Wellness Wednesday: A Midlife Gal’s Guide to a Happy, Healthy Gut by Karen Cerezo

by Karen Cerezo

Have you noticed as you’ve gotten older that you can’t eat the foods you did just a few years ago? Do those favorite dishes you once enjoyed no longer sit well with you?

Your digestive tract (a.k.a., your gut) is home to trillions of bacteria, known as gut microbes. These microbes are ultimately responsible for major bodily functions.

A healthy gut has a rich diversity of microbes and has an important role to play in combating conditions such as diabetes, heart disease, and obesity, as well as tackling inflammation, which is linked to autoimmune diseases, in addition to being responsible for breaking down and delivering essential nutrients that fuel and nourish every part of you.

Sounds pretty important, right? That’s why it’s necessary that you maintain a happy, healthy gut!

BUT…as you get older, your gastrointestinal (GI) system ages just like your joints, eyesight, and other body parts. 

So, if you’re noticing new age-related alignments like:

  • leaky gut: (gaps in the lining of the intestines) which can lead to symptoms such as food sensitivities, diarrhea, bloating, brain fog, fatigue, and chronic inflammation,
  • heartburn: (a.k.a., acid reflux),   
  • constipation: common in older adults due to a lack of adequate amounts of dietary fiber,
  • diverticulitis: an inflammatory condition that starts out as diverticulosis—when sac-like pouches (called diverticulum) protrude from the colon. By age sixty, about one-third of Americans develop these protrusions, often in areas of the colon where the muscle is weak or the colon is narrow, and
  • ulcers  

…then, it’s time to make some changes!!!

It’s common for external lifestyle factors such as diet, stress, physical activity, environment, sleep, and medications (such as antibiotics or non-steroidal anti-inflammatories) to affect our cells, but the good news is these external factors are completely under your control!

The benefits of a balanced gut, usually the result of clean living, include long-term wellness and a better menopause experience.

Karen Cerezo

The benefits of a balanced gut, usually the result of clean living, include long-term wellness and a better menopause experience.

When it comes to gut health there are positive bacteria (healthy “gut bugs”) that help your body digest and absorb nutrients, synthesize certain vitamins, and fight off toxic-forming carcinogens.

The good news is even a lifetime of bad eating is fixable—at least as far as your microbes are concerned. Amazingly, your body can create a new microbiota in as little as 24 hours—just by changing what you eat.

Another component that’s super important to your gut health is…your hormones! (Come on sis, you should have seen that one coming)!

Not only does perimenopause mess around with our weight, our mood, and our brain, but it can also cause imbalances in our digestive system and affect gut health.

You may notice an increase of uncomfortable bloating, constipation, and acid reflux (as if we don’t have enough going on in your bodies already).

Many women aren’t even aware that their hormones and their gut health are connected, but it is so important to understand what gut health issues you may be experiencing due to your fluctuating hormones.

Your estrogen and progesterone levels affect hormone receptors in your gut, and these in turn, affect how efficiently your gut works. So, a drop in those hormone levels means a change in your microbiome. At the same time, if your gut is having to cope with inflammation, triggered by factors such as alcohol, certain foods, lack of sleep, or medication, for example, it will affect the way your hormones, including serotonin—the happiness hormone—work.

If you’re struggling with perimenopausal symptoms such as hot flashes, low mood, or lack of energy, that could be due to a less than healthy gut microbiome.

During this particular season in life, an unhealthy estrobolome (the microbes that help process estrogen) can contribute to higher levels of estrogen and more problems with estrogen dominance. The more your symptoms fluctuate, the more you should be paying attention to your gut health. Notice the effect different foods have on your GI tract and how your hormone symptoms come and go. A food journal is a great way to keep track of what you are experiencing.

While the gut regulates and affects estrogen levels, the natural decline of estrogen levels caused by menopause has a direct effect on the microbiome. It’s a nice little circle that can cause midlife struggles like midsection weight gain and/or IBS.

The good news is that as you improve your microbiome health, you will begin to see improvements in your overall health, which can alleviate those annoying menopausal symptoms.

TIPS TO IMPROVE HOW YOU FEEL:

1. Avoid antibiotics (whenever possible).

Antibiotics are known destroyers of bacteria by nature. Antibiotics disrupt the gut’s delicate ecosystem and also decrease the body’s ability to fight off infection on its own.

2. Adjust up your diet.

Reducing or eliminating processed foods that affect your gut health is the best place to start. I encourage my clients to incorporate a more plant centered diet to improve overall gut health.

3. Try taking a daily probiotic.

Because our low estrogen levels can greatly impact our microbiome’s balance, a daily probiotic is super helpful when it comes to providing that good flora. Look for a supplement that contains multiple types of strains. And always, with any change in routine or diet, be sure to discuss adding a probiotic with your healthcare provider to make sure it’s appropriate for you.


There are so many changes women go through as a result of the dramatic reduction in their hormone levels that simply occur naturally during menopause. Changes in digestive and bowel habits, changes in skin health, a decrease of quality sleep, even an increase of depression, anxiety, high blood pressure, heart disease, obesity, and osteoporosis, all resulting from our fluctuating hormones.

Keeping your gut health balanced is going to have so many positive benefits for your menopausal symptoms but also for your overall health and wellness!

Whether you’re just starting to dip your toes into perimenopause, continuing to experience symptoms into post-menopause, or simply looking for some guidance on what to expect in the coming years of life, I’m here for you! For more information and support around your menopause journey, book a free discovery call and let’s find you some relief!


Karen Cerezo is a certified personal trainer, sports nutritionist, and health and wellness coach. She specializes in empowering women by helping them navigate this new, amazing season called midlife and menopause through proper nutrition, intentional movement, a positive mindset, and knowledge.

Follow Karen on Instagram: @midlife_health_coach

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Download 8 Ways to Improve Your Gut Health:


Product Review: L. Organic Chlorine Free Pads and Tampons* by Desi Garland

When you’re in perimenopause, you may begin to have irregular periods. For example, sometimes I have two menstrual cycles per month and then none at all for a few months. “Irregular” can also include heavier periods. I’ve experienced this as well. As a result, I sought out a different type of pad than the Always® I’d worn since childhood. Ironically, I turned to a product my adolescent daughter uses: L. Organic Chlorine Free Pads and Tampons. Because she introduced me to these products, I thought it fitting for her to write the first review:


Product Review: L. Organic Chlorine Free Pads and Tampons

by Desi Garland

I started using L. Organic Chlorine Free Pads and Tampons in 2020 while working at Walgreens. I happened to stumble upon them while I was stocking. I saw they provide the same options as other brands (e.g., overnight, ranges for different flows, with/without wings).

I had never seen or heard of these kinds of sanitary products before, so I looked them up to see what was being said about them. People said they were sort of safer seeing as though pads are usually unscented, and they claim to have reduced chemicals found in other brands that could have an affect on women’s hormones because they use organic cotton. That was all I needed to know to buy them because I already enjoy using other unscented products for my body, such as feminine wipes and body soap, and I liked that there was a possibility for less hormone involvement.

When I started using L. Organic, I noticed my cycle reduced from about five days to three very regularly. I also noticed that I just simply felt better during my periods as if the products were pairing better with my body.

Although L. Organic claims to be chemically free, they are not 100% free of chemicals, and because of this, they still have a toxic shock warning on the tampon box.

Overall: In my eyes there’s nothing to dislike about L. Organic Chlorine Free Pads and Tampons. They are now my go-to when buying sanitary products.

Read more about L. Organic, which is created by women for women.

L. Organic Chlorine Free Pads and Tampons are located at all major drug retailers.

*L. Organic didn’t pay either of us; this is an honest review of a product we both use.

Navigating the Change Rating:

Rating: 4 out of 5.

Desi Garland is a 19-year-old free spirit, who enjoys solitude and all things pertaining to creative arts.


Write a review for Navigating the Change.

What is Perimenopause?

There are different definitions of perimenopause, but all of them are usually the same in the opinion that perimenopause begins at the time of irregular periods—due to the deterioration of ovarian function—and ends a year after the last menstruation.

Every woman has perimenopause, and it varies for each individual. The average duration of this period is three to four years, although sometimes it can be only a few months or last a decade.

Some women during this period complain of hot flashes and are exhausted by abundant periods; in many, perimenopause occurs without any obvious symptoms.

Some may end their period suddenly, while others may have irregular menstruation for several years.

HOT FLASHES DURING PERIMENOPAUSE

Most women believe that hot flashes do not appear before menopause. The tide, the short-term failure of thermoregulation is a characteristic symptom of perimenopause. Sudden bouts of heat last from one to five minutes. The intensity of sudden tides can range from a mild sensation of heat to a feeling of heat coming from within.

At high tide, a woman blushes her face and the upper half of her body, which can include sweat, chills and sometimes confusion. Such manifestations of tides at the most inopportune time (during a performance, interview, or romantic meeting) can greatly annoy a woman. The frequency of hot flashes is also different: in some women they happen several times a week; others have hot flashes up to ten times a day and at night.

In most women, hot flashes occur when approaching menopause. But that’s not a universal feature.

Although the physiology of tides has been studied for more than thirty years, no one can say with certainty why and how they occur. The hormone estrogen is used in the process of hot flashes: it maintains a normal body temperature. If its level is reduced, it may be disrupted by thermoregulation. Estrogen therapy relieves the symptoms of hot flashes. But that’s not all!

For example, researchers found that women with this symptom and without it have no difference in estrogen levels. Better understanding of the causes of perimenopause can open the way to new, non-hormonal treatments. Also, hormone therapy relieves hot flashes, but it is not free from side effects.

In thirty-five to forty years, the female body reduces the production of progesterone. The number and quality of follicles is also reduced, which is the reason for the decrease in estrogen production and the amount of ovulation. As a result, by the age of forty, the duration of the cycle and the intensity of the monthly menstruation can vary and become irregular.

Estrogen levels can plummet, or they may rise dramatically. Over time, follicle-stimulating hormone (FSH) levels increase in a vain attempt to stimulate the ovaries to produce more estrogen.

Although high FSH rates can be a signal of the onset of perimenopause, it is impossible to focus only on the level of FSH. It is not a reliable indicator, as its level can change dramatically day by day.

SIGNS OF PERIMENOPAUSE

It is difficult to distinguish between the symptoms of perimenopause caused by changes in hormonal background and symptoms of a more general nature, which are determined by age or life events, such as children leaving from home, changes in interpersonal relationships or professional careers, or death or illness of parents.

Given the full spectrum of perimenopause traits, it is unlikely that they depend only on hormonal changes.

  • hot flashes and night sweats: It is estimated that 35-50% of women during perimenopause suffer from sudden high tides, which are accompanied by sweating and a feeling of heat, which can last up to five to ten minutes, both at night and during the day. They usually start with the upper body: head, face, neck, chest.
  • By their nature, they can be significantly different: some women feel only a slight warmth, while others sweat heavily. Most often hot flashes continue for one to two years after the onset of menopause. Ten percent of women have hot flashes for many years to come.
  • vaginal dryness: At the end of perimenopause, a drop in estrogen levels may cause thinning and dryness of the vaginal mucosa. Dryness causes discomfort, which manifests itself in the form of itching and irritation, and pain during intimate relationships, which can reduce libido.
  • uterine bleeding: This is caused bythe decrease in the amount of progesterone involved in the transformation of the endometrium, the layer of the mucous uterus before rejection can thicken, which causes abundant periods.
  • Insomnia: About 40% of women during perimenopause have trouble sleeping. A number of studies have identified a link between night sweating and sleep disturbances.
  • The problem is too complex to know the cause of sleep disorders only in fluctuations of the hormonal background. With age, sleep cycles change, and insomnia becomes a typical age problem for both women and men.
  • mood swings: Approximately 10-20% of women complain of mood swings during the perimenopause period. Some researchers attribute this to a drop in estrogen levels, but this has not yet been scientifically confirmed. In addition, the level of depression in women after forty-five years old is low.
  • The unpredictability of perimenopause can cause stress and irritation. Also, some women are more sensitive to hormonal changes, which may cause mood swings. Mood in middle age is mainly determined by factors such as stress, poor health and the presence of depressive conditions in the past.
  • other problems: Many women complain of short-term memory problems and difficulty concentrating during the menopause transition. Although estrogen and progesterone play an important role in maintaining brain activity, there is too little data to separate the effects of aging and psychological factors from those caused by hormonal changes.

How can you relieve perimenopause?

Vasomotor signs

  1. Avoid possible factors that may trigger hot flashes, such as hot, poorly ventilated rooms, hot drinks, and spicy food. Try to make your clothes multi-layered, so you can remove clothes if necessary.
  2. Try rhythmic breathing; deep breathing techniques facilitate hot flashes.
  3. The most effective treatment for severe hot flashes and night sweating is estrogen. But the dosage is prescribed by a doctor.

In all other cases, such as endocrine failures, irregular (or too many) monthly menstruations, or vaginal dryness, seek support from a gynecologist.


Dr. Lydia

Dr. Bachurina Lydia was born in the Republic of Uzbekistan in 1971. Since childhood, she wanted to be a doctor. After school she graduated from the Tashkent Medical Institute, worked as a therapist for four years, and then worked in cardiology for three years. After moving to Russia, she was certified and worked as a geriatrician for four years. Dr. Lydia is married with two sons and maintains “Beauty and Health Blog from LiDea” dedicated to medicine. She currently lives and works in Russia.

Follow Dr. Lydia on Twitter @xBXQjNpKwqIj8RI @Лидия

Что такое перименопауза?

Имеются различные определения перименопаузы, но все они обычно едины во мнении, что перименопауза начинается с момента наступления нерегулярных месячных—из-за ухудшения функции яичников—и заканчивается через год после последней менструации.

У каждой женщины перименопауза протекает очень индивидуально. Средняя продолжительность этого периода от 3 до 4 лет, хотя иногда она может составлять всего несколько месяцев или растянуться на целое десятилетие.

Некоторые женщины в этот период жалуются на приливы и их изматывают обильные месячные; у многих перименопауза протекает без каких-либо явных симптомов.

У одних месячные могут закончиться внезапно, в то время как у других нерегулярные менструации сохраняются в течение нескольких лет.

Приливы во время перименопаузы

Большинство женщин считают, что приливы появляются не ранее менопаузы.  Прилив, кратковременный сбой терморегуляции, характерный симптом перименопаузы. Внезапные приступы жара длятся от 1 до 5 минут. Интенсивность внезапных приливов может варьировать от легкого ощущения тепла до чувства жара, исходящего изнутри.

Во время прилива у женщины краснеет лицо и верхняя половина тела, появляется пот, озноб и даже иногда спутанность сознания. Подобные проявления приливов в самое неподходящее время (во время выступления, собеседования или романтической встречи) могут сильно досаждать женщине. Частота приливов также различна: у некоторых женщин они случаются несколько раз в неделю, у других приливы бывают до 10 раз в день и плюс еще ночью.

У большинства женщин приливы наступают в период приближения к менопаузе. Но это не универсальная характеристика

Хотя физиология приливов изучается уже более 30 лет, никто не может с точностью сказать, почему и как они возникают. В процессе возникновения приливов задействован гормон эстроген: он поддерживает нормальную температуру тела. При снижении его уровня возможны нарушения терморегуляции. Эстрогеновая терапия облегчает симптомы приливов. Но это еще не все!

Например, исследователи установили, что у женщин с этим симптомом и без него нет разницы в уровнях эстрогена. Лучшее понимание причин приливов в период перименопаузы может открыть дорогу к новым, негормональным методам лечения. Гормональная терапия снимает приступы приливов, но она не свободна от побочных эффектов.

В 35-40 лет женский организм снижает выработку прогестерона. Количество и качество фолликулов также уменьшается, что является причиной снижения производства эстрогена и количества овуляций. Как результат, к 40 годам продолжительность цикла и интенсивность месячных может меняться, и они становятся нерегулярными.

Уровень эстрогена может стремительно падать, а может и резко повышаться. Со временем уровень ФСГ повышается в тщетной попытке стимулировать яичники к большей выработке эстрогена.

Хотя высокие показатели ФСГ могут быть сигналом начала перименопаузы, но нельзя ориентироваться только на уровень ФСГ. Он не является надежным индикатором, поскольку его уровень может кардинально меняться день ото дня.  

Признаки перименопаузы

Довольно трудно различить симптомы перименопаузы, вызванные изменением гормонального фона, и симптомы более общего характера, которые определяются возрастом или жизненными событиями.

Например, такими как отъезд детей из дома, изменения в межличностных взаимоотношениях или профессиональной карьере, смерть или болезнь родителей. С учетом всего спектра признаков перименопаузы, маловероятно, что они зависят только от гормональных изменений.

  • Приливы и ночная потливость: Предположительно, что 35-50% женщин в период перименопаузы страдают от внезапных приливов, которые сопровождаются потоотделением и ощущением жара, которые могут длиться до 5-10 минут, как ночью, так и днем. Они обычно начинаются с верхней части тела: головы, лица, шеи, груди.
  • По своему характеру они могут значительно отличаться: одни женщины чувствуют только легкое тепло, другие же сильно потеют. Чаще всего приливы продолжаются в течение 1-2 лет после наступления менопаузы. У10% женщин приливы сохраняются еще долгие годы. 
  • Вагинальная сухость: В конце перименопаузы падение уровня эстрогена может быть причиной истончения и сухости слизистой оболочки влагалища. Сухость становится причиной дискомфорта, который проявляется в виде зуда и раздражения, болей во время интимных отношений, что может уменьшать либидо.
  • Маточные кровотечения: С уменьшением количества прогестерона, принимающего участие в трансформации эндометрия, слой слизистой матки перед отторжением может утолщаться, что вызывает обильные месячные.
  • Бессонница: Около 40% женщин в период перименопаузы имеют проблемы со сном. В ряде исследований выявлена взаимосвязь между ночным потоотделением и нарушениями сна.
  • Проблема слишком сложна, чтобы видеть причину расстройства сна только в колебаниях гормонального фона. С возрастом циклы сна меняются, ибессонница становится типичной возрастной проблемой как у женщин, так иу мужчин.
  • Перепады настроения: Приблизительно 10-20% женщин жалуются на перепады настроения в период перименопаузы. Некоторые исследователи связывают это с падением уровня эстрогена, но это пока не имеет научного подтверждения. Кроме того, уровень депрессии у женщин после 45 лет невысокий.
  • Непредсказуемость течения перименопаузы может вызывать стресс и провоцировать раздражение. Также некоторые женщины являются более чувствительными к гормональным изменениям, которые у них могут проявляться перепадами настроения. Настроение в среднем возрасте определяется в основном такими факторами, как стресс, плохое состояние    здоровья и наличие депрессивных состояний в прошлом. 
  • Другие проблемы: Многие женщины жалуются на проблемы с кратковременной памятью и трудности концентрации внимания во время менопаузального переходного периода. Хотя эстроген и прогестерон играют важную роль в поддержании мозговой активности, слишком мало данных, чтобы отделить последствия старения и психологические факторы от тех, которые вызваны гормональными изменениями. 

Как вы можете облегчить перименопаузы?

 Вазомоторные признаки

  1. избегать возможных факторов, которые могут спровоцировать возникновение приливов. Это жаркие, плохо проветриваемые помещения, горячие напитки, острая пища. Старайтесь, чтобы ваша одежда была многослойной. Так вы можете в случае необходимости снять часть одежды.
  2. ритмичное дыхание, техника глубокого дыхания облегчают приливы.
  3. Самым эффективным средством лечения тяжелых приливов и ночного потоотделения является эстроген. Но дозировку назначает только врач.

Во всех других случаях, таких как эндокринные сбои, нерегулярные и нерегулярные (или слишком много ежемесячных менструаций), Или  сухость влагалища, когда необходимо принимать эстрогены, обязательна консультация гинеколога, так как все назначения должны быть строго индивидуальны.


Dr. Lydia

Д-р Бачурина Лидия родилась в Республике Узбекистан в 1971 году. С детства хотела стать врачом. После школы окончила Ташкентский медицинский институт, четыре года работала терапевтом, а затем три года работала в кардиологии. После переезда в Россию она получила сертификат гериатрии в течение четырех лет. Д-р Лидия замужем, имеет двух сыновей и ведет “Красота и здоровье блог от LiDea“, посвященный медицине. В настоящее время живет и работает в России.

Следовать Dr. Lydia На Twitter @xBXQjNpKwqIj8RI @Лидия

Diary of a Menopausal Woman: Perimenopause is Lit 🙄

I haven’t had a period for ninety-nine days. I know this because I’ve set up my iPhone health app to keep track. Once I started having menstrual cycles twice a month, I thought this app would be a good idea. Turns out, I was right.

My last period began November 2, 2020, right before my husband’s fiftieth birthday. We used to “run red lights,” but we both declined a bloody act of intimacy. That’s not the “remember that time” either of wanted to have for such a monumental occasion. With age, comes wisdom…or maybe priorities shift.

So, I bled profusely as I have the past two years. I’ve grown used to these out-of-the-blue menstrual cycles reminiscent of CSI scenes.

But after the November one ended, there were no more.

I silently rejoiced. No more spending eight to ten dollars on pads. No more dirty looks from my husband every time I threw another box in the shopping cart.

“Didn’t you just buy some last week?” he would ask.

I stopped answering. Didn’t he realize I was wearing a pad everyday just in case my menstrual cycle began?

Each day, I wiped myself clean and did a little bathroom happy dance because there were no remnants of pink or red.

Nothing.

Perimenopause is the bomb! Do people still say the bomb? Anywho, period-free days turned into weeks, which turned into months! I hadn’t had a period in three months, and I was feeling a bit liberated.

I reveled in my perimenopausal life until February 8, 2021.

Tuesday, February 9th, to my dismay, menstruation had returned with an extra-special cycle, one that lasted beyond seven days.

At first, I was a little worried. According to my progesterone cream directions, I was to stop using it during a cycle. I was afraid for what would happen.

But there was nothing to fear.

Those period days were the most blissful I’d experienced in a long time. It seemed my hormones leveled off during that week. I got some of the best sleep I’d ever had since this whole ordeal began. There were no night sweats and no hot flashes. I’d never been so happy to have a period in my life.

Still, I knew when it was still there after day seven, that was odd. I told myself that if I continued to menstruate past day ten, then I’d call the gynecologist. That’s what Google said to do anyway. Apparently, anything after seven days is cause for concern, and there may be other reasons a woman has what’s called a long period.

But I didn’t have to call anyone. On day eleven, it stopped. Just like that. And just like that, I returned to waking up mid-morning, spreading progesterone cream on my body, and taking an extended-release melatonin pill.

Forget what I said above, perimenopause and its unpredictability sucks.

2/20/21 ~kg



Write for Navigating the Change.

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