If there’s something that isn’t spoken about enough, it’s the ever-constant hormonal changes we experience as women. Think about it. We have the ability to experience five hormonal stages in our lifetime; puberty, pregnancy, post-partum, perimenopause, and menopause. But when are we introduced to the symptoms of perimenopause?
If you grew up in my generation, conversations at home regarding what is going on with your body didn’t happen. Rather, you learned as you were experiencing the changes, from what was being taught in health class, or from friends. There was no “Dr. Google” in my childhood and teenage years — not that this doctor is at all reliable.
A lot of changes took place for me in my 30s. I endured an abusive relationship, lost 80 pounds, bought my condo, met my husband, sold the condo, bought a house, got married, and changed my career. I felt my best in my 30s. A constant for me was my dedication to living a healthy lifestyle. I was the happiest I’d ever been, the most confident, and yet, the most anxious. I did not know that anxiety was a symptom of perimenopause, nor did I realize perimenopause could start this early.
By the time I turned 40, my energy tanked. I fatigued much faster in the gym and needed more time to recover. There was insomnia. I cannot tell you how many times I cried at night because I couldn’t fall asleep. The more I stressed about it, the harder it was to fall asleep. I endured unexplained weight gain and bloating, all around my stomach, hips and thighs. We all love gaining weight there, don’t we? I had acne around my chin, the back of my neck and sometimes my chest. Didn’t I have enough of this as a teenager?? The worst of it, however, was feeling inadequate as a wife. My libido went from healthy to non-existent, and I was ready for my husband to leave me.
Welcome to perimenopause!
So, what exactly is perimenopause? Broken down, “peri” means around, so it’s the time around menopause. Typically, perimenopause is the last 4 years prior to menopause. The truth is perimenopause can last up to 10 years. This means you can begin to experience symptoms as early as your 30s.
And while you may not experience them all, symptoms of perimenopause include:
- Breast tenderness
- Decreased libido
- Facial hair
- Frequent urination
- Hair loss or thinning
- Hot flashes
- Interrupted sleep / insomnia
- Irregular cycles
- Mood swings
- Night sweats
- Urinary incontinence
- Vaginal dryness
- Weight gain, especially around the mid-section
Your symptoms associated with perimenopause are hormonal shifts, to be exact. But before I talk about the shifts, let’s quickly talk about our cycle so you can better understand the shifts.
What to know about the 28-day cycle
Our cycle is typically based on a 28-day time frame broken down into two phases; the follicular phase (days 1-14) and the luteal phase (days 15-28). While this can be longer or shorter for some, the follicular phase is less likely to shorten.
The follicular phase essentially is the part of your cycle where an egg in the follicles matures in your ovaries in preparation for release during ovulation as part of the reproductive process. At this time, your uterine lining thickens for pregnancy. You will have elevated levels of follicle stimulating hormone (FH), as it stimulates egg production. Estrogen is more dominant in the follicular phase, and supports tissue proliferation in the uterine lining. In contrast, there are low levels of progesterone, and luteinizing hormone (LH), as well as lower basal body temperatures.
By day 14 when ovulation occurs, there are sharp increases of FSH, LH, and estrogen.
As we enter the luteal phase, around day 15, estrogen starts declining. At the same time, progesterone – the dominant hormone of this phase – increases in preparation of receiving a fertilized egg. During the luteal phase, we see increases in basal body temperatures, while FSH, LH, and estrogen remain low. If an egg is not fertilized, the last week of the luteal phase will result in declining levels of progesterone. We begin the cycle all over again as the lining of the uterus is shed and we menstruate. If you think about it, our hormones function as an orchestra playing a beautiful symphony.
What exactly is perimenopause?
Perimenopause, then, is the orchestra no longer playing in concert. Rather, estrogen and progesterone levels start functioning somewhat independently, rising and falling while taking us on a hormonal ride. Our symptoms are a side effects of hormones not playing the beautiful symphony.
Estrogen stimulates the growth of the egg follicles in the ovaries, maintains the thickness of the vaginal wall and stimulates lubrication of the vagina, and maintains the mucous membrane that lines the uterus. Low levels of estrogen cause breast tenderness, dry skin, weak and/or brittle bones, trouble focusing, moodiness, vaginal dryness, hot flashed and night sweats, irregular or no periods, and even a rise in cholesterol levels.
In contrast, progesterone’s primary role is to create a stabilized uterine lining for embryo implantation. It also plays a role in mood regulation, by attaching to receptor sites in the brain that you would also find GABA. Symptoms associated with low levels of progesterone include irregular periods, headaches, mood swings, anxiety, depression, bloating and weight gain, hot flashes, trouble sleeping and difficulty conceiving.
How to treat symptoms of perimenopause
The answer is not as simple as social media implies. You know, the ads that show substantial weight loss from walking as if balancing your hormones is that easy. The truth is there is no one-size-fits-all approach. There are so many factors that play a role in hormonal health. Factors such as stress, diet, exercise, emotional well-being, hormones, other diagnoses, and even environmental exposures.
There are nutritional, lifestyle, and supplemental interventions that you can employ to support minimizing the symptoms.
Contact me by clicking the button below! Let’s dive deep into your symptoms of perimenopause. We can create a protocol that provides you with energy and leaves you feeling like your old self.