Perimenopause … WTF?!

“The first indication of menopause is a broken thermostat. It’s either that or your weight. In any case, if you don’t do something, you could be dead by August. God, middle age is an unending insult.”
― Dorothea Benton Frank, Sullivan’s Island

I just opened an email from a reader with the subject line, “WTF?!?”

Right?! I thought, and I didn’t even know what she was talking about. Once I read the body of the email, I agree even more. WTF, for sure.

“What is perimenopause and how the hell is it possible I have had it for 10 years? Is this normal? Thanks!
–E.G.”

First off, let me just say, as I watch my older friends wrestle with menopause, my same-age friends wrestle with perimenopause, my younger friends wrestle with pregnancy, and my daughters wrestle with irregular periods, there is absolutely nothing normal about being a woman. It is a constant roller coaster of emotions, blood and breastmilk, all while wearing white pants on stage. It amazes me there are so many more men in prison for violent crimes. What the heck to they have to be so upset about? They cruise through life on a flat road in the emotional equivalent of a Volvo.

H.G., I hope having a little more information helps. If it doesn’t, I recommend singing Pat Benatar at the top of your lungs while drinking Chardonnay and eating Snickers.

Perimenopause, by definition, is the time preceding menopause, and herein, I believe lies the confusion. We think of people going through menopause when they are hot and grouchy, but actually, menopause is when your ovaries stop releasing eggs and your periods stop. It is when the madness should be over, though of course you have other things to contend with like increased risk of a heart attack or stroke. That’s for another post. If you are having “menopause symptoms,” you are likely in PERImenopause. Maybe we should stop giving menopause such a bad rap, and start blaming its two-headed precursor.

The symptoms and duration of perimenopause vary greatly from woman to woman. Some people get through the whole process almost completely unscathed. In medicine, the term for this is lucky bitch. Other women, struggle nearly to the point of insanity. Most women have an experience which lies somewhere in the middle.

On average, perimenopause (which officially ends when you haven’t had a period for 12 months) lasts about 4 years. For some women, it can be over in months, for others it can continue for yes, H.G. — and I’m really so, so sorry for you — 10 years.

Symptoms include:
— hot flashes
— irregular periods often with worsening PMS
— breast soreness
— mood swings
— lower libido
— fatigue
— vaginal dryness
— insomnia
— weight gain
— and to top it all off, urine leakage and urgency

Some other info which might help you not at all to feel better:
— you can get pregnant during perimenopause
— your doctor can do blood work to assess whether you are perimenopausal, but it isn’t perfect and scientists are working on better testing
— if you are over 45 and you’ve missed 3 periods in a row, most likely you’re in it
— menopause is strongly genetically linked, so if you know when your mom went through it, there is a good chance you will hit it at about the same age, give or take a year or two
— smokers experience menopause earlier, because it damages the ovaries
— the age you got your first period, birth control and pregnancy seem to have no impact on menopause timing

There are some treatments for symptoms, such as antidepressants and vaginal lubricants, but for the most part — and I realize it is very annoying there is no magic pill — treatment focuses on healthy lifestyle choices. Exercise, a healthy diet, good sleep habits, and stress reduction can all help … if you think I don’t know you are rolling your eyes, you are wrong.

Bottom line, my best suggestion is this: Be really good in this life, so you can come back as a man in your next.

E.G. — Hang in there sister and thanks for the question.

Amy wants to weigh in here and let you know that giving up process sugar worked for her. No more hot flashes.

If you have a medical or parenting question, please shoot me an email at drkaren@tipsfromtown.com

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