Create the Perimenopause

You Want to Have:

A No-Fail Guide for Every Woman

www.nourishandflourishhealth.com

Intro and Why you should

listen to me
Perimenopause can suck, big time! Most of us go
from feeling fabulous and fertile to changing and
challenging. The good news is that perimenopause
ends and I am an expert on this subject, mainly
because Ive graduated from it and earned an
honorary degree from the school of hard knocks. I
want you to know what I wish Id known when I
started my perimenopause journey 7 years ago,
because even though it ends, it can be a long, bumpy
road without careful navigation.
Im Maria Claps, a hormonal health expert, certified
health coach, functional nutrition practitioner,
compassionate accountability partner and guilty
pleasure advocate. My coaching and nutrition
practice embodies the middle ground between old
school thinking (this is what its like to get older or
try this prescription, it will solve your problems)
and the fringe side of the alternative health world
(think positive, everythings all in your head or eat
only brown rice, spouts and tofu) There is a
balanced, better way and thats why I wrote this
guide.

Hormones and Your

Changing Body
I bet you know what menopause is, but do you really
understand perimenopause? Pure and simple, its
actually menopause preparation. Thats right---you
dont just go into menopause one day in the future.
Your body prepares for about 10 years prior.
Perimenopause is not a chronological destination,
but a state of body and mind. The main
physiological driver of this is fluctuating and
downward trending sex hormones, namely estrogen
and progesterone.
There are over 50 different hormones in the body.
They are made in the endocrine glands and travel in

our blood stream to almost every cell in our body.

Hormones work much like a lock and key. Hormones
are the key and your receptor cells are the lock. Did
you know that the amount of estrogen that you
produce in a lifetime will fit on a teaspoon? Although
they exist in tiny amounts, they are incredibly
powerful and they work in an exquisite synergy with
each other. Although many of us think that hormones
control baby making, menstruation and PMS, there is
much more to it than that! Hormones concern every
moment of every day. They are responsible for those
functions and more:

Heartbeat, breathing and blood pressure

Sleeping and waking
Metabolism, hunger and growth
Masculine and feminine traits
Bone maintenance
Fat storage
Blood sugar levels and immune system

The fluctuation in sex hormones ( estrogen,

progesterone and testosterone), especially after age
35 means great change for most women. There are
both physical and emotional changes, as a womans
ovaries prepare to go into retirement. Some women
report feeling sad about loss of youth, predictable
periods and fertility. Others look forward to more
stable moods.
While it's ok to acknowledge your feelings, I caution
you not to beat them back with a punishing antiaging routine. Personally, I hate the word antiaging. Aging is a privilege denied to many. There is
a special beauty that comes with acceptance and
contentment. I am not suggesting you toss your hair
color and give up caring. Quite the contrary, in order
to survive these challenging years with your health
and happiness intact, you will need to take better
care of yourself than ever before. And although
youll need to exert a bit more effort to stay slim and
healthy, I believe it is tremendously worthwhile After
all, what good is the wisdom and sense of knowing
that youve acquired through the years and the
confidence that comes with it, if your health is
lacking?

So, instead, what Im suggesting is that you wear the

beauty of gratitude for where you are in your life and
come along with me on a mindful journey, where I
will teach you how you can get beyond just surviving,
to truly thriving.

Symptoms that suggest you are in

the throes of perimenopause

Sudden forgetfulness
Anxiety
Hot flashes
A general feeling of blah or wanting to be
alone
Feeling unmotivated to do the basic tasks of
life (cooking, shopping, laundry, etc)
Lack of happiness with your exercise routine,
because it doesnt produce the results it
used to
Emotional fragility, such as crying spells
Unpredictable menstrual periods
A too frequent desire for wine and chocolate
Unexplained weight gain even though you
are eating less and exercising more

What Happens as we Age

The 20-something young woman is usually
considered the ideal hormonal specimen. Maybe
not so much in todays day and age as we live in an
increasingly toxic and estrogen saturated
environment, but for the most part, women in their
late teens through their early 30s make hormones in
the correct amounts and most of these women enjoy
good health.
When our hormones are balanced we can get away
with food and lifestyle indiscretions, because we
have a lot of vital reserve and very little metabolic
chaos. At around 40 years old, and depending on how
well weve tended to our health in the previous
decades, our vital reserve starts to empty. This is
when symptoms of perimenopause show up. Because

all hormones work together, when you have one

hormonal imbalance, it will affect other hormones
and your neurotransmitters too. Although hormone
levels change naturally as part of the aging process,
and we should not be looking to approximate the
hormone and energy levels of our 20s and early 30s,
we can definitely feel good, be healthy and have
balanced hormones (and enjoy occasional guilty
pleasures) well into our 50s, 60s 70s and beyond.
When women hit 40, they are often flummoxed by
the dramatic changes in their body and mood. They
may go to their doctor for these symptoms only to be
told that everythings fine, or worse this is what its
like to get older. Its common to be offered an antidepressant or hormone therapy. Modern medicine is
wonderful for setting broken bones and saving lives,
but lacks mindful, helpful strategies for women who
are in the midst of their changing years. Im not
against pharmaceutical therapy, but it should be a
last resort!

Understanding the Main Players

Cortisol - is the alpha hormone in the body. Cortisol
is produced in your adrenal glands and it helps keep
you ALIVE. What could be more important than that?
One of its main functions is to raise blood sugar in
the body. This is so we have energy for the fight or
flight response. Cortisol does this by breaking down
muscle and bone. This is not necessarily a bad thing.
But, its a bad thing when it is happening all the time.
Cortisol is released in times of stress (aka fight or
flight, which is preceded by a stressful situation,
right?) The problem is, is that in modern society, we
are too frequently in this fight or flight mode, also
called hyper-vigilance. We dont know how to relax,
how to turn this mode off and as a result, our
adrenals make far too much cortisol. Cortisol also
encourages fat deposition around the belly area,
where vital organs are. This is initially a protective
process, but many of us don't like the way it looks
and over the long haul, having too much fat around
our visceral organs is unhealthy. Cortisol also
suppresses other functions that are not crucial to

survival, like digestion, immune function and sex

hormone/reproductive function. For the short term,
its fine, but long term is another story!
2) Insulin -This is another hormone in the body that
helps keep us alive by regulating blood sugar. Too
much sugar in the blood is dangerous, so insulins job
is to push it into the cells where it can be used.
Sugar gets into the blood in two ways: either we eat
it or cortisol releases it into our blood stream. Once
insulin has put the sugar into the cells where it can
be used to produce energy, any excess is taken to the
liver and fat cells for storage. That is how too much
insulin becomes a fat storage hormone.
3) Sex Hormones (Estrogen, Progesterone and
Testosterone) - Sex hormones are made in your
ovaries during your reproductive life. It is natural for
these to decline as we age. But even though they
decline, you have to make sure that you never have
more estrogen than progesterone. Thats called
estrogen dominance and it is dangerous and can lead
to a bunch of unpleasant symptoms like painful
periods and tender breasts.
After menopause, these hormones will be made in
your adrenal glands. So it makes sense to nurture
your adrenal health before you go into menopause,
so that they have the ability to continue making
hormones for you post menopause. If theyre fatigued
from always pumping out large amounts of cortisol,
they may not be able to make your sex hormones.

Top 5 Tips To Get You Started on

Balancing Your Hormones
1) Tend to your tired adrenal glands-The adrenal
glands are primarily responsible for producing stress
hormones throughout our lives. (Make sure youve
read the previous section called The Main Players,
especially cortisol.) When we go into menopause, and
our ovaries no longer make much estrogen and
progesterone, our adrenals take over. This is a super
important point!---if you have worn out adrenal
glands (and most women in their 40s and 50s have

some degree of wear and tear on these glands), your

tired adrenal glands wont be able to produce the
optimal amounts of estrogen and progesterone that
you desperately need to stay balanced through the
years. The top two ways that you can nurture these
glands is to get adequate vitamin C (about 1000 mg),
that's because the adrenal glands are the greediest
consumers of vitamin C in your body and to practice
some type of stress management, such as yoga,
meditation or gratitude. Just choose something that
you will do, and really do it. I cant stress how
important this is to your overall health. Practice
stress management as if your life depended on it,
because the quality of your life absolutely does!
2) Evaluate your relationship with caffeine and
alcohol-Theres a generous middle ground with these
two beverages. Im not here to tell you to give them
up, however, if you are hot flashing like crazy, not
sleeping well and unhappy with your weight gain, its
time to give these a break. Cut them out for 2-3
weeks and see how your sleep improves, or your
weight drops. Then re-evaluate and see if they
belong in your day going forward. A lot of what we
need to do as women, is look at what we consume
and listen to what our bodies are telling us.
3) Exercise smarter, not harder- Many a 40 or 50something woman struggles with weight gain. It is
typically a problem of a damaged metabolism. Many
women are busy at this period of their lives, either
caring for children and aging parents or holding
down a full time job or a combination of all three.
Theyve often let care of self go out the window.
With reduced time to exercise and prepare healthy,
nourishing meals and the tendency to over consume
carbohydrates and sweets, a damaged metabolism
can result. Nevertheless, women are often horrified
at their changing body and try to beat back Father
Time with the same exercise routine they had when
they were 23 years old. If you are in stage 3 adrenal
fatigue (basically, very low functioning adrenal
glands--not a medical emergency, but it means that
your vital reserve is tanking), hard driving exercise is
hurting you, not helping you. You can do a lab test
for adrenal fatigue, but in absence of lab work, a

good rule of thumb is how well do you recover from

your current exercise routine? Are you
u exhausted
afterwards? If so, please stop doing what youre
doing and try something restorative like yoga and
walking in nature.
4) Sleep hygiene and your sleep routine-Are
Are you a
night owl? Do you feel tired in the afternoon then
get a slight bump in your
ur energy in the evening? If
so, that is a clue that you have a dysregulated
circadian rhythm. Circadian rhythms are the physical,
mental and behavioral changes that follow a roughly
24-hour
hour cycle, responding primarily to light and
darkness. They influence sleep-wake
wake cycles and
control hormone release. Abnormal circadian
rhythms have also been associated with obesity,
diabetes and depression. As humans, we are meant to
rise with the sun and sleep when its dark. I know we
cant follow this now. However, you
ou do need to
establish a healthy evening routine. Getting in bed by
10, and asleep by 11 is best for mood, health, vitality,
energy and hormone production. Also, you want to
make sure that you are sleeping in a room that is
dark, cool and quiet. I stronglyy recommend a device
curfew of 8 or 9 pm...thats right, no surfing the web
or answering emails late at night. Its going to affect
your melatonin production and your sleep, and
restorative sleep is the underpinning for healthy
hormones.
5) Nourish with nutrient dense food - After age 35,
we use way more than we build in terms of hormone
production and bone health. It is critical for your
physical health, emotional well-being
being and stress
resilience to eat nutrient dense food multiple times
daily. If you dont have the raw materials that come
from your food (B vitamins, zinc, adequate protein,
slow carbohydrates, and more) you wont be able to
build bone and make hormones that you need to stay
balanced into your 50s and beyond. See my lists of
Hormone Heaven
ven and Hormone Hell foods below and
youll be well on your way to knowing what to
include in your diet and what to avoid.

Hormone Balancing
Breakfast Smoothie
Here's the perfect, low glycemic, justjust
sweet-enough
enough smoothie that has healthy
fat, protein
ein and fiber. It should keep you
full for at least 3 hours, if not more.
Don't just use any protein powder
though. Protein powder quality varies
widely. I highly recommend
mend Fit 365. You
can get it in either vanilla or chocolate,
but I use vanilla in this recipe.
r
You can buy it here:
https://fit365.refersion.com/c/ed8c5
1/4 cup mixed frozen berries
1/4 piece of a ripe avocado
1 T chia or ground flax seeds
1 scoop Fit 365 or other protein
powder in vanilla
8 oz pure, filtered water
a few ice cubes (optional)

Put all ingredients into a blender and

blend until smooth.

Hormone Heaven Foods

1) Protein - Yes, beautiful protein. Protein breaks down into amino acids which are needed to
build muscle, bone, neurotransmitters and hormones. Good sources of protein are animals that ate
their natural diet (chicken, fish, grass fed, grass finished beef are good sources). Still acceptable,
but not as good as animal protein, are your plant proteins such as beans, lentils and tempeh (a
fermented Indonesian soy food). The potential downside of plant protein is that it usually comes
with large amounts of carbohydrates, so be mindful of portion size with your plant protein.
2) Greens and other veggies - Leafy green vegetables are a volume food. Something you can
and should eat massive amounts of. Greens are filled with essential nutrients and fiber. Many
people tell me they dont like greens. I believe you can learn to like them, but you need to at least
start somewhere. I suggest trying a recipe where leafy greens are center stage. Cruciferous
vegetables are especially important for women because of their ability to rid the body of spent
estrogen. They are things like broccoli, cauliflower, Brussels sprouts, mustard greens and arugula.
Note of caution: If you have a known hypothyroid condition, do not have cruciferous vegetables
raw more than once per week. Excessive consumption of raw cruciferous vegetables may cause the
thyroid to become slower. Its fine to have them cooked or steamed though.

3) Richly colored foods - Foods that have color throughout (not just on the skins) have high
levels of phytochemicals and nutrients. Think of things like beets, blackberries, carrots, broccoli,
blueberries and black beans. These colored foods are particularly nourishing for your adrenal
glands.

4) Water with lemon juice - A simple way to improve your health is to start your day with a
glass of water with a squeeze of lemon. This helps to increase stomach acid. Strong stomach acid
is super important because it helps to break down protein and protein is what you need to build
hormones. As we age, our stomach acid declines. This is not a good thing. Put a glass of water with
lemon on your nightstand before you go to bed and drink it when you wake up. We wake up
slightly dehydrated anyway and this is a great way to hydrate and increase stomach acid
production.
5) Fiber- Fiber is not a food per se, it's a component of various different foods. Fiber is super
important in helping to maintain hormonal balance because it helps your body (your bowel, in
particular) get rid of spent estrogen. You don't want spent estrogen recirculating throughout the
bloodstream. Fiber can help that not to happen. You want to get about 25-35 grams per day.
Sources of fiber that I like for perimenopausal women are ground flax seeds, cooked leafy green
vegetables like kale and escarole, jicama and carrots.
A little word on flax seeds: they are both a great source of fiber and one of the stronger "weak
phytoestrogens". If you test low in estrogen, adding flax is a good idea for you. However, if you are
estrogen dominant, you may want to avoid flax seeds. How do you know what your estrogen level is? Get
tested!---it's super easy and I can help you.

Hormone HeLL Foods

1) Alcohol - Lots of adults use alcohol to relax. Oh the wine I could drink and the fun cocktails I
could concoct when I was in my 30s. Not so much anymore. I still enjoy an occasional drink, but
it's more of a guilty pleasure than a regular occurrence (If you read my intro at the start of this
guide, you know I am perfectly fine with guilty pleasures. But guilty pleasures must be balanced by
a preponderance of healthy choices) A nightly glass of wine may be doing more harm than good.
Alcohol consumption is linked to anxiety, mood issues and headaches. More than 3 servings a week
raises bad estrogens and slows metabolism. Stick to three glasses a week or fewer to keep your
cortisol in check. Abstaining from alcohol may help you say bye to belly fat, mood swings,
munchies, headaches and stress!

2) Sugar and Sugar Substitutes -Thats right: no sugar, and no fake sugar substitutes either.
(Stevia is usually fine but this depends on each person separately and is something I cover in my
private coaching program) Keep in mind with anything sweet, the more you have the more you
want. If you really miss it, and who doesnt?--- have a square of dark chocolate to satisfy those
cravings. Note I said a square, not half the bar.

3) Caffeine - Caffeine intake lowers progesterone in women, and many a 40 something woman
already has naturally falling progesterone levels. I know some of you think you need coffee to get
through your day but consider at least reducing your dose. There is a generous middle ground
when it comes to your morning cup. If you suffer from insomnia or anxiety, I suggest you wean
yourself off caffeine. If those arent a problem, find the least amount of caffeine that will help your
productivity without harming your health.

4) Processed Foods - Things like boxed cereal and frozen pizza are no good. As much as
possible, stick to whole, unprocessed foods. When youre out food shopping, ask yourself, Would
my great grandmother have eaten this? This will help you shift to nutrient rich foods such as
berries, kale and grass fed organic butter instead of rich, sugary, and calorie-dense foods like
pastries.

5) Liquid Calories - A lot of the liquids we consume have hidden calories, and not very healthy
ones at that. A daily grande frappuccino from Starbucks clocks in at a whopping 430 calories, but
with none of the protein fiber and minerals found in whole foods. The same goes for fruit juice.
Whether its a juice box for your child or a grown up smoothie from the local juice bar, youre
paying for more sugar and less fiber than if you ate the whole fruit. The exception is the nutrient
dense smoothie that you make at home.

6) Meat - Its not that meat is bad for you...its that too much bad meat is bad for you. A diet high
in conventionally raised red meat combined with high carbs (aka the classic meat and potatoes
diet) can cause digestive problems. If you want to eat meat, put emphasis on pastured meats from
cows that grazed on grass, that lack synthetic hormones and antibiotics. Find a farmer if you can!

7) Dairy - Suffering with acne or bloating? Ditch the dairy. Milk has been shown to increase
matrix metalloproteinase (MMK), which ups inflammation, which leads to higher androgens and
acne. I suggest removing dairy for six weeks to see if it helps your symptoms. You can introduce
organic dairy in 6 weeks to see if there has been any improvement from taking a break. Take note
of any changes.

8) Any foods that make you feel bad - I believe in bioindividuality. What works for someone
else may not work for you. Learn to listen to your body. Just because something is healthy, does
not mean it is healthy for you. If you really want to specifically know which foods cause
inflammation for you, ask me about the Mediator Release (MRT) Test from Oxford Biomedical
Technologies lab.

9) The Dirty Dozen - The Most Contaminated Fruits and Vegetables-Conventionally grown fruits
and vegetables are billed as health food by the USDA, but come bearing traces of toxic pesticides.
Buy organic versions of the following produce as often as you can. Join a CSA. That's short for
community supported agriculture. You can start small by cultivating you own herbs in pots. For the
most up to date information on the dirty dozen, check out www.ewg.org.

Is your mood low and your weight high?

If so, you should definitely have your hormones checked! Progesterone is the first
hormone to get out of balance in perimenopausal women and its absence can make you
feel anxious.
You dont need the latest anti-anxiety prescription, you simply improve your hormones and
watch in amazement as your overall health improves.
My programs help you reclaim your hormone balance and help you live your best years yet
with energy, improved weight management and a positive mood.
You can go to https://nourishandflourishhealth.acuityscheduling.com/schedule.php
to schedule your complimentary 20 minute discovery phone session with me.

Top 6 Tips on How to Have a Productive Doctors Visit

Although most women can balance their hormones without a prescription, if you're going to do
estrogen replacement or want to do a deep dive into thyroid hormone testing, you will need a
doctor. Below are my best tips on how to get the most out of your visit.

1) EDUCATE YOURSELF: In order to get the most out

of your health care visit, you must be knowledgeable
about your body. That's where working with a health
coach comes in. Health coaches can help formulate a
list of options and tests that you will get only if YOU
ask for them. When you are informed about your
symptoms and concerns, you will easily recognize
others who are equally or more informed. Your
knowledge will help you and your team to devise an
effective plan that you understand and will be
motivated to stick to.
2) MAKE A LIST: Before you go to the appointment,
make a list of the reasons you are there. List every
symptom, prescription request, and question. If
possible, highlight the non-negotiables that you
must cover in order to feel satisfied. Share the list
you made with the doctor. It will help your doctor to
focus the visit and will ensure that your discussion
touches upon all of your most pressing concerns. Ask
for help in determining which issues are the most
important to tackle at this visit.
3) TAKE A COMPANION: Consider taking a trusted
friend or family member with you. Sometimes a
second set of ears will catch something you missed.
You can ask them to take notes. Office visits can be
packed lots of information which may be difficult to
remember after you leave.
4) DONT TRY TO IMPRESS YOUR DOCTOR: You must
be honest and open. Withholding information from
your doctor means that any plan they make for you
might be incomplete. If you are embarrassed about a
symptom, remember that the human body is their
job. It is unlikely that you will tell them about a
symptom or condition that they have never heard of

before. Consider if you are holding back something,

due to fear that they may suggest some changes you
don't want to hear. For example, if you are obese and
suffer from high triglycerides, your doctor will likely
tell you that you have to exercise. Remember, your
health care team is there to help, and they want to
see you be healthy and happy. They must know
about your symptoms, fears, and concerns before
they can help you improve them. Be forthright. Its a
key step to getting healthy.
5) BE POLITE YET ASSERTIVE: This is no time to be a
wallflower. Being a passive or non-participatory
patient gets you nowhere. It may take a little
steeling yourself to speak up because doctors have
our respect due to the hard work and education
theyve put in to get to where they are, but it is
important that you have your questions answered.
Make sure you are clear and concise about why you
are there. If you dont feel that you have the doctors
attention, you will likely not end up having a
thorough visit and you may end up more frustrated
then before you went in for your visit.
6) HAVE A PLAN BEFORE YOU LEAVE: Before the
doctor leaves the room, make sure that a plan is in
place. Be certain that you and your doctor have clear
expectations of what is to be done and why. Were
you given a prescription? Ask if there are natural
alternatives you can try instead or if you can wait a
few days to see if your symptoms improve. If you
decide to go ahead with the Rx, verify the name,
purpose, and dosage. Also, what is the follow-up
plan? When will you see him/her again? How can you
reach him/her if you have questions or changes in
your symptoms?