PERI-MENOPAUSE: Telling 40 Year-Old Women What is Going to Happen

We Tell Adolescent Girls What’s Going to Happen

So, why don’t we tell 40-year-old women what’s going to happen?

Why is it still taboo to talk about?

Remember puberty? Your reliable young body suddenly got a mind of its own. Crazy things started happening, both physically and mentally. Can you recall the helpless, out-of-control feelings that you had at that time?

Your parents probably gave you a “heads-up” in advance, so you knew (kind of) what to expect. Your friends sooner or later, were going through the same experience. It was scary and awkward, but there was the promise of becoming an adult to look forward to, and you coped with the changes.

Perimenopause is a different experience.

First, no one has likely given you that needed heads-up. Honestly, it would be difficult to do because everyone experiences perimenopause at different ages and in different ways.

Your cycle may suddenly become irregular, your sleep terrible, and your moods frightening. Then everything can go back to normal. Did that really happen?

There are the common symptoms of perimenopause… and then there are YOUR perimenopause symptoms. Everyone experiences this life process somewhat differently.

Health Care System Failure

Most of us look to our doctors for answers to personal health questions. The problem is, you may not see your gynecologist but every three to five years for a Pap screening, during which time you may move well into perimenopause. The other problem is that many perimenopausal symptoms are nonspecific, and your doctor won’t try to treat them anyway.

If you tell your doctor, “My energy is completely unpredictable. I wake up exhausted but then feel OK later in the day. Sometimes. Other days I’m fine. I yelled at my kids for no reason, then broke down in tears.” This is unlikely to elicit a prescription, and if it did, you might not want to take it.

Conventional medicine is usually ineffective at helping you with perimenopause. Leaving you… where?

The Cause

In your late 30’s, your ovaries will begin to rid themselves of their eggs by releasing more and more eggs each month. As you progress into your 40’s, there are fewer follicles available for ovulation.

Perimenopause begins when you have some cycles with no ovulation.

Estrogen and progesterone are your two main sex hormones, and these balance each other. Progesterone is released with ovulation, so fewer ovulations reduces progesterone and causes “estrogen-dominance” in your body. This is the cause of hot flashes, mood swings, vaginal dryness, irregular cycles, poor concentration, and many more perimenopausal symptoms.

As perimenopause continues, there is a gradual decrease in both estrogen and progesterone. The problem is that none of this is predictable or linear. Your hormones rise and fall erratically, creating physical and emotional havoc.

The Way Out

Treating individual perimenopause symptoms is a game of whack-a-mole: you never win.

What is required is a holistic approach to understanding the physiology of the hormone changes taking place, digestion and food reactions, and related organ and gland stress (liver, thyroid, adrenals, etc.).

Correct lab testing is critical, but even more important is for your doctor to know you and follow along with the changes in your body. Seeing your doctor at least monthly, often more frequently, allows her to understand the changes your body is making and the various components of those changes.

An effective doctor functions as a “perimenopause coach.” With this help, you can feel happy, productive, and energetic even as your body continues to change unpredictably.

I hope this helps!

Dr. Melodie Billiot