Did you know that menopause actually has three phases: perimenopause, menopause, and postmenopause. I didn’t. As a result, I have a passion for educating women about midlife stages, so you’ll be empowered to make the best choices for your life specifically during the years of change (aka hormonal chaos). Let’s begin with the little known first phase – perimenopause.
What is Perimenopause?
Perimenopause is the time between a woman’s reproductive years and menopause – a transitional phase that normally occurs 8 to 10 years before menopause hits.
For reference, the average age for perimenopause is about 47. It lasts about 4 years on average, but it can be completely different for each of us – maybe only a few months for some or even lasting years for others.
It’s pretty unpredictable since each one of us is unique in our own experience. There are commonalities, but it’s not cut and dry. Perimenopause usually starts in a woman’s 40s – but again, some could experience it in their 30s. If you experience perimenopause symptoms before the age of 40, please consult your doctor to rule out any additional causes.
In the perimenopausal phase, the ovaries slowly produce less estrogen. But something else is also happening. In addition to our bodies producing less estrogen, follicle-stimulating hormones(FSH) levels can rise to try to make up for depleting estrogen levels, and progesterone can drop – leaving a trail of symptoms in the wake of your depleted and unbalanced hormones.
Premenopause vs. Perimenopause
Premenopause and perimenopause are usually mistaken to be the same thing, mostly because healthcare professionals typically refer to anything before menopause as perimenopause. But there is a difference. Premenopause means before menopause and perimenopause means around menopause.
It’s typically not until perimenopause when a woman experiences changes in her cycle and hormone levels, and most often the time when symptoms begin to show up.
Symptoms, you say? Yes, perimenopause is when you’ll start experiencing:
- changes in your period cycle
- hot flashes
- sleep disturbances
- mood swings
It’s pretty important to understand that a woman can still get pregnant during this phase. The chances are much slimmer compared to when you’re younger, but it is a possibility so keep that in mind.
Symptoms of Perimenopause
Visible symptoms are the most significant indication that a woman is in the perimenopausal phase. Symptoms occur because of the decrease in estrogen and other sex hormones. These symptoms could include (but aren’t limited to):
- irregular periods
- periods that are heavier (or lighter) than normal
- increased premenstrual syndrome (PMS) before periods
- breast tenderness
- weight gain (often around the midsection)
- hair loss or dryness
- hot flashes
- insomnia
- heart palpitations
- headaches
- loss of sex drive
- fatigue
- mood changes
- concentration difficulties
- forgetfulness
- muscle aches
- urinary tract infections (UTIs)
- vaginal dryness and/or discomfort during sex
- fertility issues in women who are trying to conceive
Note that perimenopause symptoms can be the same after menopause, but they begin to worsen as a woman gets closer to menopause. A woman may or may not continue to have physical and/or emotional symptoms, such as hot flashes and mood swings once she reaches full menopause.
Hear it from me
I was 47 when I really started to notice changes in my cycle. I had never struggled with PMS, and all of a sudden, I was moody and irritable, had sore breasts, headaches, and I wasn’t sleeping as well as normal. It was subtle. But then I started having these horrible, painful, heavy, periods with lots of clotting. I seriously wondered if I had endometriosis. I remember one month I was in so much pain I considered going to the Emergency Room. I had no idea this was all indicative of perimenopause. No clue whatsoever. Then other symptoms started showing up and I began to recognize that it was all part of the perimenopause process. I started educating myself and seeking advice from trusted medical professionals, taking better care with my diet, and I started making multiple lifestyle changes in order to thrive during this stage of my life.
Treating Perimenopause Symptoms
I always associated the word “menopause” with old women. It only happened to Grandmas in my mind. It was like this derogatory word and stage of life. Now that I’m in it, I realize most everything I thought about menopause was wrong. I think it’s safe to say that women dread this stage of their lives. I would have, if it had even been on my radar. But I seem to live my life unaware of my age (which isn’t always a good thing). As a proponent of women-of-a-certain age being educated and empowered about midlife and beyond, I’m here to tell you there are many things you can do to help you rock this phase of your life like a true boss.
Help for hot flashes
Hot flashes result when hormonal factors affect the circulatory system.
Some ways of managing it include:
- avoiding spicy foods, hot drinks, alcohol, caffeine, and overheated rooms
- breathing deeply and slowly
- wearing loose-fitting, layered clothing that is easy to remove
- keeping a fan nearby, especially at night
- drinking cold liquids when a hot flash occurs
- living a daily detox lifestyle
- some specific foods and dietary supplements may help alleviate hot flashes (black cohosh, ground flaxseed, cruciferous vegetables, and others)
- over-the-counter hormone creams can help for a time, but they eventually become ineffective because of continued hormone depletion
Hot flashes usually persist for 1–2 years, but they can last for 10 years or longer. Without treatment, they can last for 7.4 years, on average. For some of us, they will never go away. A good reference for knowing what your personal journey will look like starts with knowing how it was for your mom to transition into menopause. Because it’s very likely yours will be near the same in symptoms and duration.
Hormone Replacement Therapy
Bioidentical Hormone Replacement Therapy (BHRT) helps significantly to relieve all symptoms of perimenopause and menopause. BHRT is only available through prescription and comes in different forms, like pills, patches, creams, and more.
There are so many possible benefits to BHRT. It’s anti-aging, supports brain health, bone health, cardiac health and more. Look for more details about BHRT in an upcoming post.
A note on other hormone replacement therapies
There are many synthetic hormone replacements and they are commonly prescribed. It’s important to be aware of this if you seek HRT so that you can make the best decision for you.
It is of the utmost importance that you are working with medical professionals who share your philosophies. You want practitioners who will truly listen to you and be open to doing things your way. Conventional medicine has failed us on many counts, so be proactive and choose wisely. Don’t be afraid to seek out like-minded practitioners to be a part of your health team and leave the others who don’t support you well in the past!
My best decision has been Bioidentical Hormone Replacement Therapy and I’ve been on it for about a year now. I have to say – I don’t know why I suffered so long without it! It’s quite a controversial topic, especially for someone with breast cancer in their history (ahem, me!). It’s very important to be working with the right healthcare team in order to support and monitor your progress. I’m happy to make a recommendation!
Regular Exercise
We all know the benefits of moving regularly and staying active are numerous. But in case you need a reminder, consistent movement can help improve your mood, blood sugar levels, insulin resistance, muscle and bone density, weight gain issues, and … even your hot flashes.
Include some form of physical activity in your daily routine. Pick something that you enjoy – not something you feel like you “have” to do. It can be as simple as dancing around your house for 10 minutes to your favorite jams. Just do something. Move your body. Raise your heart rate. Get a little sweaty and out of breath for a few minutes. Recent studies have shown that moving for just 10 minutes after each meal can make a huge improvement in your health. Microworkouts are a trend and you’ll be seeing more about them as popularity climbs!
Avoid working out intensely just before bedtime, as this can increase insomnia (which can already be a struggle for anyone on the menopause spectrum). Instead, try doing a relaxing activity right before bed, such as gentle yoga or stretching, or a warm bath with epsom salt and essential oils. Avoid long daytime naps, as this can interfere with your ability to sleep at night. Short little catnaps can be beneficial though (no more than 20 minutes), especially if you aren’t getting enough sleep at night.
You can try some of these other methods for symptom relief:
- Pay attention to your diet and avoid large meals
- Eat less dinner and finish eating earlier (by 7pm)
- Quit smoking
- Only drink alcohol in moderation – or not at all
- Limit caffeine to small quantities and only have it in the morning before 10am
RELATED: The Exercise Dilemma, Sleep Better
When to Seek a Professional
You don’t necessarily have to call your doctor to obtain a perimenopause or menopause diagnosis, but there are instances when you should see your OB-GYN. Any of these symptoms might warrant an appointment:
- spotting after your period
- blood clots during your period
- bleeding after sex
- periods that are much longer or much shorter than normal
Some possible explanations are hormonal imbalances or fibroids, both of which are treatable. However, you also want to rule out the possibility of anything more serious.
You should also call your doctor if the symptoms of either perimenopause or menopause become severe enough to interfere with your daily life. Like I said, BHRT did wonders for the quality of my life and relieved every symptom I was experiencing. Not only that, but I now have the confidence that my body is receiving the hormonal support it needs for optimal brain health, cardio health and bone health – it feels good to feel good!
RELATED: Hormones and Tests
A quick reminder
As I mentioned, you first want to be sure you’re working with healthcare professionals who support your beliefs and philosophy on what’s best for you. (Trust your instincts – you know you and are smart enough to decide what is and isn’t best for you.) A wise doctor once told me that medical professionals should remember that they work for you and you can fire them at any time. Man, that was empowering and I needed to hear it.
Too many conventional doctors these days are quick to write prescriptions with nasty side effects instead of educating you about eating a healthier diet and getting some exercise, or practicing stress management techniques or other lifestyle modifications that can have a substantial impact. If your doctor isn’t optimal, it’s time to find someone new. Look for a functional medicine practitioner or an integrative medicine doctor (or someone along those lines) who will help you manage issues with lifestyle modifications, recommending prescriptions when truly necessary, if that’s your preference.
If you’d like to feel good in perimenopause and beyond, I’d love to help you in your journey! Schedule your free initial consultation today – I look forward to working with you!
