Navigating Perimenopause & Menopause Summer Series Part 1
Navigating Perimenopause and Menopause
Summer Series Part 1:
This is part one of a Summer Series about navigating perimenopause and menopause. Over the next few newsletters, we'll explore what happens during perimenopause and menopause, common symptoms, and evidence-based strategies to help you feel your best. Today we will start with the basics.
Perimenopause
In my opinion, the most irritating part about perimenopause is the absolute lack of clarity about whether you are even in perimenopause. There is no objective sign or symptom that you can discern the moment you have started perimenopause, but there is a clear objective sign when perimenopause has ended. Some clinicians say perimenopause begins when women begin to experience irregularities with their periods. Others say it is when perimenopause symptoms begin. That being said, each person's experience is different. Some women have little to no symptoms. Some have always had irregular periods. Most of the women I talk to who are in perimenopause now, talk about sleep problems and stress and simply not feeling like themselves any more.
To learn more, last week I conducted very informal polls on social media of women 40+ to see what perimenopausal symptoms were most frustrating.
The tallied results showed that sleep and fatigue were the number one concern, followed by brain fog, weight gain, anxiety and stress.
Common Perimenopause Symptoms
Are you waking up every night at 3am? Do your joints ache? Do you have a brain fog and memory issues that are worse than baby brain? Are you exhausted, but can't fall asleep or stay asleep? Are you having hot flashes? Or cold flashes? Night sweats? Have you put on weight that you can't get rid of, especially around the mid section? Are you angry at everyone around you or cry at the drop of the hat? Have you lost sight of who you are, you just don't feel like yourself? Is sex off the table? Feeling anxious or stressed? Are your periods closer together or further apart? Is your heart racing? Shoulder pain? Vaginal dryness? Irritability? Ears ringing? Hair loss? GI issues?
Do you know something is off, but you just can't seem to identify what it is?
If you are 40+, and experiencing even a few of these symptoms, you are likely in perimenopause.
What is the difference between perimenopause and menopause?
Lets start at the beginning, shall we?
Menarche = a person's first menstrual period.
Menarche is preceded by puberty and a rise in estrogen levels and is followed by a rise in progesterone levels. This marks the beginning of our reproductive years.
Typical Age: 10-15
Menopause Transition/ Menopause Journey= A period of time encompassing the 3 stages of menopause: Perimenopause, Menopause and Postmenopause.
This represents the 10-20 year period of a biological females life where hormones are in fluctuation and/ or in steep decline, physical body changes, and includes both the ending of menstrual cycles and ending of our reproductive years. The implications of untreated menopause symptoms during this time can lead to bone density issues, heart disease, and neurological changes such as dementia.
Typical Age: 40-60
Stage1
Perimenopause = the transitional phase leading up to menopause.
This phase lasts 5-10 years before menopause. Perimenopause technically means "around menopuase" and is sometimes referred to as premenopause. Progesterone begins to fall, sometimes abruptly. Estrogen fluctuates and later plummets. This is the time period where many bio females begin to have a smattering of symptoms. Symptoms vary between people, but often include weight gain, brain fog, anxiety, hot flashes, skin and hair changes, joint pain, sleep disruption and irregular periods.
Many women in perimenopause are surprised to learn that pregnancy is still possible, even when cycles become irregular and/or stop for months at a time. In fact, until the one year mark past your final period, you are still in perimenopause and pregnancy is still possible.
A common question: What if it's been 200 days and then my period restarted?
Answer: You are still in perimenopause and will need to restart the countdown.
Typical Age: 45-55
Stage 2
Menopause = a moment in time when you have not had your period in 12 months.
This phase is 1 day. Menopause is the exact day when you have reached 365 days since the first day of your final period.
Question: Typical age: 51
Stage 3
Postmenopause = The rest of your life after menopause.
This stage lasts the rest of your life. In postmenopause you have already gone over 12 months without a period. Your progesterone and estrogen levels are low. You are no longer naturally fertile.
As symptoms begin to fade away for some, for many women they will continue to have symptoms for 5 years or more after menopause. Hot flashes, heart palpitations, vaginal dryness and sweating are common symptoms.
Special Note: Postmenopausal bleeding is not normal.
If you are postmenopausal and you begin to have vaginal bleeding, contact your doctor right away as this may be a sign of a serious medical condition.
Establish Care
Now that you know where you are in your Menopause Journey (and believe me it is a journey!) where do we go from here? Symptoms of perimenopause and menopause can be distressing and impact your quality of life. Some doctors can be dismissive about perimenopause symptoms or simply are untrained in women's health. As women, we must advocate for ourselves. Don't waste years of your life suffering with inadequate midlife care.
Find a health care provider that works for your needs. A great first step is establishing care with a Primary Care Physician (PCP), Gynecologist, Integrative Care Doctor, Functional Medicine Doctor or Nurse Practitioner who specializes in working with women in perimenopause and menopause.
If you aren't sure where to start, here is a list of Certified Menopause Providers
What to expect from your Doctor/Provider. Women in midlife (40-60) should be prepared to have labs done to check for cholesterol, anemia, thyroid issues and diabetes risk. Plan to discuss with your provider about bone health (including when to get a baseline bone scan,) heart health, vulvo-vaginal health and cancer screening. Your health provider may also work with you to find underlying causes of symptoms that may be unrelated to perimenopause. Your health care provider should also be discussing perimenopause and menopause. They should be willing to discuss and prescribe hormone therapy for women. They should also be able to discuss complementary and alternative therapies.
Shameless Plug: Let's be honest, you will get just 20 to 40 minutes per visit with your doctor. The rest of year I can help you to navigate the healthcare system, tackle symptom management and help you find yourself again. I am offering a 3 session Perimenopause Clarity Package for only $375.
You say you want a Menopause Revolution...
If you are like me and your journey has had many twists and turns, you might be asking, why are millions of women being asked to advocate for themselves and why does it take doctors so long to recognize that women are going through perimenopause? Well sadly, many doctors have not been trained in perimenopause and menopause care.
To quote a recent opinion article in the New York Times by Melinda French Gates:
We need a menopause revolution in this country. Better training is an obvious place to start. By including menopause care in both foundational and continuing education for health care practitioners, we can equip more of them to support their patients. Medical schools and residencies need to embed menopause care in their curriculums, and accreditation bodies and licensing boards need to make it a required part of training — not just for OB-GYNs, but for anyone who treats women in midlife.
In this same article Gates also requests lawmakers take action to increase education, expand menopause treatment coverage and to make treatment more equitable. And to that end Melinda French Gates has pledged an additional $200 million dollars to women's health globally bringing her investments to over $600 millions dollars over the last two years.
Perimenopause & Menopause - You Are Not Alone
I'm curious how this message lands for you.
Are you currently suffering with perimenopause symptoms and you don't know what to do?
Do you have tips of your own that you would like to share?
Send me a message and let me know how you are doing.
And feel free to pass this newsletter along to a family member, friend or neighbor who might benefit.
Holistic and Wellness Nurse Coaching
Wherever you are in your menopause journey, you don’t have to figure it out alone.
I offer a supportive, personalized space to help you move forward with clarity and compassion.
If you’re curious about working together, I am offering a 3 session Perimenopause Clarity Package for just $375. I invite you to schedule a free 30 minute Discovery Call or simply message me at Lisa@CompassionWithinCoaching.com
With love,
Lisa
Compassion Within Coaching
https://www.compassionwithincoaching.com/
Disclaimer: The content of this newsletter is intended to support your health and wellness journey through education and reflection. It should not be construed as medical advice or replace the individualized recommendations of your healthcare provider.