Feeling overwhelmed, confused and alone because of the changes happening to your body. Here are 10 things you need to know about perimenopause.
1. You’re not crazy
If you suddenly start experiencing all kinds of mood swings (raging like a wild bull one minute, crying like a baby the next), can no longer sleep through the night (because of hot flashes and night sweats, or a racing mind), gained a whole bunch of weight around your belly while you were laying awake at night, can’t seem to moisturize away your itchy dry skin or relieve vaginal dryness or itching, find that sex has become painful, or suddenly find that you have an impossible case of B.O. that you just can’t shake…. do not worry. You’re not crazy! You are not imagining all these strange and not-so-wonderful symptoms; you’re very likely in perimenopause.
Perimenopause is the time, usually about six to eight years, leading up to your last period and during this time we face that long list of potential symptoms all related to fluctuating progesterone and estrogen production and overall dropping of hormone levels in our body. Most Canadians reach menopause between the ages of 45 and 55, with an average age of 51.
Every person born with a uterus and ovaries will go through perimenopause. Research shows that 95% of women will experience menopausal symptoms and yet most women feel unprepared for perimenopause. How messed up is that? Half the world’s population goes through this thing called perimenopause and yet almost half of us are blindsided by it?
It’s not right that some women go years thinking they are making up or exaggerating symptoms, that their must be something wrong with them if they can’t handle everyday life stresses, that they must be crazy! I am here to tell you, them, and everyone that they are not crazy!
2. It’s not just about the hot flashes and irregular periods
Yes, they’re annoying (to say the least), but perimenopause is also about changes in your mood, sleep patterns, and sex drive. In fact, there are more than 30 perimenopausal symptoms; some of them surprising and many of them start out so benign that you don’t recognize them until they take over your life, body, and mind. It’s not unusual to wake up one day feeling irritable, anxious, or even depressed during this time.
Also, do not be surprised if you go to your doctor with your long list of symptoms and get completely dismissed because you still have a regular menstrual cycle, haven’t had a hot flash yet or are too young. While some practitioners have experience managing patients through the menopause transition, many do not. Unfortunately, the reality is that many doctors don’t have the education, training or time needed to support women through this difficult period known as the menopausal transition. The truth is we need to be ready to advocate for ourselves.
3. Perimenopause occurs as a result of hormone changes
During perimenopause, progesterone and estrogen levels fluctuate at an alarming rate. Since we began our menstrual cycle, we’ve been experiencing hormonal fluctuations every month as our bodies prepare for pregnancy or, if the egg does not get fertilized, the shedding of our uterus.
So what makes these hormonal changes different during perimenopause?
It’s simple; our egg reserve is dwindling, and our ovaries are not producing the same amount of hormones they used to (we experience a drop in progesterone and estrogen levels). Ovulation becomes erratic, our menstrual cycle becomes irregular and unpredictable and we have crazy mood swings that create a whole slew of emotional symptoms – feeling out of control, anxious and frustrated, and alone.
If you are suffering from extreme perimenopausal symptoms this explanation does little to ease your mind. But it is important to understand why this is happening so that you can make informed decisions about your health.
4. No two perimenopause journeys are the same
Another truth you might not be ready for… There’s no magic cure for perimenopause. Some women will coast through their perimenopausal symptoms with nary a drop of sweat while others’ lives will be severely impacted by hot flashes, abnormal bleeding, a menstrual cycle so heavy that they end up in emergency (twice for one of my friends) or such extreme sleep disturbances that ‘feeling tired’ would be a welcomed relief from the intense daily exhaustion.
Every woman’s perimenopause journey is different, yet most women will agree that taking the time to learn about their bodies and perimenopause is their best chance of managing and mitigating their symptoms. Get informed, read our stories, and learn the language of perimenopause. Then start talking to your friends, mother, and sisters, and even better, talk to your doctor or health practitioner about your symptoms and possible solutions to help you to ease your menopausal symptoms.
5. There’s no one-size-fits-all solution
Because every woman’s experience with perimenopause is so different, so too will be the coping strategies and treatments that will work best for every woman. Perhaps you are a strong advocate for Western medicine and popping a pill sounds like a great and simple solution to support you through your perimenopausal symptoms. Options like Menopause Hormone Therapy (MHT) or birth control pills may be just what you need.
Other women might opt for Eastern remedies such as herbal supplements, acupuncture, yoga, or meditation to help them find ease and reduce their perimenopause symptoms.
Some women even find they can relieve symptoms through simple lifestyle changes, such as eating a healthy diet, an exercise regime of strength training and low-impact cardio, adequate sleep, reduced alcohol consumption, and stress management.
Or perhaps you want to try a combination of these approaches. At the end of the day, it’s important to understand your options, decide what the right approach is for you, and then don’t be afraid to ask for the support you need.
6. Your sex drive may change during perimenopause
Some women find that their sex drive increases with the onset of perimenopause, possibly due to increased blood flow to the pelvic area. These women, however, tend to be the exception to the rule.
According to John Hopkins Medicine, more than a third of women in perimenopause, or who are postmenopausal, report having sexual difficulties, from lack of interest in sex to trouble having an orgasm. Our drop in estrogen levels can also make the vaginal tissues less stretchy and you may experience vaginal dryness, which can cause intercourse to be painful.
Many women find that with a little creativity, some toys, a good Fabio novel and some vaginal lubricants they can still keep the spark alive during perimenopause. Talk openly with your partner about how you’re both feeling, and experiment to find out what works for you.
7. You can still get pregnant
Perimenopause is a transitional phase, so even if your libido is so low that you barely have sex anymore, or you are suffering from extreme vaginal dryness that makes sex incredibly painful (even when using vaginal lubricants), it is possible to become pregnant during perimenopause.
Remember what your mom told you in high school, it only takes one tiny sperm to fertilize an egg (although now we’re a little wiser and know that timing is everything). So unless you really want to add another bundle of joy to your challenging new perimenopause life, continue using contraception until you’ve gone at least 12 months without a period.
8. It’s time to prioritize self-care
It’s important to take care of yourself during perimenopause, both mentally and physically. Make sure you’re eating a healthy balanced diet, exercising regularly, getting enough sleep and managing stress levels.
Find time for yourself and do activities you enjoy, like reading a book or going for a walk, or a night out with your girlfriends. Even better, pamper yourself. Invest in some good quality skincare products, get a massage or mani-pedi, take yourself out for brunch – whatever makes you feel relaxed and happy.
It may feel a little indulgent at first, but self-care is an important part of coping with the physical and emotional changes that come with perimenopause. Trust me, you’re worth it.
9. You’re not alone
The path of perimenopause can be isolating, especially since very few women have the language to express their perimenopausal symptoms and experiences. You may feel like you are lacking support or that no one truly understands what you are going through – I promise this is not the case. The moment you are bold enough to mention perimenopause to a friend, I guarantee they will be all too eager to talk about it and share their experiences.
If you’re in early menopause and your friends haven’t caught up yet, never fear, we’re here for you. Through our stories, we hope you will feel connected and empowered to take on this new phase of your life.
And if you feel like you need extra support (because let’s be honest sometimes our perimenopause, mood swings, anxiety and low moods, are just too much to handle on our own) reach out to your doctor or a therapist for counseling services. They can help provide you with the tools, medicine, and support you need to feel more in control and empowered.
10. Menopause brings a new set of health concerns
Although it may feel like it sometimes, perimenopause won’t last forever. Once you hit menopause (defined as 12 consecutive months without a period), you’ll feel a sense of relief as your perimenopausal symptoms settle down a bit.
The truth, however, is that with menopause comes a whole new list of potential health concerns, including risk of heart disease, stroke, and osteoporosis. I tell you this, not to cause alarm or despair, but so that you will continue to look ahead and take a proactive approach to your health. If you haven’t already, discuss an appropriate health screening schedule with your doctor.
The bottom line is that as long as you’re armed with knowledge and are taking measures to look after yourself, there’s no reason why you can’t sail through menopause and come out feeling strong, wise, and empowered on the other side.
A time of self-discovery
In the meantime, hang in there and know that as your perimenopause hormonal changes level out, the hot flashes and night sweats, mood swings, abnormal bleeding, vaginal dryness, and sleep disturbances will likely also pass.
And instead of approaching perimenopause with angst, try thinking of it as an empowering time of self-discovery, personal growth, and transformation. Enjoy it as a time for self-care and nurturing; for slowing down, listening to your body, and learning how to navigate the changes of perimenopause.
Resources: John Hopkins Medicine https://www.hopkinsmedicine.org/health/wellness-and-prevention/how-sex-changes-after-menopause#:~:text=Your%20estrogen%20takes%20a%20nosedive,for%20you%20to%20become%20aroused.