause symptoms [7] . Eating cakes, fried foods and pizza, can increase the risk of heart disease, a condition that women are already at greater risk of from the onset of perimenopause. Foods high in trans fats may reduce serotonin production in the brain, leading to depression as well as adversely affecting memory[8].

  1. Dietary Changes 

Just over 25% of women noted that dietary changes were a mild or moderate trigger for them resulting in digestive issues, bloating and skin related symptoms. Perimenopausal hormone changes can have a big impact on mood and the way we eat can have a big impact on how we feel. A vicious circle can be set off by making poor food choices in an attempt to elevate mood and energy levels, that leads to weight gain and then yo-yo dieting. Add to that general age-related decline in digestive enzymes and stomach acid and that impact on gut bacteria prevalence we can see how the gut begins to struggle to function as efficiently as women journey through perimenopause. 

  1. Spicy Food 

For women who enjoy spicy foods, it might be time to rethink. Just under a quarter (24%) of women found this was a mild trigger that can set off digestive issues, palpitations, and bladder sensitivity. It is also widely known that spicy food can trigger hot flushes in perimenopausal women.  This is because the natural chemicals in chilies, (capsaicin) and black pepper (piperine), dilate blood vessels, and overly dilated vessels will tend to amplify vasomotor symptoms (hot flushes, night sweats).