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Women's Health
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I Went Into Early Perimenopause & Learned Why Balancing Blood Sugar Is So Important

Anna Cabeca, D.O.
January 30, 2019
Anna Cabeca, D.O.
Triple board certified OB/GYN
By Anna Cabeca, D.O.
Triple board certified OB/GYN
Dr. Anna Cabeca is a menopause and sexual health expert currently working in Georgia. She received her doctor of osteopathic medicine in gynecology and obstetrics from the Emory University School of Medicine.
January 30, 2019
Here at mbg, we're all about women's hormone health. We strongly believe that our hormones benefit from a healthy lifestyle and that every green smoothie, yoga class, and minute of meditation matters. But there's a time in every woman's hormonal life—called perimenopause—that's long been overlooked. This era is marked by big hormonal shifts that can greatly affect quality of life, causing a lot of anxiety and discomfort. So this week, we're shining the light on this next frontier of hormone health so that we're all more informed and empowered.

The hormonal "changes" that come with menopause start way before you hit your 50s with a transitional period called perimenopause. This stage in a woman's life can last anywhere from five to 15 years and is marked by a gradual loss of female sex hormones.

Many women have some anxiety about perimenopause, but knowledge is power. As a holistic OB/GYN, author of the book The Hormone Fix, and a physician who is passionate about helping women restore balance to their bodies and feel their best, it's my job to make sure you know exactly what's going on with your hormones during this time.

What's really happening to your hormones during perimenopause.

The first hormone to start its descent during perimenopause is progesterone, followed by estrogen and others. This shift will cause symptoms—like missed periods, PMS, breakthrough bleeding, palpitations, migraines, hot flashes, vaginal dryness, insomnia, and anxiety—that foreshadow menopause. During perimenopause, some of you might feel like your body isn't your own anymore, like something is seriously wrong, but it's just nature messing with your hormonal balance.

So far, medicine has failed to find safe, effective solutions to the hormone fluctuations that can make our lives more difficult during this time. My own search into workable treatments arose from my own hormonal problems after being thrown into premature menopause by the tragedy of losing a child. Even as an OB-GYN and women's health physician, I struggled to find answers—only to be thwarted by a medical community that wanted me to take antidepressants and other medications, power through it, or just learn to live with my agonizing symptoms. But I'm not one to sit back and let symptoms derail me. I wanted real answers to what's going on in my body and why.

The perimenopause–blood sugar connection you need to know about.

My investigations led me to discover something no doctors were telling their patients: Although hormones like estrogen and progesterone grab most of the attention, there also three other hormones running this change-of-life show: insulin, cortisol, and oxytocin.

Insulin affects many other hormones, including the sex hormones (estrogen, progesterone, and testosterone). So when it is unbalanced, other hormones go out of kilter too. In perimenopause, you can become "insulin-resistant." This means you have excess insulin in your body and your cells no longer react properly to its instructions. In other words, they don't open up when insulin tries to do its job of ushering glucose (blood sugar) into cells for energy.

We develop insulin resistance because our bodies can no longer deal with high amounts of carbohydrates we used to eat—even healthy ones like fruits, whole grains, potatoes, or brown rice. Too much sugar builds up in our blood, and the result is hormone havoc: hot flashes, fatigue, difficulty concentrating, weight gain, and other perimenopausal symptoms.

The role of cortisol in hormone health.

The second big player is cortisol, the key stress hormone that is an immediate responder in times of danger and stress. Following a stressful event, your adrenal glands pour out cortisol, which boosts the amount of blood sugar available for fuel and revs up your heart rate so you can fight off or escape a threat, or otherwise deal with the stress.

As we get older, cortisol levels tend to stay high due to our increasingly stressful lifestyles. The chronic elevation of cortisol is another chief culprit in the decline of your sex hormones. It robs your body of DHEA, progesterone, estrogen, and testosterone and causes blood sugar to rise. You can put on weight as a result, especially around your belly. You lose your sex drive and suffer other sinister symptoms like night sweats, mood swings, insomnia, and burn out—all because of cortisol.

Why oxytocin matters, too.

Finally, there's oxytocin, my favorite hormone. It's the hormone of love, bonding, and connection. It's the hormone that floods our brains during childbirth as we cradle our newborn. It also surges with orgasm, laughter, play, hugging, caressing your pet, and giving. It's an anti-aging hormone too.

Oxytocin is the archenemy of cortisol. Increase oxytocin, and cortisol drops. That's why I sometimes say that you can "hug your belly fat away," as loving hugs are a great way to produce lots of oxytocin. The more oxytocin in your body, the calmer, less afraid, and more social you'll feel.

How to balance insulin, oxytocin, and cortisol for fewer symptoms.

When insulin, cortisol, and oxytocin are in sync, you can greatly reduce the symptoms of perimenopause and still feel happy, energized, and content. Here's how to make that happen—naturally, without drugs or artificial hormones.

1. Try fasting for better hormone balance.

I recommend that all my perimenopausal clients adopt "intermittent fasting." You simply start off by aiming for a 13- to 15-hour fast, which takes place overnight while you're asleep. It's neither difficult nor draconian. Just eat nothing after 7 p.m. until breakfast the next day (at least 13 hours later), or shoot for a longer fast that you don't break until lunch. These long fasting periods can help combat insulin resistance and help you maintain a healthy weight.

2. Try the herb maca.

This superfood is made from a radish-like tuber that grows above 11,000 feet in Peru's central highlands. Highly nutritious, it helps control blood sugar and insulin levels in the body, boosts energy for workouts, and regulates hormones. A four-month study1 of perimenopausal women (aged 41 to 50 years) who supplemented with maca found that the herb balanced estrogen, progesterone, and other hormones—plus, eased night sweats, insomnia, anxiety, depression, and heart palpitations. One or two scoops of maca in smoothies or tea every day are a good way to harness all the powers of this amazing herb.

3. Follow a green keto diet.

A ketogenic diet is one that is low in carbohydrates, high in healthy fats, and moderate in healthy protein. It is valuable because it drives insulin down and reverses insulin resistance. Adding in more alkaline foods (such as greens and many nonstarchy veggies) tamps down cortisol and thus gets that hormone under control.

4. Boost oxytocin naturally.

There are many ways to trigger the release of oxytocin. The most fun one is to have orgasms more often. You can also cuddle with your partner or at least hug more frequently. Nurture your friendships, practice generosity, and be more self-loving. Taking supplements such as vitamin C, vitamin D, magnesium, vitamin B complex, and melatonin can also help. These work in different ways, but generally they support the oxytocin receptors on cells that open up and let this hormone in.

There's a lot going on with your sex hormones like estrogen and progesterone during perimenopause, but that doesn't mean we can forget about other major hormones that play such a large role in how we feel on a daily basis. By working to balance cortisol, insulin, and oxytocin, we can make perimenopause so much more manageable.

Anna Cabeca, D.O. author page.
Anna Cabeca, D.O.
Triple board certified OB/GYN

Dr. Anna Cabeca is a menopause and sexual health expert currently working in Georgia. She received her doctor of osteopathic medicine in gynecology and obstetrics from the Emory University School of Medicine. Cabeca is the creator of many products for hormone and dietary support and is the author of The Hormone Fix, a comprehensive diet and lifestyle plan for women approaching or in menopause. She has been featured on NBC, CBS, and ABC and in the Huffington Post and Reader's Digest.