Your Hot Flushes Are Not Random And Neither Is Your Anxiety

Hot flushes can be more than heat, they can feel like a sudden loss of control. If you have ever had that split-second surge of panic before a flush, or noticed anxiety and low mood creeping in at the same time, you are not imagining things and you are not “going crazy”. I’m Susie Garden, naturopath and clinical nutritionist, and I’m sharing the hormone connection that so many women never get told about.

In this week's episode, I connect the dots between perimenopause symptoms that often get treated as separate problems - hot flushes, racing heart, anxious spirals and emotional flatness. I explain how fluctuating oestrogen impacts the hypothalamus in your brain and your temperature regulation, why progesterone decline can reduce GABA’s calming effect, and how serotonin shifts plus increased cortisol sensitivity can make your nervous system feel reactive. I also talk about why low mood in perimenopause does not always look like classic depression, and how sleep disruption, blood sugar swings, inflammation and constant stress can make you feel unlike yourself.

Then I get practical. You’ll hear my favourite foundations for perimenopause and menopause support: stabilising blood sugar with protein, fibre and healthy fats, reducing alcohol to improve sleep and hot flushes, making strength training non-negotiable for mood and resilience, adding phytoestrogen-rich foods like flaxseeds and legumes, and using simple nervous system tools like belly breathing and time in nature. I also cover when broader support may help, including personalised supplements, gut support and a conversation with your GP about menopause hormone therapy, because there is no one-size-fits-all plan.

If you want tailored support, book a free peri weight loss assessment using the link in the show notes, then share this with a friend who needs it. Follow or subscribe so you don’t miss next week, and if you found it helpful, leave a five-star review and tell me what part hit home for you.

Are you a woman feeling stressed, flat and experiencing the challenges of perimenopause or menopause?

It’s time to reclaim your youthful energy, radiance and self-assurance (and your ideal weight).

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Here's how I can support you -

1. Hit your health and wellbeing goals this year, balance your hormones and lose weight with your own personalised protocol, based on your body's biochemistry. Sounds awesome right!! Book a free 30 minute Peri Weight Loss Assessment with me so we can discuss your health and wellbeing goals and also see how I might be able to support you. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book your call here. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

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Transcript

Welcome And Why This Matters

SPEAKER_00 0:00

Hi, I'm Susie Garden and this is the Ageless and Autumn Podcast. I'm an age-defying naturopath and clinical nutritionist and I'm here to bust myths around women's health and ageing so that you can be ageless and awesome in your 40s, 50s, and beyond. The Ageless and Awesome Podcast is dedicated to helping women through perimenopause and menopause with great health, a positive mindset, and outrageous confidence. Hit subscribe or follow now and let's get started. Hello, gorgeous one, and welcome to this week's episode of the Ageless and Awesome Podcast. I'm Susie Garden, your host. I'm a perimenopause naturopath, weight loss nutritionist, and proud perimenopause survivor. Yes, I made it through to the other side and I survived. In fact, I'm thriving, and this is what I want for you. And this is one of the real reasons that I do this podcast every single week, is because there is still so much misinformation. There's still such a lack of support as well for women going through this. And guess what? If you're in your late 30s, 40s, 50s, you get there, you will get you'll go through this part of life. And for many people, there are symptoms. There's probably, I think the stats are 20% of women will not get any symptoms. 80% will get something, and many, many women get quite severe symptoms. So today I'm going to talk about one of the most, I guess, stereotypical signs or symptoms of perimenopause, can sometimes continue into postmenopause, is hot flushes, anxiety, and low mood. And I'm going to talk today about the hormone connection that probably no one has explained to you. Um, so you know, hot flushes can feel really unsettling and often quite isolating, particularly if you don't initially realize what is going on. I still remember the first time I had a hot flush and I knew, I did know. I thought, oh gosh, this must be what a hot flush is like. I'm talking about hot flushes, anxiety and low mood, because in many ways they kind of go together. Um, and I'm gonna get into that shortly. But the thing is, when you experience a hot flush or multiple hot flushes, they can feel really unsettling because you're kind of trapped in your body and your body is behaving in a way that perhaps you haven't experienced before, particularly if you're someone that hasn't had any sort of issues like health issues throughout your lifetime. I haven't really. So to have something like that going on randomly, multiple times a day, and at really inconvenient times, by the way, it is really quite um unsettling. Yeah. Um, and particularly, you know, if you've never been, for example, an anxious person before, and suddenly you get the heart racing, chest feeling tight, your mind spiraling, or maybe your mood feels kind of flat or irritable or unpredictable. You know, there's so much going on in the body on a hormonal level at this time that it's no wonder we get all of the symptoms that we do. So if any of this resonates with you, I want you to know you're not imagining it. You're not overreacting, you're not alone, definitely. Even though these are, I mean, hot flushes people talk about. I don't know that people talk about the low mood, the low motivation, and the anxiety that's that goes along with this because they think it's only happening to me, or you know, there's there's something going on that I don't understand. So today I'm gonna connect the dots between these symptoms because they are not random, they are hormonal. So, firstly, let's talk about why these symptoms often show up together. Hot flushes, anxiety, and low mood are all influenced by the same hormonal shifts, which is primarily, as you would imagine, estrogen fluctuations, the declining progesterone, and increased cortisol sensitivity. And these hormones don't just affect your reproductive system. I think, you know, and certainly, I mean, I'm a healthcare professional. I've been, you know, a healthcare professional for a really long time. And I was never trained that estrogen and progesterone don't just affect your reproductive system, not in any great detail. You always think of those hormones as being sex hormones, and that's they're irresponsible for reproduction and menstrual cycles and those kinds of things. You don't realize that we have estrogen receptors all over our body. So there is a role for estrogen in multiple body systems, not just reproduction. So these hormones don't just affect your reproductive system, they affect your brain in a big way. They affect your nervous system, your temperature regulation, your mood, your stress response, multiple other things. So when they change, your experience of your body can also change. And that can feel incredibly destabilizing, scary, um, like you just have completely lost control of your your body and your life. And if you don't understand why, then you it makes you feel even more at a loss and even more anxious, I think. So let's start with hot flushes or hot flashes if you're um in North America. Hot flashes or hot flushes are not random, they are driven by changes in how your brain regulates temperature. Specifically, there's this part of the brain called the hypothalamus. It's like your master controller of your stress response, your relaxation response, many other things. And estrogen plays a role in keeping your internal temperature stable. So as estrogen fluctuates, so it boosts, like it surges and then it drops, the hypothalamus becomes more sensitive. The temperature range that your body feels most comfortable in becomes a little narrower. So even a small increase or shift in, I should say shift, because sometimes it's when you step out into the cold, it's not just heat, um, but a small uh change in the environmental temperature can trigger this heat response. But that's not the only trigger. Sometimes it's stress. There's quite a lot of um uh I don't know if I want to say the word research. I think there's research about the impact of stress on hot flushes. We definitely know if you manage stress better, your hot flushes will absolutely improve. Um, but yeah, that the body reacts like it's overheating, and so you get this warmth, can be really uncomfortable. It can feel like we describe it as a flush because it's like this whoosh of heat. So some people describe it as coming from the base of like the pelvis up, some people describe it as going down. It's really quite an individual experience, it's often uh accompanied by intense sweating and often a rapid heartbeat and a feeling of palpitations, and you can also get a sense of anxiety, it's almost like a split second of this feeling of anxiety just before it happens. It certainly was my experience, and it is many women's experience. So you you so firstly you get this microsecond of feeling like, oh my gosh, something's really wrong, and then woof, there it goes. Um, and it can be really embarrassing, like if you're you know giving a presentation or something like that, and suddenly you're pouring with sweat, and you've got the armpit sweat going, you've got sweat running down your face. It's a horrible experience. And you know, I I remember as sort of like a teenager watching something like the Golden Girls, for example, and and they would make hot flushes out to be such a joke. You know, they'd go and stand in front of the fridge and open the fridge and be fanning themselves, and it was kind of really dismissed, I think, as a symptom. It's not, it's not just that you get a feeling of heat. It is really intense. And as I said, when you're getting that with the sweat, with the increased heartbeat, with that sensation of anxiousness, it's really not great. And particularly if it's having happening multiple times a day. At my worst, I was getting I count, I started counting them because I wanted to sort of really track where I was at. And at my worst, I was getting around 11 a day in my waking hours. So that's a lot. That's a lot. Um, now some of the common triggers include alcohol is one, caffeine can also impact some women like that, sugar for some people, stress is a big one, as I mentioned before. Sometimes spicy foods or warm environments or stepping suddenly into a cold environment. But the underlying trigger really is this estrogen instability. So you might say, oh, it's caused by, you know, I get this after I have a coffee or whatever, but really it's the estrogen instability that's causing it. And you can get it with absolutely no trigger. That was certainly my experience was I could just be sitting at my desk, whoosh, there it would happen. It would often happen when I was teaching yoga, and that was horrible because I'd just be soaked through my active wear. It was horrible. Um, so let's move on to anxiety and why it can just appear out of nowhere. Because this is often a symptom that worries women the most. I think most of us are aware of hot flushes. We can kind of accept them for many people that it's just going to be something that happens. Although, just aside, it doesn't have to be something that happens. Um, but the anxiety can be really concerning because many women may not have any other symptoms, but they get this anxiousness and they feel like, you know, what is going on? Like I've never had anxiety before. Why now? Uh, and they get very concerned that this is now going to be some sort of chronic health condition. The thing is, oestrogen influences serotonin, and serotonin is your mood-regulating neurotransmitter. So you've got that aspect. And then you've got progesterone. Progesterone influences something called GABA. GABA is your calming neurotransmitter. So when you think about the hormonal picture, early on in perimenopause, your progesterone really starts to decline and it doesn't come back up. It's not like estrogen, which will surge and drop. Progesterone just tends to drop. Um, and that has a destabilizing effect on what we call your HPA axis. So the hypothalamus, there's that word again, pituitary gland, which is also just under the hypothalamus. It's like a master controller of multiple body systems and hormones. And the A is adrenals, which of course where cortisone, cortisol, and adrenaline are produced. So HPA axis. So progesterone destabilizes that HPA axis. Um, so when estrogen is fluctuating, that impacts your brain, and progesterone is declining, both of the calming systems of the body, your GABA, your serotonin, are impacted. And at the same time, cortisol, your stress hormone, can become a little more dominant in some people. And this creates a nervous system that is more reactive, more sensitive, quicker to trigger a stress response. So you might experience things like racing thoughts, just this general sense of unease, this overconcern, uh, particularly for family members, overconcern over, you know, overthinking, over concern over whatever is going on in your world, really turning it over and turning it over in your mind. And worst case scenarioing it, um heart palpitations, that's a big one that can make you feel awful, and just feeling overwhelmed by just things going on in your day that used to be very manageable and now are just overwhelming. And because this is new, it feels frightening. Because it can be quite sudden, it feels frightening. But it's important to understand this is not necessarily a chronic mental health condition. It's not a personality change, it is a neurochemical shift. I mean, obviously, you always want to go and get that assessed by a healthcare care practitioner. Uh, but also when you're having that discussion with your healthcare practitioner, it might be worth saying, you know, I think I'm in perimenopause. Could this be related? Because that can really help your healthcare practitioner when they're assessing where you're at. So the other thing I wanted to talk about, which I don't think is talked about a lot when we talk about perimenopause, is low mood and emotional flatness. Now, I experienced this myself, and low mood in perimenopause doesn't always look like classic depression. It can feel like just emotional flat, just flatness is how I would describe it, just feeling really flat, not getting those surges of joy. Um, you're just feeling flat and reduced motivation, that was a big one for me. Um, irritability, feeling disconnected, feeling like, you know, you just, I don't know, just not engaged with life, not engaged with friends, family, etc. And, you know, this links back to dopamine changes, serotonin fluctuations, also chronic stress, which a lot of us experience. I think, particularly at the moment, there's a lot going on in the world, which we get exposed to, whether it's through watching the news, whether it's on social media. And I really encourage you, like, yes, it's good to be across things, but remember headlines and are what drives clicks. So you will often see terrible headlines that really can make you feel anxious, but the story itself isn't that big. I'm noticing this a lot. Um, and I've recently just sort of stopped myself looking at the news constantly because it's just not good for me, and a lot of it is just stirring up panic and stress unnecessarily. Um the other thing that that can cause this low mood and emotional flatness is sleep disruption. And again, like so many of us in perimenopause and postmenopause can have disturbed sleep. So that is just gonna feed that low mood and flatness. You know, when your brain chemistry shifts like it does during this phase of life, your emotional landscape also shifts. And, you know, if you layer on that blood sugar instability, inflammation, which happens because your estrogen's low and poor sleep, that feeling of not feeling like yourself anymore becomes very real. And it's scary because you think, is this my life now? And a lot of women, when they come to see me initially, are like, I'm worried that this is my life now. Um, and I don't want it to be, you know, I want to feel joy, I want to be engaged and involved in life and not just feel so flat and so fatigued and just not like myself. So let's talk about what supports these symptoms. Firstly, and I think I probably say this almost every podcast is stabilized blood sugar. Super important, particularly once we get to our 40s, because this starts to change. So this is and this is foundational to good health. So it's actually very easy to do, um, which is balancing out your meals with protein, fiber, healthy fats. What this will do is improve energy for one thing, but also reduce mood swings and anxiety as well. I know that sounds a bit like really just food, but I've been working with food for a long time now, and I still get amazed at the incredible power of eating the right food and particularly eating a personalized nutrition plan. But even just making sure you've got enough fiber, the standard that we're hearing at the moment is about aiming for about 30 grams per meal, and again, for a protein amount does come down to your body weight and like your goals. Like, if you're in a in a place where you're wanting to build muscle, you might need a little bit more. I'm still I'm hearing, you know, lots of different recommendations about how much protein to have, and there are some really create, like this, you would have seen it. There's a massive protein push in big food at the moment and in the supplement world, and a lot of it is I've seen so many fads over the years, and I don't want to sound, I sound pretty jaded, don't I? But I've seen so many of these fads that we all suddenly we've all got to eat all these massive amounts of protein, and you know, it is possible to have too much. If you've got kidney issues, you definitely don't want to be doing that without talking with your healthcare professional. Um, but for many women in perimenopause, having sort of around that one, I'm hearing everything from like 1.3 to 1.6 seems to be one of the more reasonable amounts of protein to have. Um sorry, let me rephrase that 1.3 to 1.6 grams per kilo of body weight. Now, generally, that's the your ideal body weight. So if you are carrying extra weight, you may want to look at what's my ideal body weight and calculate it on that. But again, this will, as I said, it changes. Like if you're building muscle, if you've got um a chronic disease, it requires a lot of healing. You may need more protein. So, yeah, I I don't want people to take this as uh health advice. This is really very much general advice. If you've got specific needs, you do need to speak to your healthcare professional to make sure that you're getting what you need. Um, so stabilizing blood sugar is super important. Also, reducing alcohol again, it's something I think I say almost every pot. And I, you know, I've reduced my alcohol quite a bit. Like, not that I was a massive drinker, but I'm probably only having one or two glasses a week, if that now. And oh, I'll tell you, you just feel so much better for it. Alcohol worsens hot flushes for sure, worsens sleep quality, absolutely, worsens anxiety, worsens mood fluctuations. But even small reductions in alcohol can make a noticeable difference. So I encourage if you feel like you know, I've got so many women that come through in their initial consult with me and they're drinking, you know, maybe half a bottle of wine, sharing a bottle of wine with their partner every night, and they think that that's pretty normal, and that that's actually quite a lot. So um, that would be something that I'd consider you may wish to have a think about. Maybe even just go like dry for a month and just see how you feel. You you will probably notice quite the difference. Uh, number three is strength training. Oh man, I love strength training. It improves insulin sensitivity, it improves your moods. I mean, getting those endorphins. I uh went to my PT session this morning and lifted my body weight, which oh my god, the rush from doing that, amazing. Uh it also improves your dopamine function and just your overall resilience. Plus, oh, there's so many other benefits from you know an a healthy aging point of view. So, strength training honestly is a must. It is a must. If you're a female over 40, find a way to get it done. Um, whether it's joining a gym, whether it's doing some things at home, if you've got some special needs, then definitely consider getting a trainer. Even if you get a trainer to do a program for you and you get it reviewed every, you know, six to eight weeks, something like that. Um, having a trainer for me personally has just been a game changer because I have an appointment, I have to go. Um, I have a pretty amazing home gym, but yeah, it's hard to get motivated to go. Uh, but when you have an appointment and there's consequences, and that is so good for keeping you accountable and keeping you in your strength training routine. Uh, number four is phytoestrogen rich foods. So foods like flaxseeds, uh tofu, legumes can gently support estrogen pathways. This is not like eating estrogen. Okay, it just helps modulate estrogen. It helps support the pathways. Kiwi fruit is an uh actually no, kiwi fruit is a phytoceroton-rich food. That's actually also another really good one. Um, they've done some really good studies on kiwi fruit and having it at night. Um, having two kiwi fruit at night really helps with sleep because serotonin, you may not know, is actually the precursor to melatonin. So if you don't have enough serotonin, you're not going to have enough melatonin. And um the kiwi fruit are a natural source of serotonin. Very cool, very good for your gut health as well. Uh, so nervous system support is my next one. So daily practice matter more than trying to get these really long practices in. Like if you're thinking, right, I'm gonna meditate for half an hour every day. That's a big goal if you're not a regular meditator. That's a long time to sit with yourself. So if you just can do some belly breathing throughout the day, if you can do some walking, if you've got animals that need walking, walking them is fantastic. Spending time in nature whenever you can. Um, even if it's just your backyard or walking to your local park, that is hugely beneficial. And particularly if you do it in a mindful way. So not wearing headphones, not listening to music, listening to a podcast or anything like that, but actually just going down, listening to the birds, listening to the sounds, even if the sounds are cars. Um, and just really being present is what you need to be doing to ground your nervous system. And just generally reducing overstimulation. So, in you know, staying away from the screen is probably the best one. Avoiding your emails, particularly at night. Um, I think I've mentioned before I have a pretty good uh policy around not having my phone near me at night. Um, but I did do occasionally get into a little habit of just checking my emails before I go to bed. Like, how dumb is that? If anything's gonna get your mind stimulated, is seeing emails come through at night. So stop that. Your body needs signals of safety, so give them that. Number six is consider broader support. So for some women, this might include targeted supplementation, uh, it might be gut support, it might be really specific stress management supplement, um, or having a conversation with your doctor about menopause hormone therapy. There is not a one-size-fits-all approach to this. And I think it's possibly one of the reasons women have been underserved in this area is because we all present a little differently. So, whereas some women will present with the hot flushes, so I mean, that makes it pretty easy for a healthcare professional to go, okay, I know what this is. But if you're presenting with low mood, if you're presenting with low motivation um or some anxiety or anxiousness, then it that's a little harder to identify the cause. So it really you really do need to have individual um uh tailoring, I guess, to your own protocol. And and that's why I've got a real thing. Like, I know there's a whole um there's so many women that come to you and they've bought supplements off websites, and it's like you really need stuff that is the right thing for you, not what just came up in your feed. So I highly encourage you not to just go and buy supplements off the internet, but to actually get some recommendations specifically for you and your situation. So, if there's one thing I want you to take from today's podcast, it's this you're not becoming someone else, you're not just getting older, you're not losing your mind, you are in a hormonal transition that affects your brain, your body, and your emotions. And with understanding and support and some really targeted protocols just for you, these symptoms can improve significantly. So if you are experiencing symptoms like this, the hot flushes, the anxiety, the low mood, you're feeling unsure what to do next, and you're scared. You don't really want to go and have a discussion with your doctor and end up on um an antidepressant, which I have a lot of women who are concerned about that. You don't have to figure this out on your own. Um, you know, you inside the GLOW protocol, which is my signature program, I take a whole body approach. So I look at hormones, metabolism, nervous system, lifestyle. And if I feel you need referral to a GP, I will absolutely do that. And the thing is, everything is connected, so it's not really just a single pronged approach. You really do need to have this multi-approach so that you can get things under control quite quickly. And you would be amazed how quickly you can change the path, how quickly you can feel so much better. So, if you'd like to explore what that support might look like for you, you can absolutely book a free peri weight loss assessment with me using the link in the show notes. It's just like a 20-30-minute video call where I learn a little bit more about you and what's going on. I talk to you about how I work with women and we can decide if we're a good fit or not. So, thank you for being here with me today. If this episode resonated, please share it with a friend who might be going through the same thing. Because honestly, so many women are, and so many women are doing this very quietly. And we all deserve to feel like ourselves again. Thanks so much for joining me on the Ageless and Awesome podcast. If you would like this episode, please make sure you click the little plus button if you're on Apple Podcasts, or the follow button if you're on Spotify, so that you get each new episode delivered to you every single week. If you feel like writing me a five-star review, you would absolutely make my day. If you found this episode resonated with you, head over to my Instagram and DM me at the Perry Metaports Park. I would love to connect with you.