What is Perimenopause Anyway?

Let’s start with some basic definitions first. 

Premenopause - The time between the first period and sometime in your late 30s or 40s when hormones are doing their thing and everything is pretty predictable from month to month (or predictably unpredictable for some). 

Perimenopause - Period (not your actual period, I mean time here) of transition when the ovaries start to get a little lazy with the hormone production. This may last for anywhere from 2-10 years. Let’s break it down even further. 

• Early perimenopause - estrogen is really wacky, progesterone and testosterone start to decline. Periods may be heavier and more frequent (sorry to be the bearer of bad news). 

• Late perimenopause - estrogen is getting pretty low. Periods become further and further apart. (Is that a good thing?) 

Menopause = 365 days after your last menstrual period. This means you don’t know that you’re officially in menopause until it has been a full year. How many of you are actually counting the days?!

Post-menopause - 366+ days after your last menstrual period. 

• In early post-menopause (roughly the first 5-8 years), hormone levels are still stabilizing, so many women are very symptomatic during this time. 

• In late post-menopause, about 5-8 years after the final menstrual period, hormone levels have stabilized and (most of) the worst of the symptoms have settled down (except the vaginal stuff, but that’s for a later email).

Ok, so why do we care about perimenopause so much that we have an awareness month? 

It turns out that hormone receptors, including estrogen, progesterone, and testosterone receptors, are found in EVERY TISSUE in the body. We’re looking at you, brain. Did you know that hot flashes actually come from dysregulation of the body’s thermostat due which is in the brain due to hormone shifts? Yup. That’s not the only impact on the brain…Brain fog, fatigue, new or worsening anxiety or depression come along with changes in hormone levels in the brain. It doesn’t stop there…the gut is full of hormone receptors too. You know the GI stuff that comes along with periods? That’s because there are hormone receptors in the gut too.

Here’s a list of some of the symptoms that MAY come along with hormonal changes during perimenopause:

• Hot flashes/night sweats

• Palpitations

• Insomnia/Sleep pattern changes

• Depression/Anxiety

• Mood swings

• Brain fog/Difficulty Concentrating

• Fatigue

• Frequent UTIs

• Vaginal dryness

• Low libido

• Pain with sex

• Vertigo 

• Itchy, crawling skin

• Restless legs

• Headaches/Migraines

• Bloating/digestive changes

• Breast tenderness

• Aching joints

• Frozen shoulder

• Thinning hair

• Tinnitus

• Itchy ears

• Burning tongue

Is the list long enough?

The good news is there is a lot that you can do to manage the symptoms. You don’t just have to grin and bear it. More to come on that - stay tuned!

A little light reading to prep for menopause