I'd say let's talk about the elephant in the room...
…but it’s not an elephant.
It's a lot of wildly swinging hormones, for a lot of women in their late 30s and into their 40s (and 50s!).
That is a huge rotating portion of the population and yet most women are left in the dark about this inevitable period of time in their lives.
The changes that occur before menopause, aka perimenopause, is not something that happens just before menopause. Much of the literature says that it starts 4 years before menopause but for many women, the decade to decade and a half before menstruation ceases is a time of hormonal upheaval.
Why is it not couched this way?
Why don’t we talk about it?
Women’s lives are dictated by hormonal fluctuations anyway — why be mum on how there is a significant shift in that after 20-30 years of consistent menstruation?
It’s important to categorize this downshift in hormonal production as something to pay attention to because at the end of the day, it’s your body and it’s your lived experience.
We learn about puberty! We learn about menarche! Why don't we learn about peri menopause and menopause?
What's extra crazy to me is that it often happens in what ends up being a really insanely busy time in a woman's life: career advancements, aging parents, growing kids, relationship realizations… and then add in some heavy bleeding and an erratic cycle on top of that, with teenage-like mood swings, night sweats, and acne. What the actual…
So here are some straight up facts about what could be going on in your body. If you’re concerned or you have questions, ask your doctor.
I am very pro-doctor, pro-expert, pro-science. And! Doctors and experts and the whole of science have largely ignored women’s health and are really now only beginning to study various things on women… like, for instance, most pharmaceuticals. So it is important to be a discerning consumer, both with your medical professionals and also with your information.
I highly recommend the book The Menopause Manifesto by Dr. Jen Gunter if you’re at all curious about this stage of life.
what is menopause?
It’s when you stop getting your period. It’s supposed to happen. The national average in America is 51, but if possible, you can look back to the women in your lineage to see what your timeline might be. (Women who have gone through menopause for reasons other than… men
What is perimenopause?
It’s the time before you stop your period, and it’s marked by hormonal changes. OED says “the period of a woman's life shortly before the occurrence of the menopause” which sounds like calling it “the Google” and also, it’s not “shortly” before menopause and perpetuating that myth is harmful to women in their late 30s and early 40s who are experiencing normal hormonal shifts and, being under educated, think something is wrong. It’s part of why it feels so dismissive when a practitioner shrugs and says, “It’s just hormones.” Listen: we are meat suits mediated by hormones, so life is hormones and there’s nothing just about that.
what are some signs and symptoms to look out for?
Early: period changes (length, duration, amount of bleeding, skipping cycles), mood shifts (…rage. I mean rage.)
Mid: all of the above, mild temperature fluctuations, mild heat flushes, sleep disturbances, vaginal dryness, anxiety, brain fog, fatigue
Late: all of the above with an increase in heat flushes and more extreme period changes
what can I do to be more comfortable?
Hormone Replacement Therapy
The HRT of 2024 is not your mother’s HRT. Literally: the study telling us all that women predisposed to certain cancers or women who are cancer survivors can’t do HRT is about 25 years old, the NIH was only required to add women into empirical studies a decade before that, and we’ve come a long way both in terms of research and experience since then.
Talk with your doctor about hormone replacement therapy.
Diet and Exercise
Menopause journal showed that women in early menopause had near complete relief from hot flashes by abiding by a plant based diet rich in soy products. Decreasing estrogen has an incredible impact on muscle mass, and strength training is a lifeline for many perimenopausal women… there are ways you can adjust your lifestyle and minimize your discomfort.
Acupuncture
I mean… what kind of acupuncturist would I be if I didn’t throw this one in there? It’s a known cycle regulator, helps with hot flashes, eases emotional upheaval (see the above rage), helps with sleep, clears your head… If you’re local, come on in so we can get started helping you feel better!
Herbs
Of course herbs are helpful. Plant medicine has grown up alongside humans and we have a symbiotic relationship so it would be quite confusing if certain herbs weren’t helpful! Western herbs are often available over the counter, and if you’re interested in a tailored approach through a TCM lens, we encourage you to book an online or in person herbal consult to help ease your symptoms.
