Menopause, euphemistically known as ‘the change’ by our mothers’ generation, is the time in a woman’s life when her menstrual cycle has stopped and she has not had a period in 12 months.
Perimenopause encompasses all the crazy that precedes that milestone. Most of us don’t hear a whole hell of a lot about perimenopause until we stumble across something online that seems to explain our weird symptoms or the strange and disturbing changes that our body is going through. For many of us it is a relief to finally figure out what is going on; to realize it’s not ‘just me.’ It has a name! It’s called perimenopause. Most women refer to it as “going through menopause.”
Perimenopause comes as a surprise for many women. (It did for me!) Unlike menarche, the beginning of our periods (from the word Greek words ‘men’/month and ‘arche’/beginning), which we may have half-eagerly, half-fearfully anticipated with our girlfriends, we don’t talk about menopause much. Yes, there are the jokes about hot flashes: “is it hot in here or is it just me?” or “they’re not hot flashes, they’re power surges!” But there is very little discussion of what to expect and when.
I mean, I knew it was something that would happen to me eventually – the average woman has experienced menopause by age 51 – but I had no idea of how you actually got there or what it would feel like. It wasn’t until a whole bunch of uncomfortable, life-disrupting symptoms came together (and I Googled them, of course) that I realized that what I was experiencing was the beginning of the transition to menopause.
It would have saved me a lot of trouble and angst to understand what to expect ahead of time. So to save others the frustration and confusion I went through, to confirm what you may suspect, or to commiserate with those of you who were as clueless as I was, here are 12 Thing I Wish I Knew Before I Reached Menopause.
1. Perimenopause marks the period during which our bodies start to decrease the production of the hormones that govern our menstrual cycles, primarily estrogen and progesterone. They don’t drop all at once or evenly and can be affected by factors like diet, sleep, exercise, stress, and even your exposure to sunlight.
2. It is a transition. Unlike menarche, the beginning of menstruation, which seems to leap onto the scene in a single bright red instant, the transition to menopause, or ‘not menstruating’ takes time. Of course, the transition to menarche took time too, but the goings on were more internal and didn’t seem to affect lives very much. (Then again, we were in 10, 11, 12 – it’s not like we had so much life to interrupt).
Perimenopause on the other hand makes itself known to most women, even if we don’t quite know what’s going on. And for most of us it will take a few years until it’s done and we’ve bled out last period. Yes, years.
3. You may start to experience symptoms of perimenopause well before your period becomes irregular or lighter. I was still menstruating regularly when I started to experience what I later realized were the symptoms of menopause. In fact my periods continued steadily for two years after I started to gain weight inexplicably and wake up with night sweats (more on symptoms below).
4. The symptoms of perimenopause can vary for different women, but some of the most common ones are: hot flashes, night sweats, insomnia, weight gain (especially dangerous fat around your belly/waist – ugh!), dry eyes, low libido, vaginal dryness, brain fog, fatigue. None of that sounds like fun, but before you consign yourself to years of suffering, know that there are solutions and treatments for most, if not all, of these symptoms.
5. Hormone replacement therapy (HRT) is not as scary or dangerous as you may have been led to believe. The Women’s Health Initiative study, which supposedly “proved” that HRT is dangerous and ‘causes’ breast cancer was poorly done, terribly reported, and inconclusive on most accounts. The well-regarded book, “Estrogen Matters” explains the serious flaws in the study as well as the blatantly unethical behavior of the researchers who went to the media with their false claims. I strongly recommend it before you decide on HRT one way or the other.
5. HRT isn’t just for controlling menopause symptoms. Estrogen, when taken with progesterone, has numerous protective benefits beyond menopause including reducing your risk of heart disease, colon cancer, diabetes, Alzheimer’s disease. osteoporosis, and [list others here.]. And while it’s questionable whether or not it increases breast cancer risk, even for women who have already had breast cancer, the WHI study showed that women who are diagnosed with breast cancer while taking HRT are less likely to die than women who are not taking hormones. After learning all this, I decided to try HRT (even though my grandmother died of breast cancer) and I feel great – no regrets!
6. It is 100% possible to lose weight, keep well, and feel great during perimenopause. Using simple techniques of meal timing, short-term fasting, healthy eating, and moderate exercise, I lost 15+ lbs of fat and gained lean muscle just in time for my 50th birthday. Yes, you can too – I promise!
7. The changes you are experiencing are hormonal. That may seem obvious but it is worth repeating because we often look to other areas for solutions and relief, but the only strategies that will try work and not just mask symptoms are those that address and correct hormone imbalances.
This is true for menopausal weight gain – in fact ALL weight gain. As a result, simple (false) solutions like “eat less and exercise more” or “cut calories and create a deficit” or “hit the gym 6x a week” WILL NOT WORK because they do not address your hormones. In fact, the conventional wisdom approach will screw up your hormones EVEN MORE and lead to greater weight gain in the long-term. This is true even if they appear to help you shed a few pounds at first.
8. Exercise is key to not only feeling better during perimenopause, but also maintaining health and vitality long after. As we age and our hormones decrease, we are at greater risk for osteopenia (loss of bone mass) and sarcopenia (loss of muscle mass). Both are leading causes of mobility issues: aching joints, arthritis, muscle fatigue, etc, and can result in more serious problems like hip fractures when we get older.
Exercise is also an important way to balance hormones and improve our mood. Numerous studies have found exercise to be as effective, if not more so, than medication for depression and anxiety. Strength training and walking are the best and quickest ways to get and stay fit at this point in our lives.
9. Menopause can mess with our sleep cycles, but that doesn’t mean we need less sleep. In fact, the opposite. Yes, I know it’s hard – like I said above, the craziness we’re experiencing is hormonal and sleep is no exception: the balance between cortisol (the wakeful, energetic, ‘stress’ hormone), and melatonin (the ‘it’s time for bed’ hormone) can get out of whack at this time and need to brought back into harmony. Yes, this is possible and doesn’t have to be difficult. But…
10. The hormonal chaos of perimenopause and the ultimate downshift of menopause mean that our tendency to burn the candle at both ends has to stop. We need to sleep. We need to relax. We need to destress. Yes, I know you’ve been hearing this forever but now it’s real.
11. Let me repeat the above: now is the time to figure out what it is YOU need to relax and find ways to work it into your day, week, routine. Your attempt to do and have it all and be everything to everyone an and will compromise your long-term health and lead to premature aging and even disease.
Sorry to sound so dire but a) it’s true, and b) you need to take your own health as seriously as you do everyone else’s. As a type-A burning-all-cylinders type told me of his epiphany: “you can mind your wellness or you can mind your illness.” That’s the choice.
Find a relaxing activity and do it. Yoga, walking, meditation, tai chi, gardening. Slow down and take a little time for yourself every day. It doesn’t have to be hours: 5-10 minutes twice a day will help. A LOT.
12. Menopause may be the end of menstruation but it’s the beginning of a whole new phase of life. Until now, my body has been focused on preparing me for, and maintaining my ability to get pregnant and sustain a baby with my body. That stage was great – I birthed and nursed two kids – but now it is over. In a society that values women first for our (youthful) looks and second for our reproductive value, it can be a challenge to figure out what we’re ‘worth’ now that those are gone. It can also be immensely freeing. I’m going with Door Number Two – and looking forward to seeing, no, deciding what comes next.