Menopause & perimenopause
Perimenopause — the beginning of hormonal change
by Marcelle
Pick, OB/GYN NP
Up until relatively recently, conventional medicine has had little to offer women
suffering from symptoms of hormonal change. Until a woman was deemed to be officially
in menopause and could be prescribed
synthetic hormone therapy, she was often told that her symptoms were all
in her head. Even today, women struggling with hormonal imbalance are frequently
sent home with a prescription for
antidepressants, rather than being offered real solutions for a very real
condition.
In integrative medical circles, there has long been recognition that a transitional
period of time exists before menopause, which is different for each woman, when
fluctuating hormones may cause her serious distress. Thankfully, conventional medicine
has caught up and we now have an official name for this passage in medical textbooks:
perimenopause — defined as a transition period that precedes menopause,
as in “pre-menopause,” which is symptomatic of hormonal imbalances and
fluctuations in a woman’s body.
Symptoms of perimenopause can begin as early
as 10–15 years before menses completely stop. Women in their late 30’s,
40’s and early 50’s may transition in and out of a perimenopausal state
many times before they finally enter menopause. If you are currently experiencing
symptoms such as irregular
periods, heavy bleeding,
hot flashes,
sleep disruption, headaches,
dry eyes,
vaginal changes, hair loss,
weight gain,
loss of libido or extreme emotional distress, you may be relieved to know
that these are all common signs of perimenopause.
Tips for Personal Program Success
Clear out temptations. To jump-start your new eating plan, go through your kitchen and pantry and toss all the processed and unhealthy foods. At the least, rearrange your foods into different cabinets, so you can't reach for "bad" things so easily out of habit.
Along with the more obvious changes listed above, many of my perimenopausal patients
find their short-term memory impairment or a lack of focus to be very irksome. These
cognitive effects of hormonal imbalance are frequently overlooked in mainstream
discussions about perimenopause. Yet
fuzzy thinking and an inability to multitask can definitely be traced to
your physical state, as can increased
anxiety, fatigue,
depression and drastic
mood swings. These symptoms
are actually signals being thrown up by your body to make you stop in your tracks
and take notice. Women often remark on the brain fog that comes over them after
childbirth, affording them only the attention span to focus on their new baby. A
similar phenomenon occurs with the hormonal fluctuations leading up to menopause
— only this time the miasma of your hormones is telling you to stop and pay
attention to yourself!
It may be reassuring to remember that a woman’s body is always in flux, always
changing, and never more so than in the years that characterize puberty and perimenopause.
In the same way you can be “pubescent” you can also be “perimenopausal.”
But these are just words, not a rigid definition of who you are, what your body
is capable of, or who you are going to be.
During perimenopause, the ratio of estrogen to progesterone is frequently in a state
of flux, which can manifest along with other symptoms as very heavy (and maybe even
frightening) bleeding. In our culture, many women tend to be operating with an internal
hormonal balance tipped toward the estrogen
side of the scale. This tilt is often the result of a diet high in simple carbs
and low in quality protein, a lack of essential nutrients and fats, and chronic
exposure to environmental toxins and artificial hormones such as
endocrine disruptors. Prolonged emotional and physical stress, which I define
as anything that works against your state of balance, will also upset the hormonal
applecart. In today’s fast-paced, disconnected, eat-and-run world, it is no
surprise to me that younger and younger women are coming in to my practice with
symptoms of hormonal imbalance
and perimenopause.
In some cases, women in perimenopause may have low levels of progesterone in comparison
to their estrogen levels. In other cases, the progesterone level is fine, but estrogen
levels are too high. Another case we are seeing more frequently is where all three
of the key hormones which flux during this time, estrogen, progesterone and testosterone,
are too low. What’s most important to recognize is that each woman needs to
be evaluated differently, preferably by a medical practitioner conversant in integrative
or alternative medicine. More often than in the past I find conventional doctors
are quite willing to discuss the reality of perimenopause, but natural, long-lasting
solutions are still hard to come by. Most conventional practitioners don’t
believe that people can change their lifestyle and eating habits. My response is
that I know and have seen that they can. And I will tell you this: no woman needs
to suffer with symptoms of hormonal balance, at perimenopause, menopause, or after
menopause. You can feel better and you can start right now.
Being in perimenopause does not necessarily mean that you will follow an immediate
and direct path to menopause. Some women go
for years in this transitional state, whereas others sail through in just a few
months. What does seem to influence the severity of symptoms is the weight of other
burdens women may have placed on their bodies over the years. Poor nutrition, chronic
stress, and a lack of daily exercise are three major amplifiers because they each
play a significant role in the body’s ability to detoxify and maintain homeostasis.
Lifestyle choices such as smoking or drinking to excess are likewise compounding
factors.
Another hidden element of perimenopause is fear. Many women are terrified by the
prospect of losing their biological fertility, just when stress and low testosterone
may be zapping their libido.
Our youth-obsessed culture has been extremely hard on aging women, but I have witnessed
the dynamic transformation that takes place in my patients. The joys of life
after menopause are many and great — you just have to learn how to
manage the symptoms leading up to it!
After more than 20 years of helping women with their premenopausal issues, I understand
firsthand women’s frustration with the way healthcare is often delivered.
With projections indicating that for the first time in history our children’s
life expectancy may be shorter than our own, the time is ripe to make some changes
in the way we care for ourselves — changes that aren’t oriented toward
drugs. I’ve found that a combination approach, one that takes into account
all four corners of a woman’s foundation of health, provides the most relief.
That’s why I created the Personal Program
to give women the basic tools necessary to navigate the confusing waters of perimenopause:
in short, optimal nutrition, hormonal balance, mindful exercise habits, and emotional
support.
By taking our Essential Nutrients
and using our Herbal Equilibrium
as directed, members have taken the initial steps toward healing their bodies and
restoring their natural hormonal balance. Frequently they then find the energy and
will to make lifestyle
and dietary changes that dramatically improve their quality of life. Many
write to us to describe their transformation. I encourage you to read these
women’s stories for yourself and learn more about your health in our
health topics section.
Wherever you are in your journey through perimenopause, the symptoms you feel will
ultimately influence your actions and reactions. So take our
hormonal profile and learn for yourself what proactive steps might benefit
you the most. Know that you do have the power to help yourself during this time
and that we are always here to help.
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at 1-800-798-7902. We're here to listen and help.
We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.
Original Publication Date: 05/23/2002
Last Modified:
01/05/2010
Principal Author: Marcelle Pick, OB/GYN NP