By Julie Tilsner, Natural Solutions
I was having a typical conversation with my friend Debbie that led to a shocking revelation. We were laughing and complaining about getting older–our more frequent mood swings, the changes in our hair texture–when suddenly Debbie whispered, “It’s because we’re in perimenopause.”
“Perimenopause?” I hissed. “We’re too young!” Nope, Debbie said. Mid-40s. Wait, I’m just getting used to being in my 40s, a mom of two, a real grown-up. How could menopause be just around the corner? And why am I so horrified by the mere mention of it?
While in theory I want to embrace these wise woman years when they come, in reality menopause (in our culture at least) suggests not-so-graceful aging, accompanied by withering and a loss of femininity and purpose. Is that what my friends and I have to look forward to? Surely there are other ways to approach this transition, I thought. I don’t want to have my mother’s painful menopause. As it turns out, I don’t have to.
The perils of perimenopause
For my mother the onset of menopause was pretty typical: Her first period at 13, menopause complete by age 52. Shortly after she turned 47, her periods–always 28 days apart–became erratic. Within the year she was walloped with hot flashes, insomnia, weight gain, and virulent mood swings. “I didn’t even recognize myself,” she told me. She figured she was entering menopause because all of her friends were experiencing similar symptoms, but she was unprepared for the havoc these gnarly side effects were wreaking on her life. “I honestly thought I was going out of my mind,” she said.
Miserable, my mom turned to hormone replacement therapy (HRT) to ease her symptoms–and it worked for her. But because the 2001 Women’s Health Initiative study showed that continued use of HRT increases risk of breast cancer, strokes, and heart disease, I don’t see it as an option for me. Frankly, it scares me, and as someone who gave birth to both my kids naturally, I prefer taking a more natural route.
While experts agree that women generally mirror their mother’s experience in menopause, they also say that lifestyle choices, health, and attitude can trump genetics. After talking to dozens of leading integrative doctors and other women who’ve been through it, I now know that there’s another conversation I should be having with my mom and my friends–and it’s not the one about how much menopause is going to suck.
Our bodies, ourselves
Medically speaking, menopause occurs one year after a woman’s last period and marks the end of her fertility. Perimenopause–the four to seven years leading up to menopause–is a time of wildly fluctuating hormone levels, which can spark a variety of physical, mental, and emotional symptoms.
“Think of [perimenopausal] estrogen levels as the Dow Jones industrial average,” says Mary Jane Minkin, MD, a professor of ob-gyn at Yale University. “Estrogen goes way up, then it comes crashing down.” Levels stabilize after menopause, and most of the uncomfortable symptoms go away, she says.
Many of us have come to dread the inevitable march toward menopause, equating it with crazy-producing symptoms we read about or watch our own mothers go through. The move from our fertile years into “withered old age” strikes fear in those of us who were raised to equate female worth with youth and attractiveness. From a holistic standpoint, however, the transition into menopause is a powerful opportunity for self-discovery and renewal. It’s a natural process of a woman’s reproductive cycle, a transition from the childbearing years–not a condition to be “cured,” as Western medicine would have us believe.
Nevertheless, some women experience one or many of the following symptoms, sometimes relentlessly:
Hot flashes and night sweats. Both are a form of vasomotor (the constricting and dilating of blood vessels) instability. Hot flashes can come on at any time, day or night, and may or may not involve sweating. Night sweats, as the name suggests, involve excessive sweating in the evening, usually while you sleep. Experts surmise these temperature spikes are a response to the body’s search for estrogen.
Insomnia. When estrogen levels drop, the adrenal glands, which are designed to balance estrogen and many other hormones, go on high alert and pump out cortisol, a stress hormone that triggers a fight-or-flight response. Their heightened state upsets our circadian rhythm and disrupts our otherwise normal sleep patterns.
Weight gain. Fat cells carry estrogen, so our bodies produce more of them to replace the lost hormones, says Holly Lucille, ND, RN, a naturopath based in Los Angeles and author of Creating and Maintaining Balance: A Woman’s Guide to Safe, Natural, Hormone Health (Impakt Health, 2004). This causes sudden weight gain for many women regardless of how little they eat or how much they exercise.
Irritability. During perimenopause, estrogen spikes and progesterone drops, creating intense anxiousness and irritability. Overtaxed adrenals also play a role in extreme mood swings.
Brain fog. Profound shifts in hormone levels, much like the ones we experienced during puberty and pregnancy, can make organizing thoughts and finishing sentences challenging.
Loss of libido. Lower estrogen and testosterone levels conspire to flatten our desire–at least temporarily. Some women experience vaginal dryness, which can make intercourse painful. Others have problems with body image, which prevents them from feeling desirable.
Depression. Fluctuating hormones, including a drop in mood-enhancing progesterone levels, can bring you down. Add a foggy head and sleepless nights to the equation, and this low feeling can turn into a bad case of the blues.
Doctors say these symptoms appear to be hammering women harder nowadays because of our lifestyle choices. “There are very few women who breeze through menopause without any symptoms,” says Tracy Gaudet, MD, director of the Duke Center for Integrative Medicine and the author of several books, including Consciously Female (Bantam Books, 2004). “Just about every woman will experience some symptoms. And while you can’t control those symptoms, you can influence them.”
How? By being in good physical and mental health before the transition begins. In other words, if you have a high-stress job, only exercise sporadically, forget to eat or scarf down junk food on the go, and have no down time at all, you’re moving into menopause already depleted–and things will only get worse. “You’re doing yourself a big favor if you’re healthy going into menopause,” says Minkin. “That isn’t to say you’re not going to have challenges. But I tell my patients it’s best to hit the ground running.”
Next: Prepping for perimenopause