Even though Perimenopause Awareness Month (September) is over, I wanted to address this important topic in “Ask Andi Anything.” Because, unlike September – which lasts just 30 days – perimenopause, for many women, can last from a few months to up to 10 years!
And the crazy thing is that MOST women have NO IDEA that the changes they are experiencing as early as their 30s are related to perimenopause. Too many of us are never told what to expect in perimenopause and menopause, so our symptoms get dismissed or (even worse) misdiagnosed.
According to recent studies, by the year 2030, there will be an estimated 1 billion women entering perimenopause and menopause. Menopausal women will make up the largest demographic in the United States!*
(Who says women don’t run the world?)
Since The Change Is Personal is a place to come for valuable information about perimenopause and menopause, I’m sharing some of the most popular questions I get asked about perimenopause, so you have a better idea of what to expect.
Q: What exactly IS perimenopause?
A: Perimenopause is the transition that takes women from child-bearing years into menopause. Once your body no longer ovulates, you haven’t had a period for 12 consecutive months, and your reproductive years end, you’re in menopause. The phase after that is considered postmenopause.
Perimenopause typically begins 5-10 years before menopause, which for most women in the United States, happens around age 51. However, perimenopause can begin as early as your 30s, when you may begin to experience the associated symptoms of the menopausal transition.
Perimenopausal symptoms can be directly related to fluctuating and declining hormone levels, including estrogen, progesterone, and testosterone.
Q: How do I know if I’m in perimenopause?
A: One of the most common indications that your body is in perimenopause is irregular periods. But, this isn’t always attributed to perimenopause for many different reasons. For example, certain types of birth control medications, PCOS (polycystic ovary syndrome), stress, excessive exercise, weight fluctuations or fibroids (non-cancerous growths in the uterus) can make your period irregular or nonexistent.
Mood swings, decreased energy, low sex drive, sleep disturbances, joint/muscle pain, and even brain fog – all potential symptoms of perimenopause – are often attributed to working too many hours, caring for children, arguing with teenagers, and other typical aspects of daily life and aging.
Some women gain a few extra pounds during perimenopause, regardless of diet and exercise. Some women start suffering from hot flashes, night sweats, incontinence, vaginal dryness (and other vaginal changes, such as an increase in odor or infection), and painful sex when perimenopause begins, and deal with those horrible symptoms for YEARS beyond menopause!
Did you know that changes in your skin or gut health may also be symptoms of perimenopause? Fluctuations or a decrease in hormones may cause your skin to become dry, itchy, and flaky (not to mention SAGGY!!). And bloating, gas, and constipation become more common in the perimenopausal years.
If you’re experiencing ANY of these symptoms, are in your 30s, 40s, or 50s, and still getting your period, it may be time to talk with your provider about perimenopause.
Q: What’s the best way to address my perimenopausal symptoms?
A: The experiences of perimenopause are different for everyone, so there’s not one best way to address your symptoms. However, if hot flashes are interrupting your day, a low libido is affecting your relationship, or brain fog leaves you feeling “all over the place,” know that you don’t have to suffer through these symptoms indefinitely.
A good place to start is by finding a medical provider who understands perimenopause and menopause. It’s important to note that many providers (including general practitioners and OB/GYNs) are not well-versed in hormone support and replacement.
Women are often told that they are experiencing a mood disorder, such as depression or anxiety, they are too stressed, need to sleep, lose weight, or drink more water. OR they are dismissed altogether instead of being heard, thoroughly evaluated, and appropriately supported! So, it’s important to do your research and talk to a provider who understands the options.
One of those options may include bioidentical hormone replacement therapy (BHRT). When you are in perimenopause, you may or may not be ready for hormone “replacement” due to the fluctuation in your hormones, but you may benefit from some hormonal support. Your provider may prescribe hormones at a lower dose as a cream to be applied vaginally for vaginal dryness or painful sex, or to the face and neck to help prevent the signs of aging.
Hormones may also be prescribed as oral tablets/capsules, sublingual tablets (dissolve under the tongue), topical creams, buccal troches (dissolve between the upper cheek and gum), pellets that are injected under the skin, patches, or as an injectable to help balance and replenish your hormones. Compounded BHRT is a great option for many women, because the medications are customized specifically for your individual needs.
Q: Do I have to wait until menopause to start hormone therapy?
A: Typically, no! You don’t have to wait to start hormone therapy to help relieve symptoms of perimenopause. As I discussed above, speaking to a hormone specialist is essential to determine your personal course of therapies, and to rule out other health conditions and risks.
Prior to menopause is often an ideal time to begin hormone therapy, especially if perimenopausal symptoms are disrupting your life. Since the decline of hormones – especially estrogen and testosterone – have been associated with increased risk of heart disease, osteoporosis/osteopenia, and dementia, perimenopause may be a good time to discuss hormone support with your provider. If you and your provider decide that hormone therapy is a good option, you can begin during the transition to menopause.
Once you hit menopause and postmenopause, it’s a good idea to begin hormone therapy within 10 years, or before age 60, for the most benefit.
Questions for Andi?
Email your questions to: askandi@belmarpharmacy.com
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*Menopausal women will make up the biggest U.S. demographic — so why is medicine still ignoring them?
*The information expressed in this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read on this site.