In the second of our 3 part series on the big M (menopause) Hannah is joined by Renee Irvine from the Peri Project, a collaboration designed to support women to take charge of their perimenopause experience, minimise the disruption and maximise health and wellbeing.

In this episode Hannah and Renee chat about how nutrition and naturopathy can help us navigate perimenopause. 

Show notes

Hannah:
Welcome to the Burn Pod, listeners. Now, if you haven’t already, jump on back to our previous episode where we got stuck into the subject of perimenopause with Kirsten Brown from the Peri Project. In that episode, we introduced perimenopause, what it is, when it starts to occur, what it looks like and the ways that we can support ourselves through this. We are very excited now to actually expand on this topic in more detail with Renee Irvine from the Peri Project, and in particular, get stuck into how nutrition and naturopathy can support us through this time.

Hannah:
Now, Renee is a qualified naturopath, a personal trainer, a mama to two young boys and a local resident of Melbourne’s inner west. Her goal is to treat the underlying cause and educate clients to improve their health. She uses a combination of nutrition, herbal medicine, dietary analysis and advice and health coaching to assist her clients to achieve their best health on a physical, emotional, and mental level. So welcome, Renee.

Renee Irvine:
Thanks so much. Thanks for having me.

Hannah:
It’s awesome to have you on board. Now, so our listeners get to know you a little bit more, tell us a little bit about yourself, what you got you started in this area. I guess, what your role is with the Peri Project and what you’re passionate about.

Renee Irvine:
Wow. I could just go on for a long time about all of those things. So what led me to studying to be a naturopath, that journey started a long time ago. I’m nearly 39, and I started studying when I was 22, 23. So, I guess my interest and my passion about that area really has evolved a lot.

Renee Irvine:
As a much younger person then, I was really interested in natural health, I guess, from my own journey of not feeling like I was getting great support from conventional medicine with some of my health concerns. I was just getting fobbed off a little bit, kind of going in to see doctors and being like, “I don’t feel good. Something’s not kind of right.” And kind of looking at sort of alternative ways of improving my health. And I started just seeing a naturopath in the student clinic and they gave me fantastic tips, really mainly around nutrition. My nutrition was very, very poor back then, being a 21-year-old…

Hannah:
Uni student, maybe?

Renee Irvine:
Well, I wasn’t a uni student just then yet, but I was a vegan. I literally lived off toast. I mean, I was just really not living my best life. I got lucky and saw some really fantastic students who gave me such great tips around things. And I was like, “Wow, I want to know more about this and I want to help other people as well.” And that kind of spurred on my sort of interest, and then I started the degree.

Renee Irvine:
I think things kind of changed after… Fast-forwarding years later, I had kids and I decided to start practising . And I guess as a mother to two children, I’d had not the best pregnancies. I wasn’t feeling great postpartum and having some hormonal issues and things like that. I guess that’s where I started to kind of go, “Okay, I’m really interested in women’s reproductive health.”

Renee Irvine:
And then I guess, now fast-forward even a few more years, I’m at that kind of key age, I’m 38 turning 39 this year, perimenopause is potentially on the horizon and most of my clients are kind of in that age group, so that kind of 35 to sort of late forties, early fifties. And I guess I started seeing that I was kind of talking to my clients about the same sorts of things around hormones, asking questions around where they were at with their hormones and their family history and that sort of thing. And kind of realising that there was a really common theme with women and also where these women just didn’t, A, either didn’t know what perimenopause was or, B, were horrified at the prospect of me mentioning the possibility that they were perimenopausal, because they had this perception that perimenopause is for old women-

Hannah:
For old people, yeah, yeah, yeah.

Renee Irvine:
… grandmothers and that kind of thing. And so that was already kind of happening in the background. And then, by chance, I met Kirsten at a Christmas work party and I’d already met Janis, but we just started talking about perimenopause. It was like, “Whoa, this is a hot topic that we’re either experiencing or we’re seeing in our clients,” and that kind of thing. And we just sort of talked about the need for changing the face of perimenopause and providing education and understanding around it, and the Peri Project kind of came from there. And I guess in terms of my role with the Peri Project, I did sort of step back from being directly involved with the Peri Project sort of late last year, just schedule, lockdown, homeschooling. All of the fun things.

Renee Irvine:
So I’m kind of on the… I don’t know what we called it, but I’m sort of like on the advisory committee at the moment. But I’m still hanging to get more involved again and be a part of it because it is something that I’m very, very passionate about and it just becomes more and more relevant. The more women I speak to about hormones and perimenopause, the more I can see the need for the Peri Project.

Hannah:
Yeah, exactly. I was saying to Kirsten when we had our chat that it’s a topic that you don’t hear anything. It’s like a taboo topic. You hear about the scary, scary menopause. And for someone, I’m in my early thirties, menopause is still a very long way away, far away on the horizon. But no one is talking about the impact that the pre, the space or the time before menopause, when things are starting to change, your body’s not going to be one minute be able to reproduce, next minute, you’re straight into menopause. It’s going to be like a lead up. And no one talks about that.

Hannah:
So it’s really interesting. I’m really glad we’re starting to have this conversation. And there’s a conversation I’d love to get even more into, what do our cycles mean for us as women in all stages of life? Because I know that sometimes when I’m at a particular stage in my cycle, I don’t have any energy and I don’t want to go to the gym and I feel crappy and I want to eat chocolate. So there’s ways that we can support ourselves at all stages of our life. So my gals listening, if you are not even in your thirties, this definitely doesn’t mean that this won’t be relevant and you’ll learn a lot from it.

Renee Irvine:
100%.

Hannah:
Keep on listening. Well, could you give us an introduction to nutrition and naturopathy as it relates to perimenopause and menopause?

Renee Irvine:
Yeah. Oh, God, where do I start?

Hannah:
I know, that’s a big question, sorry.

Renee Irvine:
Naturopathy at its core, it’s a holistic health model that really focuses on things like addressing the underlying cause and a strong preventative medicine approach. So the idea that prevention is the best cure so that we can look at what’s up ahead in terms of ageing or illness or disease, and do work on ourselves and improving our health to potentially avoid certain outcomes or just improve the journey. So in terms of how I translate that to our transition as we age through perimenopause and beyond, I really look at it, again, firstly, changing the idea of perimenopause as being this absolute horror show. And it happens to us and life ruining, and then we don’t have sex anymore and everything falls apart.

Renee Irvine:
And kind of just sort of, I think, educating people around that, we’re often hearing the horror stories from people, we’re not necessarily hearing the positives or the changes that occurred that are not unpleasant, but also that we can potentially reduce some of those really severe negative outcomes that we’ve heard associated with perimenopause and menopause. So that, again, from a preventative point of view, if I’m working with women who are in their early thirties and they’ve got problem periods, they have the heavy bleeding, painful periods, irregular periods and things like that, by working on supporting their hormones better and supporting the way that their body functions better, that that may actually improve their outcome as they transition through perimenopause.

Renee Irvine:
So again, it’s really about this preventative approach. It’s not looking at hormonal fluctuations. It’s not a disease, perimenopause isn’t a disease, but it can be a sign of an imbalance, so where things are just kind of fluctuating in a way that’s not cohesive to good health and good functioning. So I guess that kind of addressing the underlying cause, “Okay, what’s going on with this person’s hormones? What’s their health background that’s maybe contributed to these fluctuations and things not working as effectively?” And also that from that preventative point of view, how can we ensure that we’re avoiding some of these negative associations with perimenopause and menopause, things like cardiovascular disease, bone health disease, diabetes and those sorts of things. And then also the symptoms that we hear about, like the hot flashes and poor sleep and those kinds of things. How can we potentially avoid these things down the track? So that’s, I guess, in a crux the focal point.

Hannah:
Well, because naturopathy is considered a non-conventional medicine, and I guess a very simplified way of me looking at what it means to me is, is it mashed up herbs? That’s terrible. I should probably know a little bit more about it. But a lot of people’s ideas of what naturopathy is, is just herbs in a bottle. So what is it that you do with naturopathy, when it comes to those heavy bleeds or our cycles?

Renee Irvine:
I guess that one of the key differences is the time spent with my clients doing the case taking. So, you think about when you go to see a GP… And this is not about a criticism about conventional medicine. I really see naturopathy as being complimentary and alongside of conventional medicine. And I really like working with, want to work with, GPs and specialists and all of these kinds of the other healthcare practitioners that are really important when we’re talking specifically about perimenopause. So I guess the key difference is is that you go to a doctor, you’ve got a 10 minute block. Sometimes you might get a 20 minute if you book a long appointment. They’re really going by, “What are your symptoms? Tell me as much information as you can in as little time as possible. Here’s a referral. We might do some investigations.” Or, “Here’s a script for a medication and let’s see how that goes.”

Renee Irvine:
And again, as I said, there’s no issue with that. But for people where they’re maybe not getting the good results, or they’re just not feeling heard, having an appointment with a naturopath where the initial consult is 60 minutes. So it’s 60 minutes of meticulous case taking. So someone will present with me and say… I’ll be like, “What brings you here?” And they might start going, “I think I’m going to do pending perimenopause. My period felt really normal, and now it’s gone kind of haywire and my sleep’s affected and I’m bleeding bucket loads and I’m getting my period two weeks later. I went to my doctor and my doctor said, ‘This is your option. Let’s put the Mirena in.’ And I don’t really feel like that’s going to work for me. I want to understand what’s going on,” or, “I would like to try a different approach.”

Renee Irvine:
So, starting from there, that’s where I get as much information as possible about the immediate experience. So, “Tell me more about your period.” I get all the details, often quite juicy details. “Tell me about the blood. How heavy? What does it look like?” All of those kinds of things. I also get timelines. “Tell me about your period, when you first got it, what was it like in your twenties. If you’ve had children, what was it like after you’ve had children?” So that timeline tells me a lot as well. Family history is a really big important one too.

Renee Irvine:
Because naturopathy is a holistic approach, we’re not seeing things being driven by one cause. So it’s not just, “Ah, your hormones are out of whack because you’re a woman and that’s just what happens.” From a naturopathic perspective, we know that there are other contributing factors that can cause your hormones to go more haywire than they need to be during that transition. And that might be things like lots and lots of stress, poor nutrition, issues with gut health, previous diseases or illnesses, maybe autoimmune disease or something like that. So it’s this bigger picture. So I’m gleaning all this information from all different kind of perspective and then putting the pieces of the puzzle together.

Renee Irvine:
So from there, I come up with a treatment plan and generally that treatment plan will include some dietary advice, maybe more protein, more leafy greens, more colour, and those kinds of things. And I’m saying very generally. Some clients, I use just food as medicine. But then especially when it comes to hormones, I will use herbal medicine. And they’re definitely a little bit more complex than just mashed up [crosstalk 00:13:44]. They kind of are. So basically I use either liquid herb mixes that I make myself, so I have individual herbs I’ve put together in a concoction, or there’s sometimes pre-formulated pills or capsules. Nutritional supplements often come into play as well, and I would use those in a sort of synergistic kind of way. For me, herbal medicine is the hero when it comes to hormonal issues. I definitely could get great results if I was just a nutritionist and just focusing on nutrition. But for me, the herbs, really, they can turn things around really quickly for people.

Hannah:
Are we able to even get into a couple of details around what herb or what herbs mixture can support different kinds of hormonal imbalances? Just so we get a couple of examples.

Renee Irvine:
Yeah, definitely. So, I guess the first thing I would say before I talk about herbs is that because naturopathy’s really focusing on the individual, I won’t always use the same herbs for everyone. Because everyone’s coming to see me and I could have five women who are going through perimenopause with identical symptoms, but because of all of that other information I’ve gleaned from them about their lives and the influencing factors, I might come up with five different treatments. However, there are definitely key herbs.

Renee Irvine:
I think the most common one that’s got a lot of research behind it, you can buy over the counter formulas, is a herb called black cohosh. It’s Latin binomial is [Latin 00:15:21], I want to get really specific. It is definitely one of my favourite herbs. It’s a fantastic herb for helping to, I guess, create balance around that oestrogen picture, because what’s kind of potentially wrecking havoc on the body as we transition through perimenopause is fluctuating hormones.

Renee Irvine:
So even though the end results, so once we’re post-menopause, is declined and very low oestrogen, during that transition of perimenopause, we can go on a bit of a roller coaster where we actually potentially have very high oestrogen. And that can be one of the driving factors of these symptoms that people experience. So black cohosh has what we call a modulating effect, so it helps to even out that oestrogen production. It’s got a really great body of evidence behind it for reducing things specifically like hot flashes and some of the mood changes that women experience. So that’s probably one of the key herbs I would use.

Renee Irvine:
To kind of highlight some of the differences between how I would treat people with different symptoms, for a lot of my clients who are going through perimenopause, one of their key symptoms is very, very heavy menstrual bleeding. Or even flooding, so where they actually get gushing of blood for a day or two of their period. And that’s, A, it’s unpleasant to experience, but it can also lead to things like iron deficiency and low energy and that sort of thing. So in those kinds of cases, I use a couple of different herbs that can assist with reducing heavy bleeding. So one of them is called lady’s mantle and another one is called tienchi ginseng, I think that’s what it’s called.

Renee Irvine:
And they’re what we call astringent herbs. So astringent is a… It helps to dry things up and reduce the bleed. And they also have an impact on kind of assisting with the tone of the uterus as well. So sometimes that kind of heavy bleeding can be caused by the uterus, which has muscles within the wall, maybe losing a bit of tone with those kind of contractions as we bleed during our cycle. So they’re kind of key herbs I use.

Renee Irvine:
I also use another herb called Vitex or sometimes called chaste tree, not always as commonly in later perimenopause, but definitely earlier perimenopause stages where women really maybe are experiencing irregular cycles and lots of PMS. Vitex is just beautiful for regulating the cycle, so that you’re not bleeding every two weeks, and it’s also a wonderful one for reducing PMS symptoms. And that one works very directly with a hormonal system called the hypothalamus pituitary axis-

Hannah:
What a mouthful.

Renee Irvine:
Yeah, the HPA for short. But it helps with regulating that system, which in turn helps with regulating some of those hormones that get produced as a result.

Renee Irvine:
So they’re kind of some of my hero herbs that I use. And I would definitely say, yes, you can get into a lot of these herbs over the counter. I’m not a big fan of people buying herbs over the counter because there’s so many extenuating factors. Is this person on a medication? What’s their previous history? There’s certain herbs that you wouldn’t use in someone who has a history of breast cancer, for example, and things like that.

Renee Irvine:
And that kind of information’s not necessarily included in over the counter herbs, or where they’re sold at pharmacies where the staff there don’t have a herbal medicine background or training. So that would be my only thing I’d say, where I do get a bit cautious around talking about how great these herbs are because then people are like, “Whoa, I’m going to Google this.”

Hannah:
“I’m going to buy a whole pack of them.”

Renee Irvine:
And then, “I’m taking one a day and it doesn’t feel like it’s working, so I’m just going to double the dose.” And that can be… Because herbal medicine, whilst it’s considered natural, it’s not always going to be safe, as I said, because there’s individual variables that can impact how your body deals with those herbs.

Hannah:
So I guess one of the major concerns that we hear, being health and fitness, is that as soon as we start moving in towards that sort of premenopause, menopausal age, the weight gain and all the impossible ability to remove the weight or get rid of any weight, lose any weight. And I know that particularly for some ladies, my mom included and also Rachel, who’ll be on a podcast shortly, they went through breast cancer, which was connected to their oestrogen. And so they have to have oestrogen blockers, which has been brought on early menopause. But it’s also because they don’t have that oestrogen, they’re finding it really near impossible to lose any weight and it’s very easy to gain weight. Are there sort of natural remedies that can… I’m not necessarily obviously like… There’s no perfect cure. But is there something that can support that area at all, other than obviously your nutrition and your exercise? With other ways that you can support that kind of oestrogen fluctuation, I guess?

Renee Irvine:
Definitely. So depending… So like you said with people who maybe have had breast cancer where they’ve been put on oestrogen blocking medications, I work with those clients, but I never ever work with anything that might interact with hormones. Because it’s just not safe, really. Certain cancers are driven by excess oestrogen and if that estrogen’s been blocked, it’s been blocked for a reason. With [crosstalk 00:21:15] people, I do my best to kind of support the other areas. I find with a lot of people, women who experience some of the worst kind of adverse effects or things like the weight gain, and they’re having trouble shifting it, I find when you look at their history, there’s some sort of extenuating variables that potentially have perpetuated that picture.

Renee Irvine:
I definitely find that a history of dieting is a really big contributing factor, high stress, disrupted sleep, maybe even blood glucose irregularities, so issues with their blood glucose and insulin. So I try and look at those variables there, because they’re sort of big ones, especially if someone has… Because again, in that kind of demographic, things like pre-diabetes or even type two diabetes is quite common with perimenopause. So if I can support and may potentially improve blood glucose and insulin regulation, that’s something that I can do that may help with shifting the weight. And then same thing, if there’s lots of stress involved or the sleep’s really poor and disrupted, working on those parameters can often help as well. But I would say that weight loss in that perimenopause group, I think is really difficult. And I think that I also try to really shift the focus away from aesthetics, as hard as I know that is, I mean, I’m not so [crosstalk 00:22:43]. I could shift some weight.

Renee Irvine:
But trying to focus on, “Let’s just focus on you feeling good. What kinds of things can we get you to do, or what kinds of things can we shift so that you just feel great?” You’re waking up feeling good and refreshed, which means that in turn, you can get to Pilates or you can get to the gym early. It means that you’re going to make better food choices because you’re not reaching for something that’s going to give you an energy hit, and I find that that’s a better approach. I know it’s not the satisfactory approach for a lot of people. They really want to hear about the magic tidbit to weight loss, and I know that that can be a really hard thing. But my approach in my kind of practise is really to try not to focus too much on weight and focus on all the other things. And then that’s where, as I said, the nutrition and lifestyle, exercise component is a really big, important part.

Hannah:
Yeah, exactly. And you sound like how we approach the concept of movement, exercise and fitness. No one wants to go in there and focus on the number on the scales. You want to feel fitter, feel healthier, feel happier and feel stronger. And those are things that can still occur, regardless of menopause or perimenopause.

Renee Irvine:
Absolutely.

Hannah:
And so, lifting that heavier weight, being able to hold that plank for longer, building a stronger core, building a fitter body will inevitably help across all of the realms of fat loss or weight loss or sleep and everything else. So exactly, changing that sort of focus a bit. Which obviously it’s hard, everyone wants to see a change in the scales if they do work. But I guess it’s just recognising that you’re coming to that stage in your life, that things might be a little bit… They won’t shift as well as they maybe previously did in the past, and that’s okay. Let’s shift the focus now to something that makes us feel good.

Renee Irvine:
I have a saying that I talk to a lot of my clients about of focusing on the benefit versus the outcome. If we’re really thinking about, “This is my goal, I want to weigh X amount,” and that is what’s on the horizon for you and that’s the dangling carrot, it can be hard to keep your motivation up if you’re not seeing results. Whereas if you’re focusing on, especially during perimenopause, if you’re focusing on the benefit of eating well, exercising, reducing stress, getting enough sleep, all of these things have an immense benefit on your body and your health as you age, because as you lose the protective effects of oestrogen, you have a higher risk of bone renewal disease, cardiovascular disease, certain cancers and things like that. And they can be potentially alleviated by a healthy diet and lifestyle, reducing stress, all of those kinds of things.

Renee Irvine:
So it’s like, yeah, fine, you might not be feeling this immediate benefit only like, “Wow, I look like a million bucks because I’ve been eating my five serves of veggies and two serves of fruit daily.” But the payoff in the long-term is going to be beneficial in terms of avoidance of disease or illness. And again, I know that’s hard. I mean, I’m human too. I have my… I’ve had two kids. I’ll look in the mirror sometimes and go, “Oh God, I do want to shift some kilos.” But I know for myself that if that was my only motivation for looking after myself, I know that I don’t stay on track.

Hannah:
Exactly. It wouldn’t last.

Renee Irvine:
Whereas, I know that when I exercise and eat well, I just feel better overall. And that’s something that’s generally more important than fitting into clothes that I did when I was 18.

Hannah:
Exactly. Thanks for joining us, Renee. It was really awesome to get stuck into naturopathy, as a general topic and what that is, but how it actually relates to perimenopause and our hormones, particularly across our life stages as women. Now next episode, we’re going to get stuck into nutrition as it relates to perimenopause and menopause. So until then, guys, have a wonderful rest of your day and tune in for our next podcast.

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