Perimenopause: What to expect and how you can thrive

Chances are you’ve heard the word menopause more than perimenopause. You’ve heard about the hot flashes. And the mood swings. And the weight gain.

Menopause is portrayed as this rollercoaster of symptoms that suddenly occurs when you’re in your 40s or 50s. But that doesn’t tell the whole story. The truth is that your body undergoes a natural (and usually slow) progression to menopause called perimenopause.

Menopause is diagnosed in hindsight when you’ve gone 12 months without a period.

Until that point, the hormonal imbalance of perimenopause brings with it a wave of discomfort that can last for months or years.

The early signs and symptoms of perimenopause

Night sweats are one of the first signs of perimenopause. You may also notice that your menstrual cycle is increasingly becoming less predictable. Your menstrual cycle will become more and more irregular until you have your final period. 

Other common perimenopause symptoms you may experience:

  • Hot flashes – these sensations will actually occur more frequently during menopause, but it can be helpful to start tracking what your triggers are (usually coffee and red wine) to keep hot flashes at bay
  • A change in blood flow – your menstrual bleeding can get heavier or lighter as your cycle becomes more irregular
  • Sleep difficulties – the hormonal imbalance of perimenopause causes a natural decline of progesterone. This could be responsible for your sleep troubles, since progesterone acts on the brain pathways that induce sleep
  • Heart palpitations – about 1 in 4 women reported their heart racing or fluttering occasionally through perimenopause 
  • Mood changes – the hormone imbalances caused by perimenopause can make you feel more anxious, depressed, and/or irritable. 

The difference between perimenopause and PMS

Sometimes it can be hard to tell if you’re going through perimenopause or if you’re having a tough case of PMS (premenstrual syndrome). One of the best things you can do is keep track of your symptoms.  This can help you establish a baseline of what each cycle is like so that you can easily identify changes.

If your PMS symptoms are increasingly becoming more intense, this could be a sign of perimenopause.  

If you have a history of periods without PMS and you’ve recently developed PMS, that could also be a sign of perimenopause.

Managing stress to ease perimenopause symptoms

The onset of perimenopause tends to happen between 45-55 years of age, when most women experience significant life changes. Caring for aging parents and children or preparing for a new phase of your career creates additional stress.

When you are experiencing more stress on a frequent basis, your body begins to produce more cortisol (the stress hormone). Increased stress levels can worsen the existing hormone imbalances of perimenopause and make your symptoms much worse.

With our functional medicine approach, we believe that testing your cortisol levels is an important part of your perimenopause treatment. We believe in helping you manage your stress and supporting your adrenal glands (which produce cortisol) throughout perimenopause to ease your symptoms.

A holistic approach to treating perimenopause and estrogen dominance

The uncomfortable symptoms of perimenopause can be attributed to hormonal imbalances where your body has significantly more estrogen than progesterone, called estrogen dominance

It is no surprise then, why hormonal birth control can be used to treat estrogen dominance. For women who have used birth control in the past with no issues, an IUD or progesterone-only pill may be a perfect fit. 

If you would rather avoid hormonal birth control, you have other options. Treating estrogen dominance does not have to be reduced to taking hormones. 

Your perimenopause symptoms can be treated in a way that aligns best with you.

A clinician trained in functional medicine can support you by developing a treatment plan that is aligned with your values. Do you believe that meditation has a positive effect on your well-being? Do you want nutrition to play a stronger role in your treatment plan? Do you believe that supplements can be just as powerful as traditional medicine? Your perimenopause treatment plan can be based on the lifestyle factors and habits that are most important to you so that you are an active participant in your care. 

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The disconnect between perimenopause and the medical community

Perimenopause is a natural phase of a woman’s life. However, you may not hear much about perimenopause from your traditional physician. More often than not, perimenopause is considered something women “just have to go through” and treatment options beyond hormonal birth control may be dismissed.

The truth is that functional medicine treatment options like supplementation, meditation, and dietary recommendations are not discussed at length in medical school, especially in the realm of women’s health.

Unfortunately, traditional physicians also usually do not have enough time to effectively treat perimenopause. It takes much more than a routine appointment to uncover the specific lifestyle factors, stress levels, and medical history that could be enhancing your perimenopause symptoms. 

Choosing the right provider to thrive

You can thrive during perimenopause. It starts with having a healthcare provider who listens and validates your experience. 

You know your body best and you are in tune with the changes happening to your body. It is essential that your provider collaborates with you to develop a plan of care that is aligned with your values. 

You do not have to suffer through perimenopause. If you are experiencing symptoms that have been dismissed as something “you just have to go through” by your physician, then contact a functional medicine practitioner for a better approach to treatment.  

 

 

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