Is it Peri-Menopause?

Remember puberty? It was a process. Over time, you developed breasts and grew armpit and pubic hair. You might have have gained weight or had acne flare-ups without warning. There were mood swings that made it de rigueur for you to give absolutely everybody major attitude. And then you had your first period. Ta-d-a-a-ah! Welcome to “womanhood!”

Menopause is kinda the same sort of process — only in reverse. It has three phases that extend over time in the following order:

• Premenopause – This is when you’re still having your monthly cycle and menopause is last thing on your mind.

• Peri-menopause – This is the transitional phase that happens between premenopause and post-menopause. It spans from the first symptom of menopause to the final cessation of the menstrual cycle. There is a lot to know about peri-menopause, but we can’t get there without first understanding how it connects to post-menopause.

• Post-menopause – This is the last phase of menopause and it begins with the total absence of a menstrual cycle for a full 12 consecutive months.

A little note about menopause in general

So here’s a very important thing to know:  “Menopause” is technically only one day of a woman’s life. The moment you pass the threshold of your one-year anniversary (i.e., 12 consecutive months without a menstrual cycle) is the day you actually reach menopause. After that day, you are post-menpausal.

If this fact surprises you, don’t feel bad. Forty-five percent of all women don’t know the difference between peri-menopause and post-menopause. In this blog post, I’ll be sharing three tell-tale signs that you’re in peri-menopause and actions you can take to help manage it’s symptoms.

How to know if you’re in peri-menopause

Timing is sometimes a “tip-off” that peri-menopause may have arrived. For most women, natural peri-menopause starts in their early forties, but it can also begin as early as the mid-thirties. Some women might be in this stage for a few months while others may continue in peri-menopause for 10 years or more.

Technically, the first sign that you’re in peri-menopause is when the level of progesterone in your body begins to drop.  Low progesterone causes an imbalance in your follicle stimulating hormone (FSH) which controls the production of estrogen. During peri-menopause, FSH goes erratic — rising and falling like a rollercoaster and causing inconsistent periods.

This internal chaos can be tricky to self-diagnose. Symptoms that are often mistaken for peri-menopause may in fact be a sign of something more serious. See your doctor immediately if you experience any of the following:

• Heavy bleeding or bleeding with clotting
• Periods lasting longer than normal
• Spotting after your period or after sex
• Your periods are getting closer and closer together

The 3 telltale signs of true peri-menopause

There are generally three signs you can easily detect that signal you’ve entered peri-menopause:

• Menstrual Cycle Fluctuations
• Hot Flashes
• Mood Swings

Menstrual Cycle Fluctuations

Also know as “erratic periods,” menstrual cycle fluctuations are one of the first telltale signs of peri-menopause. And it’s one that can bring serious consequences. Consider the following…

Many women who experience menstrual cycle fluctuations mistakenly believe they are post-menopausal and therefore can no longer get pregnant. This is not true! If you don’t get anything else from this blog post, please understand this:

You CAN get pregnant during peri-menopause!

Here’s what you need to remember:

• Even if you have not had a period in several months, as long as you are within the window of 12 consecutive months since your last period, you are still in peri-menopause. If you are sexually active with a man during peri-menopause, you can absolutely get pregnant.

• If it has been more than 12 consecutive months since your last period, then you are in postmenopause — and therefore in the clear as far as the risk of pregnancy is concerned!

While we’re on this topic of unintentional pregnancy during peri-menopause, I would be remiss if I did not point out the heightened risk of a multiple pregnancy during this phase. This is because when your periods are erratic, it is possible to ovulate twice in a single month. In this scenario, if the timing is perfect, two eggs can get fertilized by two sperm resulting in fraternal twins. Ask me how I know. (Oh, shoot! I’ll just tell you: I have fraternal twins!)

When monitoring menstrual cycle fluctuations, the main point is to stay vigilant and protect yourself. There is certainly wisdom in keeping a journal that tracks your menstrual cycle during this time. Don’t be unduly alarmed at how asynchronous your menses may become. As you move deeper into peri-menopause, your periods will start moving further and further apart and this process can literally go on for years. And remember: Even if you go 11+ months without a period, but then you have a period in the 12th month, you are still in peri-menopause! And, of course, the cycle of vigilance then begins all over again until you finally reach the 12 consecutive months without a period threshold.

Hot Flashes

A hot flash is the sudden searing sensation of body heat resulting in a profusion of pouring sweat and clammy skin, followed by chills. Hot flashes are the most iconic symptom of peri-menopause and affect 80% of all peri-menopausal women.

The cause of hot flashes is unknown. Hot flashes can strike at any time without warning and last anywhere from 30 seconds to five minutes. It doesn’t matter whether you’re in the middle of the most important presentation of your career or sitting alone and reading a book. Hot flashes don’t care. They are a primal force of nature and will likely be a part of your life for up to 10 years.

Fortunately, there are ways to stop or at least mitigate the intensity of hot flashes. It all depends on whether you prefer a natural approach or medical intervention.

If you want to go the natural route, here are several suggestions:

Dress in layers. It’s helpful to have something to take off when your internal furnace begins to kick on.

Carry a fan. When you feel a hot flash coming on, you just want immediate relief. So instead of sticking your head in the freezer (which does work, by the way) keeping a manual or battery operated fan in your purse works really well to discreetly fend off a hot flash.

Cool your pulse. Running your hands and specifically the pulse points on your wrist under cold water provides relief. This will bring your temperature down quickly because blood vessels in that area are closer to the surface of the skin.

Drink water. We lose water when we experience hot flashes and it’s important to replenish that water loss. And here’s a not-so-much-fun fact: Your chance of experiencing more hot flashes actually increases when you’re not hydrated.

Move your body. Of course, this means adding exercise to your daily regimen. Studies show that women who are overweight tend to experience more hot flashes than women who are not. Moving is actually the key to the fountain of youth and exercise is some of the best medicine that you can ever take.

Keep a journal of what you put into your body. It is wise to eliminate caffeine, alcohol, smoking, and spicy foods, because all of these are known triggers for hot flashes. If you can’t go “cold turkey” on them all at once, try gradually phasing them out one at a time. It could make a real difference in your level of comfort regarding hot flashes.

Introduce life-affirming practices and products. Lifestyle practices designed to reduce stress in your life such as meditation, yoga, prayer, massage, mindfulness, and relaxation techniques have all been shown to make a difference in the frequency and intensity of hot flashes in some cases. Using botanical and herbal products may also help. However, if you are considering combining herbs, it’s recommended that you first seek out the assistance of an herbalist or a naturopathic physician — especially if you’re taking other medications.

About hormone therapy for peri-menopausal symptoms

Hormone therapy replaces the progesterone and estrogen women lose in peri-menopause. As such, it can alleviate some menopausal symptoms including hot flashes. Hormone therapies (HT) are either natural (made in a lab and derived from plants such as legumes, seeds and whole grains), synthetic (made in a lab and not derived from anything naturally occurring), or bioidentical (made in a lab to be chemically identical to the ones your body makes.)

The variables involved in trying to calculate the advantages and risks of different forms of HT are far too numerous and complex for the scope of this blog post. Suffice it to say that if you are considering HT, the best advice is to consult your doctor or an experienced menopause practitioner. This is to see if HT is the right solution for you based on your individual health profile. HT is much more than just a way to end hot flashes!

Mood Swings

The symptom of mood swings are sometimes subtle and hard to notice, but if you one day find yourself inexplicably crying in your car on the side of the road, you may be peri-menopausal.

Declining estrogen levels can cause women undergoing peri-menopause to experience a wide range of emotional changes, including irritability, feelings of sadness, lack of motivation, anxiety, panic attacks, aggressiveness, difficulty in concentrating, fatigue, depression, and tension.

It’s also fair to say that there may be other possible causes for these symptoms as well. Here again, it’s important to discuss these symptoms with your doctor to rule out any underlying medical conditions or consider a referral to a reputable therapist for a few sessions.

So what can you do about mood swings?

Eat well and exercise. Revamping your diet to be more healthy and incorporating exercise into your daily regimen can definitely make a difference in your mood. We are all bio- emotional beings and for mental health, you can’t beat the effect of positive endorphins that are released when you exercise and eat well.

Find a self-affirming practice. Yoga, mindfulness practices, meditation, rhythmic breathing, dancing, singing, and maintaining an attitude of gratitude are some suggestions. Here again, all of these practices can do a lot to center you in a more grounded state of well-being. Similarly, engaging in a creative outlet like music or art can help swing the tide of mood shifts back towards positive.

Find a supportive community that helps you foster a sense of achievement, belonging and feeling the you are cared for. There are many to choose from. And surprise — Crazy, Sexy Menopause is just such a community, specifically created designed to support women as they navigate the menopausal experience. We are committed to creating and maintaining a safe and compassionate community where women support each other in their intention to heal, learn and practice more vibrant living through Mindset, Meals and Movement modalities no matter where they are on the menopause spectrum.

We hope you’ll join us.-