Are you going through the change..How do you know if you’re perimenopausal?
Before I kick-off...
It's not you — it's us!
While I may jest a bit in this blog-post, I can assure you that perimenopause is no laughing matter — not for the person suffering from it, and not for the people suffering from the person suffering from it.
Perimenopause is unfortunately, the most erratic stage of a woman’s entire REproductive life.
God help us all! 😱
It is super-important for women to become aware of this transitional phase, and to prepare themselves — and their loved ones — so that everyone knows what to (possibly) expect during this time. Otherwise it can feel like a very confusing and isolating time for all concerned.
Many of my female clients haven’t even acknowledged or fully accepted their perimenopausal state — mainly because they haven’t officially been diagnosed by a doctor.
Please know, that if you are a woman of a certain age (as we’ll discuss below) and you’ve been experiencing a number of the symptoms below, then congratulations — you’re in ‘perimenopause’.
And unfortunately you’ll just have to deal with it.
Ladies, I strongly recommend that you share this blog-post with your significant other. It’s incredibly important that they know what you’re HAVING to go through. And, it saves them from ‘flying blind’.
Please know ‘everyone’ — that we don’t want to be feeling the way that we’re feeling, or acting the way we’re acting, any more than you want to be on the receiving end of it all. So, please (please) try not to take it personally. (It’s not you — it’s us!)
We need love, understanding and support as part of our overall natural treatment approach, which I will discuss below.
If like me, you're now perimenopausal — then A VERY (very) WARM welcome to you!
On the rag
I’ve recently turned 44 years old.
However, last year, when I turned 43 years old, I announced to DMF (my long-term partner) —
“You know what, I’ve been menstruating every month for the last thirty years! That’s a lot of ‘periods’ — especially considering I’ve never actually required the services of my uterus!”
He exclaimed — “Bloody hell!”
I exclaimed back — “Precisely!”
Note: I chose not to have kids a long time ago, because it’s MY uterus and I’ll breed if I want to. So yes, I’ve been having regular monthly periods since I was 13 years old. Since that ‘fateful’ day, I’ve endured approximately thirteen periods per year – bringing me to a grand total of: 573 ‘menstruations’ (or thereabouts).
Now, as I said, I’ve always had a reasonably regular (27-day) cycle. Until a couple of years ago that is…
The year was 2017. During that year, my periods suddenly started going ‘wonky’. They started arriving a little earlier than anticipated, and while I have always had heavy periods, these new ones made me wonder if I was ‘bleeding to death’…
Then, I had a number of short-cycles in succession — which significantly increased my period-tally that year! EEE—gads!
(I also suffered from my first ever UTI during this time. And, because of this, I got incredibly confused about whether I was experiencing fevers or night-sweats…)
At the time, I thought it was the ‘beginning of the end’ — perimenopause at the tender age of 42!
However, as it turned out, I was simply being over-dramatic. (Who me?!)
The problem was that I had been undergoing a bunch of ongoing stress. And, once I got that sorted out, everything went back to being ‘manageable’ not long after.
What had happened during this time, was that I had recently pinned all my hopes & dreams on solely running my own private practice, I was over-working & over extending myself, I was experiencing some significant ‘family issues’, and I made two very reluctant appearances on the television over a short space of time (NewsHub, and The Cafe).
Since this time, I decided that it was not worth risking my health — or sacrificing my ovaries — to be the next: Mike Puru1 😉
(Let the record state that I’m okay with working hard, ‘pinning’ my hopes & dreams, and being a shy & reclusive writer. All of that I can maintain – no problem!)
During that period...
I will admit this all came as quite a shock.
I’d always been like ‘clock-work’, and I had always just taken it for granted that ‘it’ would just appear at the some old time.
So, as you can imagine, once I thought my child-bearing years were over, well, I wanted them back now, didn’t I!
No, not so that I could give DMF a child — don’t be daft!
I wanted the blood.
I wanted the cervical mucus.
But, more than this, I craved the youth that these secretions represented!
All I could think about was getting all hot, hairy, and hormonally unstable. And having my vagina shrivel-up and fall off. (Like a dead leaf in the autumn of its life…)
This was not the way I wanted to go out!
“Dear God, if you could just see fit to regulating my periods again — to restore me to my former glory; and to keep my fanny moist — then I promise you that I WILL be a better woman!”
I'm sorry to have resorted to using the word: "moist". I am well aware that it is not a general 'crowd-pleaser'.
Have you got the 'Warm Fuzzies'?
How do you know if you're perimenopausal?
It’s the period we go through that bridges the female reproductive and non-reproductive states.
Note: Peri-menopausal should not be confused with Pre-menopausal (the latter meaning that you’re, well, pre-perimenopausal; you’re at your fullest reproductive capacity!)
In most cases, perimenopause occurs in the 43-54 year old age bracket.
(Although, it can occur in your late 30s/early 40s.)
Hormonally, during perimenopause, you will experience fluctuating oestrogen levels, declining progesterone levels, and disturbed master gland feedback communication. (I’m talking about the ovarian-pituitary-hypothalamic network here.)
All of this hormonal imbalance, as you can imagine, plays major havoc with our menstrual cycles, as well as our whole bloody wellbeing!
We women never quite know what to expect from month to month and, unfortunately, neither do our poor bloody partners! 😬
(And, from what I have observed in practice over the years, women appear to be going through this change earlier — in their early 40s rather than in their early 50s. I’m absolutely putting this down to increased stress levels.)
Here are the symptoms you may experience:
01—Heavy or irregular bleeding
Because our hormones are erratic at this time, we essentially flick between cycles of ovulating and not ovulating.
This can mean shorter (more times bleeding) and/or longer menstrual cycles (fewer times bleeding.)
If your oestrogen is cycling high in comparison to your dwindling progesterone levels, it can also mean lots of blood. Lots and lots of bloody blood.
(Heavy bleeding during the night impacts our sleep by making us keep getting-up to ‘change’. It also plays havoc with our energy — our iron stores)
A hot flush is like going up in flames. It’s an ascending heat that starts low and moves up the body.
Note: This is opposed to a ‘liverish’ type of heat, like the one you experience at around 2am, after you’ve been ‘boozing’. This is a radiating heat – where you need to get the ‘blankees’ off yourself ASAP.
(Hot flushes during the night also impacts our sleep.)
03—Migraines and/or headaches
If you’re already a sufferer of hormonal-related-head-pain, you are unfortunately likely to get worse during this time. (Bloody erratic oestrogen levels and over-excited bloody blood vessels!)3
Symptoms could include (but are not limited to): blurred vision, stiff neck, irritability, tired/yawning, nausea, vomiting, photo & phonophobia, heightened sense of smell, limited food tolerance, difficulty focusing, and poor concentration.
Thankfully, Practitioner-grade Coenzyme Q10 can help improve these symptoms, and can also help to lessen the frequency with which the migraines ‘feature’ in your life. Talk to your trusted Naturopath about whether this supplement is right for you.
Ref: Thank the lord!
04—Weight gain and abdominal obesity (the battle of the bulge)
Unfortunately, we are 3x more likely to experience weight gain at this stage in our life.😱
This happens when our oestrogen levels drop-off, effectively redistributing the fat on our bodies to our belly!
Unfortunately this visceral adipose tissue (VAT) or, ‘extra-padding’, can promote inflammation and insulin resistance; further complicating the clinical picture of perimenopause.
(And, putting on excess weight doesn’t exactly make us feel very good about ourselves.)
A.K.A sore boobies.
Progesterone is a pain-killer/tranquilizer of sorts. And unfortunately, during this phase of our life, this hormone is ‘heading south’.
Note: The pain will be worse if your fluctuating oestrogen is on the rise.
06—Sleep disturbance and/or insomnia
You may have trouble getting to sleep, or you may wake a number of times during the night. You may also wake a lot earlier than you would appreciate. Or! You may experience all three things.
This can be due to a number of reasons –
Heavy bleeding – when we have our menses.
Hot flushes during the night.
The neurological changes that precede and persist during perimenopause. (More on this below.)
Calcium deficiency – here you tend to wake at around 3am and struggle to get back to sleep.
Note: Calcium is a mineral that women need in increasing quantities as we age.
Poor sleep unfortunately makes our perimenopausal symptoms worse.
07—Anxiety/mood swings (irritability), and cognitive changes (poor memory)
Hormonal changes not only disturb master gland feedback communication (that I mentioned earlier), but it also impacts the HPA axis and therefore stress adaption.
And these symptoms, alongside chronic stress, all actually feed into one other and can make our perimenopause ‘experience’ even worse.
Again, perimenopause is unfortunately the most erratic stage of our entire reproductive years. And, it’s arguably the most DISRUPTIVE time in our life from an overall physiological and psychological perspective.
It’s very important to be aware that these symptoms don’t just happen in the lead-up to our period (like PMS). These symptoms can happen throughout the entire bloody month! And, unfortunately, the perimenopausal phase can last for many years.
And if that weren't enough to BLOODY-WELL contend with...
Depression has now been added to the list of symptoms.
You have a 20% chance of this occurring. It can either be a completely new symptom you have to contend with, or it can be a relapse of a previous depressive state.
And apparently it’s not your ‘normal person’ type of depression (like I can suffer from if I don’t watch myself).
It is actually its very own sub-category of Depression!2
With ‘perimenopausal depression’ you can experience:
Anger, irritability, paranoia, and uncharacteristic verbal outbursts!
(Great, really freakin’ great.)
And, to top-it-off, this type of depression unfortunately presents itself as ‘crazy, psycho, mental bitch’ – as these episodes/outbursts can last from minutes to hours, and then just spontaneously resolve.
This is boringly called: On-off phenomena.
(Clearly, I prefer ‘crazy, psycho, mental bitch’, but god help any male who uses this ‘female-only’ terminology to describe us — it will not go well for them ☝️)
Note: Hormonal changes not only disturb master gland feedback communication (that I mentioned earlier), but it also impacts the HPA axis and therefore stress adaption. For more on this, check out a previous blog-post that I wrote on how chronic stress and depression are intrinsically linked.
But wait — there’s more!
This type of depression is also associated with:
Fatigue and decreased energy (unrelated to insufficient sleep), self-esteem issues, social isolation, poor concentration, and having no bloody interest in procreating (having sex) – funnily enough…
As part of an overall treatment programme, Resveratrol can help improve cognitive function, and help to reduce belly weight.
That's not all.
Due to the age that perimenopause occurs, the issues can be compounded, because:
We may also be suffering from:
Thyroid dysfunction, autoimmunity, cancer (breast), mood disorders, osteoarthritis, osteoporosis, high blood-pressure, Type-2 Diabetes, cardiovascular diseases, etc
Note: We may also be taking a statin drug to modify our cholesterol level, which will also be negatively impacting our sex-hormones.
We may also be dealing with:
Teenagers/empty nest, marital issues, elderly parents, financial & work stresses.
Or, some perimenopausal woman may be dealing with (very) young children — having not procreated until their late 30s/early 40s!
Here’s another blog-post I wrote on such things:
Are you stuck in Flight mode?
As part of an overall treatment programme, calcium & vitamin D supplementation can help improve sleep and reduce belly fat.
The age of onset for perimenopause is only 47% heritable. This means that it's largely open to manipulation!
You need your own personalised treatment programme
Please be aware that every woman’s version of perimenopause will be different, so it’s important to work with a knowledgable, and experienced Naturopath to determine your particular ‘brand’, and your specific requirements.
Your Naturopath will also ensure that Practitioner-grade products are used, at the correct dosages, and for the correct amount of time required to facilitate you throughout this entire transitional phase.
A treatment programme for perimenopause should always include stress support
Specific medicinal herbs that can help reduce stress & anxiety during this time include: Rhodiola, Withania, Licorice and Rehmannia. (Reducing stress & anxiety can also help to improve your sleep.)
Rhodiola is actually my most favouritest herb to use for my clients during their ‘transition period’ 🤗
Note: Lemon Balm has been found to reduce stress & anxiety, as well as alleviate depression and help promote sleep. However, this herb is contraindicated in Hypothyroidism – which MANY of my clients suffer from.
Stave off Perimenopause for as long as possible
Your Hypothalamus is a ‘boss gland’ that resides in your head. And, its ageing actually precedes the onset of perimenopause.
(This Hypothalamic ageing also affects our melatonin and circadian pathways which is another reason why sleeping becomes more difficult during this time.)
Fortunately, we can postpone our reproductive capabilities from going ‘kaput’ by slowing down the ageing of our Hypothalamus using supplements such as SAMe or methionine. (As part of your comprehensive treatment programme.)4
To balance your hormones a plant-based diet is generally indicated here. Think veggies, fruit, legumes, nuts, and seeds (flaxseed in particular).
Or, the Mediterranean diet is a winner to modify your weight and reduce your cardiovascular risks.
And, if you do nothing else, do yourself a huge favour and significantly reduce your alcohol and caffeine intake – ideally eliminate them completely for a good 2—3 months! By doing this, you’ll help to regulate many of your perimenopausal symptoms.
Walking is very helpful to those suffering from Depression6 , and it’s also helpful to keep the weight off during perimenopause.
High Intensity Interval Training (HIIT) can prove helpful in reducing belly fat.7 However, I wouldn’t advise this type of exercise unless you were in otherwise excellent health. (This intense activity might ‘backfire’ in this case.)
If you develop Depression, or you relapse — you will need additional support
Here, inflammation in your body needs to be addressed.
This may be done by looking into your diet. An anti-inflammatory diet reduces the chance of you suffering from depression by 20%.5 We can also add anti-inflammatory supplementation to your treatment regime.
Note: Rehmannia and Withania (mentioned above) are actually anti-flammatory medicinal herbs. And, all of the medicinal herbs mentioned help to reduce chronic stress which in turn helps to stave off inflammation.
And lastly, and maybe most importantly...
Be careful! Make sure that you’re still having safe sex, lest you end up giving yourself the physical & emotional shock of a life-time.
While it’s much less likely you’ll be able to carry a baby to term at your age… you can sure-as-hell still get pregnant! And, then you’ll have to deal with the extreme unpleasantness of going through a miscarriage, or a missed miscarriage 😖
Note: Woman can still have children in their early 40s – all things going well.
It's something unpredictable, but in the end it's right...
Make an appointment to see Lisa
Lisa Fitzgibbon is a qualified (2006), experienced and registered Naturopath and Medical Herbalist. She runs her own private practice OOMPH, in Grey Lynn (Auckland, New Zealand).
Lisa has been involved in the Natural Health industry for 13 years. She draws on her professional training and experience, as well as her own personal experience to bring you realistic, holistic health advice.
Book online to see Lisa at OOMPH.