Hi. I'm Nurse Barb, and this is your Daily Dose.
I recently launched a new website, YourMenoCoach.com
that has lots of answers about all aspects of midlife
and the menopause transition, including perimenopause.
If you head over there, you'll see some E courses that are divided into chapters
so you can find information on everything you care about
from hot flashes and night sweats to bioidentical hormones
and why you're gaining weight and what you can do about it.
So today, let's talk about perimenopause. What is that?
Well, perimenopause
is that time in your life before your periods stop completely.
Because menopause is just one day in your life.
And that's the one day when you haven't had any periods for 12 or more months.
But, peri, the word means around.
So perimenopause is around menopause.
It's that time in our life when we have a hormonal roller coaster
where our hormones can be having wild swings up and down.
We can have a lot of symptoms and we can have very irregular periods.
So before pre menopause, we can have periods
that are pretty much what we expect.
They come when we expect them.
They last about as long as we expect.
And there the interval between periods is pretty predictable
and we can still get pregnant.
So perimenopause is that time when everything is disrupted.
There's no guarantee of getting pregnant.
We have fewer and fewer eggs in our ovaries,
and that means that our hormone levels are changing.
So with perimenopause, many women start to have a lot of symptoms,
but often they're not connecting the dots that this could actually be menopause.
Because when we look in the mirror, we don't look our age.
But when our periods are still irregular, we're like, well,
we're still having periods, so this can't possibly be menopause.
And oftentimes when we see
a health care provider, they're not connecting the dots either.
But if you're having sleep disruption or brain fog, issues with your memory,
profound fatigue, no sex drive, a lot of weight gain,
breast tenderness, feeling like your PMSing all the time.
That might be perimenopause.
So ask yourself a few questions.
Are you having periods that are starting to get a little bit irregular?
Maybe they're coming closer together or much, much further apart.
Maybe you're skipping two or three months.
Maybe instead of bleeding for four or five days,
you're only bleeding for one or two or you're bleeding for seven or ten days.
Maybe you're bleeding continuously for weeks and weeks.
Maybe you're starting to feel a little bit hot at night
when you're in bed and you get a clammy feeling
on the back of your neck, or you're waking up drenched in night sweats.
Maybe you're having a little bit of issue with leaking urine
when you cough or sneeze or laugh, or worse
when you're trying to get to the bathroom and your bladder decides
to just let everything go before you're quite ready.
Maybe your sex drive packed up its bags.
It didn't even wave goodbye, but is gone.
Maybe you're noticing a lot of weight gain, especially around your midsection.
All of these are symptoms of perimenopause,
but very often we think, well, it's got to be something else.
Maybe it's my thyroid or I'm working too hard, or I'm under a lot of stress.
But what I'm here to tell you
is that as our hormone levels start to change, what happens
is that almost every aspect of our life in our body starts to change.
You see, our estrogen levels are starting to decline in perimenopause.
And estrogen is the hormone you've had in your body since puberty.
Estrogen is a natural hormone.
So estrogen is what makes us women.
It gives us curves, gives us soft skin, a higher pitched voice.
And every single month, when we have a period
in our menstrual cycle, our body produces estrogen.
Let me show you with my uterus model here.
So this uterus model could come apart, right?
So what you can see is the inside of the uterus and these little silver things.
These are just the magnets that hold the other part.
So what you have here is the uterus
and you have ovaries and this is what's going on inside the ovary.
Here's the lining of the uterus or the endometrium,
the cervix and the vagina, where all the blood comes out.
So every month since puberty, since you were, you know,
teen or pre-teen, your ovaries started to make an egg.
And that egg released estrogen.
Estrogen told the lining of the uterus to build up with blood,
to be prepared for the possibility of a fertilized egg.
Then you ovulate and the egg comes through the fallopian tube.
If it meets up with sperm, then there's a pregnancy.
If it doesn't, then the egg dissolves in the tube,
and then the ovary makes progesterone. Progesterone
limits the growth of the lining of the uterus.
And then what happens is that that line gets more thick and glandular,
and then both hormone levels, they drop and we get a period.
So all that lining sloughed off through the cervix and the vagina.
But in perimenopause, what happens?
We don't have as many eggs, so we don't ovulate regularly.
I'm going to say that again, ovulation is inconsistent with perimenopause,
and that's what leads to a lot of these wide swings in hormones.
So one month we may have a lot of breast tenderness from a lot of estrogen
and and headaches, and then the next month feel just fine.
One month we may have a lot of hot flashes and night sweats,
and that can go on for two or three months where we're highly symptomatic.
And then the symptoms go away like magic and we revert to our normal again.
So perimenopause
that time around, menopause, there's a lot of variability, variability
in symptoms, variability in periods.
So what should you watch out for?
Well, if you're having periods that last
for more than ten days or they're coming more often
than every 21 days, do talk to your health care provider.
If you're bleeding so heavily that you can't even leave the bathroom
because there's not enough protection in the world to help.
And this is going on for a couple of days.
Do talk to your health care provider.
Here's a rule of thumb.
If you're soaking through a pad and or a tampon
in one hour or less, and that's going on for more than 6 hours,
do talk to your health care provider and get evaluated.
So what can you expect with perimenopause?
How long is it going to last? Again, that's variable.
Some women will experience symptoms of perimenopause
where everything's unpredictable and there's a hormonal roller coaster.
For three, five, seven, or even ten years.
But there's a lot that can be done.
You can talk to a
certified menopause practitioner or someone familiar with women's health,
and they can talk to you about options so that you can kind of take
those big hormonal swings and kind of smooth them out.
One thing that can be safe for women who are nonsmokers
and who don't have migraines
is to use a combined oral contraceptive or the birth control pill,
because that's something that can be safely used in the forties for most women,
and that can smooth out those hormonal wide swings
in that hormonal rollercoaster.
If you're experiencing a lot of these symptoms and you're
in your late thirties, that's also a time to talk to a health care provider
because that may indicate a premature menopause.
So I hope this has helped answer your questions about perimenopause.
There's a lot that you can do to feel better.
You don't have to just suffer and put up with it.
Remember, it might last three, seven or more years.
For more information, you can head over to my blog,
NurseBarb.com or to my new menopause website, YourMenoCoach.com
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Take care and be well.