Perimenopause 101
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What the heck is perimenopause?
We can’t really define perimenopause without going over what menopause is, so let’s start there.
Menopause is defined as going 12 months without a period i.e. if you haven’t had a period for 12 consecutive months, you’re classified as menopausal when you hit the 13th month.
Perimenopause, which translates to ‘around menopause’, is the transition leading up to menopause. Sound vague? It’s because it is! Perimenopause can be two years for some, while ten years for others. Most menstruators will begin to see perimenopausal changes in the 40s; however, some people could see them in their late 30s while others in their early 50s. The timing depends on a variety of different factors like genetics, family history, menstrual history, surgery, fertility treatments, medication use, past medical history, nutrition and organ function, stress levels, lifestyle, and more.
What kind of changes can I expect and what should I be looking out for?
Well, there’s no standard set of symptoms – perimenopausal and menopausal experiences can vary quite significantly.
For some, it’s a smooth ride with not many or any symptoms. For others, it can be a roller coast full of loop-du-loops, twists, turns, ups, downs, and everything in between. And for most people, it’s somewhere in the middle of those experiences. What determines your experience is a multitude of factors (as with most things in life): age, stress, sleep, genetics, family history, nutrition, body composition, medication use, surgery history, lifestyle habits, overall health status, past medical history, level of contentment and satisfaction in life, etc.
You’re likely perimenopausal if you have any three of the following according to endocrinologist Dr. Jerilynn Prior:
new changes in flow: heavier or longer
menstrual cycles that are shorter in length (from day 1 of one period to day 1 of your next period)
maintenance insomnia where you fall asleep but wake up in the middle
night sweats which are most likely worse before your period
new or more pronounced mood swings before your period
weight gain without changes in your nutrition or exercise regimen
sore, swollen, or lumpy breasts that you haven’t experienced before
increased menstrual cramps
new-onset or increased migraine headaches
Other symptoms that can come up around this time include fluid retention, appetite changes, fatigue, mood changes like irritability anxiety, and depression, vaginal dryness, worsening incontinence, and memory changes.
As estrogen fluctuates, you may have times where you feel great while other times where you feel crummy. The amount of progesterone you’re making will play a role in how you experience life during this transition as well since progesterone counterbalances estrogen and progesterone declines as menopause inches closer.
And don’t forget, chronological aging is happening simultaneously! This means that a loss in lean muscle mass, a decrease in metabolism, and weight change are quite common during this phase of life.
Then, on top of that, daily life continues on as we navigate all of this. So a holistic approach to your health and wellbeing is vital!
Wow, there’s a lot that happens! How can I support myself through this change?
There are lots of ways to support your physical, mental, and emotional health. And your needs will be different than someone else going through perimenopause. Ultimately, it has to be the right fit for you and should include all aspects of your health and life-like sleep, stress management, hormonal support, food and nutrition, exercise, self-care, community support, medications or hormone replacement therapy where appropriate, supplementation with herbs or nutrients, and more.
With the appropriate testing and guidance, you can definitely improve your symptoms, experiences, and health as you transition through perimenopause. Look for next month’s post for a more in-depth look at conventional medical, natural, and lifestyle support for the perimenopausal transition!
