Perimenopause sucks

Are you in your 40s and feeling… different than you used to? Not just in the I have more experience and more responsibilities kind of different, but, like your body, your self, is different than it was?

Perimenopause is this weird, in-between, hormonal place to be. We all know what actual menopause is going to look like—no periods, hot flashes, night sweats, maybe some insomnia and difficulty concentrating. But perimenopause? That sucker can look like just about anything.

Perimenopause literally means around menopause —  and that’s what we’re talking about, the period around the time when a woman goes into menopause. So, like six months? Maybe. Two years? Yup, maybe. Five years? Could be. TEN YEARS? Yeah, it’s possible. But, if I had to choose an average, I would say 3-5 years is typical. Basically, any time in your forties.

And just like menstrual cycles vary wildly between women, perimenopause does the same. For some women, their cycles get shorter—21-25 days instead of 28. For others, their cycles become longer and erratic — one cycle 28, the next 42, the next 17. Periods? Either longer and heavier, or shorter and lighter. Or, exactly as they’ve always been.

Why the not so sudden changes? Fluctuating hormones. There are a few times in a woman’s menstrual story that hormones behave erratically. One is when you first get your period—and while you might not remember your early days, if you have any tween/teen girls in your house, you know that these fluctuating hormones can change a person fast! Another is during and after pregnancy. And the third is in the perimenopausal years. In our younger reproductive years, the cyclical estrogen and progesterone balance each other out. In perimenopause, estrogen tends to be higher, and often unopposed by adequate progesterone. Also, ovulation isn’t as regular as it was before, which means that even month to month, our hormones can be very different.

Here are some of the common symptoms experienced during perimenopause:

• Changing periods (see above).
• Insomnia. This can look like difficulty falling asleep, staying asleep or just waking up too damn early in the morning and not being able to get back to sleep.
• Night sweats. While day time hot flashes are generally rare before true menopause begins, night sweats become more common.
• Weight gain not related to a change in diet or exercise. Honestly, this can be one of the most frustrating symptoms for many women.
• Anxiety. Even if there is no history of previous anxiety.

And, here are some things that you can do to help make the transition easier:

• Prioritize sleep. Practice good sleep hygiene—go to bed at the same time, no screens before bed, figure out what the right type of blanket is for you. Seems small. Isn’t.
• Stress management. Long term stress drives up your cortisol, and high cortisol exacerbates high estrogen, which is common in perimenopause. Yoga, meditation and deep breathing are all great tools to help teach the nervous system how to flip from sympathetic (go-go-go, fight or flight), to parasympathetic (relax, rest and digest). Figure out where you can cut back—practice saying no. Herbs and supplements can help here as well.
• Balance blood sugar. High insulin and blood sugar can also exacerbate perimenopausal symptoms. Make sure that you include adequate protein, fats, fruits, vegetables and grains in your diet. There is no one size fits all for a blood sugar balancing diet — it varies by individual. Some people need to eat multiple small meals per day to feel best, others find intermittent fasting helps. Work with your naturopath or nutritionist to explore the possibilities. Again, supplements can help.
• Hormone support. This can be supplements, herbs or a bio-identical hormone like progesterone. I use hormones to alleviate symptoms, ease the transition, and improve later outcomes.
• Acceptance. This can be a tough one, but we need to embrace our changing bodies. This is a normal part of the process of being woman! Hear me roar!