You’re Not Crazy, You’re in Perimenopause

As the fertility cycle slows down, major changes start to take root. Purist’s Contributing Health Editor Tapp Francke shares strategies to get through this challenging time.
Making your body as healthy as possible will help you get through perimenopause. Photograph by Evan Phillip

Menopause takes the main stage for hormonal changes in a woman’s later life. However, the transition period, called perimenopause, can be just as tumultuous and last up to 10 years! This particular period in every woman’s life is largely underrated. We speak about puberty, pregnancy, post-childbirth and menopause as hormonally turbulent times in our lives, but very rarely discuss the slow burn of perimenopause. Even my spell-check does not recognize it.

Perimenopause usually happens to women when they are in their 40s, but sometimes can happen as early as their 30s. Like puberty, perimenopause entails significant hormonal shifts. Typically, this transition begins seven to 10 years prior to menopause. During this period, the ovaries begin to make less estrogen. Between 35 and 55, a woman’s estrogen levels drop around 75 percent.

A woman’s fertile years are controlled by a delicate, well-orchestrated dance of hormones. Estrogen, which is produced by the ovaries, plays a critical role in multiple systems. It is a chemical messenger that controls how almost every tissue and organ system behaves. The consequences of having less available estrogen throughout the body are varied and can range from unnoticeable to severe. Some women sail through this transitional time completely unaffected by the hormonal shifts and changes, while others feel the effects profoundly.

These symptoms of perimenopause include hot flashes, frequent UTIs, weight gain, increased PMS, moodiness, depression, breast tenderness, low libido, fatigue, vaginal dryness, incontinence, irregular menstrual cycle, insomnia, urinary urgency, increased heartbeat, headaches, difficulty concentrating, hair changes, muscle aches, decreased fertility, forgetfulness, bone loss, changes in cholesterol levels and discomfort during sex.

How a woman experiences perimenopause has a lot to do with her stress level. The decrease in available estrogen has a negative impact on her neurotransmitters. This is amplified by the stressors associated with this demanding time in a woman’s life: caring for aging parents, raising young children, reaching a peak in our careers or all of the above.

Perimenopause, though uncomfortable, is a natural event in the body. It is the necessary slowdown of the fertility cycle to bridge the time between fertility and infertility. Natural methods of balancing the body can be utilized to moderate the symptoms. Making your body as healthy as possible and not participating in behaviors that can have negative long-term consequences will have a big impact on how well you get through perimenopause. Here are a few tips:

•Don’t smoke

•Maintain ideal body weight

•Exercise—both aerobic and strength training

•Treat and control medical conditions such as diabetes, high cholesterol and high blood pressure

•Follow a diet low in saturated fat and low in trans fat

•Eat a diet high in fiber, whole grains, legumes, fruits, cruciferous vegetables, fish (especially omega 3-rich fatty fish), nuts and seeds, and folate-rich foods