Perimenopause: What You Need to Know If You Are in Your Thirties (or More)
If you are a person with a uterus, you probably got an awkward conversation when you were about nine or ten years old explaining some of the changes that were going on in your body. (Maybe you’ve watched a movie that memorably used pancake batter to shape the female reproductive system.)
Be that as it may, you probably got something .
But it turns out that there is no such screening of sex-disaggregated films for people between the ages of 30 and 30. Thus, many women find themselves caught off guard by the gradual changes in their menstrual cycle – and perhaps their overall sanity. It’s not the capital-C menopause change that we all have vague expectations for, but her bitchy little sister, perimenopause.
What Happens in Perimenopause
For many women, it takes several years between achieving a DivaCup monthly and setting the clock regularly before leaving it all behind. The time leading up to menopause (which the American Congress of Obstetricians and Gynecologists defines as the absence of menstruation for 12 months because the ovaries have stopped producing hormones) is called perimenopause, and it may not be very fun.
Your cycle may be lengthening or shortening, who knows! You could bleed less – or more! You can experience hot flashes, sleep disturbances, bloating, headaches, and truly horrific PMS. But your periods continue to limp or speed up, and you continue to experience hormonal cycles. The result is a lot more cute cowards, sent to the grave only in the early stages, and some serious physical and emotional discomfort.
“A lot of women and their suppliers don’t realize this,” says Dr. Joanne Pinkerton. Pinkerton is the Executive Director of the North American Menopause Society and Professor of Obstetrics and Gynecology at the University of Virginia Health System.
“Symptoms can be very vague,” she says.
For example, it may not be missed periods. It can be weight gain and headaches, or brain fog and painful sex. Plus, she says, some women cycle into and out of perimenopause, which makes them very difficult.
“Sometimes women just come in and think they’re going crazy – no one else has symptoms,” says Pinkerton.
And they may think they are too young, as change may begin in the late 30s or early 40s. The average age for menopause is 51 , but for many women it is before 40 – sometimes due to cancer treatments, certain surgeries, autoimmune diseases, genetics, or simple old luck, according to the US Department of Women’s Health. health and social services.
Timing does not start evenly or end evenly. Their rough onset is reflected in the completion of lay and menstruation, which ultimately end in menopause.
Pinkerton, for example, says she remembers going out with her family to celebrate her first periods (!) And then felt very embarrassed when they hadn’t returned for months. But this is typical. When young women go through puberty and have their period for the first time, the hormonal pathway that causes the ovaries to produce eggs is immature, leading to irregular periods for a while.
After these first few periods, possibly with different cycle times, puberty begins and they become more predictable. “Finally, women have regular cycles,” says Pinkerton. “Many women have very predictable cycles of up to 30-40 years.”
Your doctor can help
Not every woman approaching middle age has a hard time. “Some women just march, others will have a lot, a lot of hesitation,” says Pinkerton. “I think taking care of women, getting through perimenopause, is sometimes more difficult than going through menopause.”
The most common symptoms of perimenopause are: irregular periods, hot flashes, trouble sleeping, mood changes, decreased vaginal lubrication, increased urinary tract infections, urinary incontinence, and changes in sex drive.
Pinkerton recommends that perimenopausal women take a comprehensive look at their problems. The comparison to puberty is apt – after all, not many 12-year-olds have mortgages, jobs, teenage children, and aging parents.
“When someone walks in and says, ‘I don’t know what to do, I feel like I’m falling apart,’ I draw a circle and place the patient in the middle,” says Pinkerton. She monitors stress, sleep, physical and mental health.
Help is available. The doctor may provide hormonal birth control or an IUD to regulate and calm the ovaries. It may be helpful to take low doses of antidepressants, especially before your period.
Pinkerton also adds that 16 percent of new diagnoses of depression occur in perimenopause, so beware. Flood periods when women soak a pillow for an hour or more, or produce huge grapefruit-sized clots, pose a risk of anemia. Another funny surprise of perimenopause, she said, could be pregnancy – the second-highest indicator of unwanted pregnancy, she said, occurs in women over the age of 40.
“Even if your ovary is not working, it is working,” she says.
For all the potential doom and grimness, women can take steps to prevent at least some of this. Healthy eating is very important, as is exercise. Sleep disorders can make it difficult to maintain good sleep, but it’s worth a try.
First of all, remember that there is help. If your gynecologist doesn’t listen to you or heed your concerns, she says, look elsewhere.
“Women don’t have to suffer in silence,” says Pinkerton. “If it affects your work or relationship, you need to get in.”