Hello everyone!  Let’s talk about menopause and perimenopause symptoms, shall we?

Have you read that book Our Bodies, Ourselves?  Gosh, it’s an old one.  It conjures up college years for me.  It was first published in in the early 1970’s and re-issued in updated forms every 4-6 years.  It’s a manual of sorts that discusses women’s bodies and the physical and emotional changes that occur as we age.

I remember picking it up in my early 20’s and pouring over it.  Every chapter talked about intimate topics in such a straightforward way.  It felt like I’d found a treasure box of vital info that I’d never been privy to.  It talked about vaginas, urethras, and clitorises (clitori??).  It talked about sex.  It talked about orgasm, menopause, pregnancy, breast feeding.  It had PICTURES of everything.  As a 20 something I was enthralled.  It discussed all these topics that typically were discussed in health class that one time in middle school, (when most of us were too self conscious to really listen).

It shared them with grace and ease.

That book normalized talking about body parts and functions in a way I’d never really heard.  Fast forward nearly 20 years and I’m a gynecologist who spends everyday talking with women about their body parts and functions.

If you want to see a little of the history of Our Bodies, Ourselves, go here.

Knowledge is powerful. Understanding how our body works and knowing what to expect helps us weather changes our body undergoes with grace and ease.  Knowing to anticipate a symptom is the next step to having a more relaxed perspective on how our body changes.  Time and time again I hear women say they would have felt fine dealing with a particular health concern, if they would have just known that it was normal.

“Just knowing that it’s nothing bad, makes me not worry about it.”

So today, I’d like to take a few minutes today to talk about perimenopause symptoms.  This will be a high level overview of the symptoms women experience.  In a future post, I’l get into solutions.

Perimenopause just means that transitional time between having regular cycles and menopause, when you’ve gone 12 consecutive months without a cycle (outside pregnancy and while you are not on birth control or any meds that cause your period to go away).

Perimenopause symptoms can be really troubling if you don’t know they are coming.  It’s like a second adolescence and can really be a big bummer to encounter if no one let you in on its inevitable arrival.

You can read about the nitty gritty of what to expect in your perimenopause by reading below.

After you read it, let me know in the comment section what your experience has been like.  Did you have an easy time or a difficult time?  What would have made it easier?  If commenting publicly is not your thing, just email me at kristangevinemd@gmail.com  I read every note.

The nitty gritty:

Perimenopause just means the transition between regular periods and menopause.  It can last for 2-8 years before menopause.

You are in menopause when you’ve gone 12 consecutive months with out a menstrual cycle.  The average age for this to occur is 51.3 years old.

Menopause occurs as our ovaries get to the end of their days of releasing eggs and hormones.  The changes are the direct result of a dramatic drop in hormone production.

Everyone can experience different degrees of intensity of symptoms during this transitional time. It’s analogous to being a teenager:  some young adults have easy teenage years and some have tumultuous years.

Symptoms women may have are the following:

Your periods may start spacing out.  They may stop being monthly and you may skip a month or two or three.  They may space out and then return to monthly and then space out again.  You may go 6 or 8 months without a cycle and then have them monthly for a spell.   They may simply stop all together.  They can change in duration: they might go from being 3 days long to being 7 days long or on the flip side they may shorten (that’s what I hope happens to me).

These feel different to everyone but are commonly described as a feeling like the temperature has all of a sudden been cranked up.  It can be quick or like you’ve stepped into a sauna for 10 minutes or more.  You can all of a sudden just be sweating.  It can come and go rapidly for a few minutes or all day.  It can make you feel panic.  Some women say the change in temperature was so startling they felt light headed, had palpitations, had a sense of nausea, and even chest pain.  Obviously these symptoms landed them with and ER visit to make sure they weren’t suffering from a heart attack.

This is the night time version of hot flashes.  Imagine sleeping just fine.  Then imagine you wake up and the sheets are wet, the comforter is wet, and you have sweat all over, including funny places like your shins.  You don’t feel fevery, but dang, you feel wet and now cold because you’ve had a night sweat and now are laying in a wet bed.  These can occur rarely or repetitively all night long.  They can totally mess up your sleep or you can be a lucky lady and sleep right through them.

If hot flashes occur at night, they can disrupt sleep, even if you don’t know they are occurring.  This can lead to sleep deprivation.  Lack of regular, restorative sleep can make you moody, tired (surprise, surprise), tearful, anxious, snippy, tense, irritable or depressed.

Similar to how you get a dry mouth, dry skin or dry nasal passages, the vagina can get dry too.  In perimenopause and menopause, the vagina gets less estrogen.  Estrogen helps the vagina with moisture and when it decreases the vagina can feel dry and irritated.  This can be annoying in and of itself, but can be particularly bothersome with sex.  This may sounds silly, but think of play-doh.  It’s soft, compliant and flexible when it’s new.  But if left out overnight, it gets hard, dry and crumbles and cracks.  You know where I’m going with this, right?  Vaginal tissue is just like play-doh.  When estrogen levels decline, the natural moisture and lubrication declines and the result is vaginal dryness and irritation.  No one likes their vagina to feel like dry, cracking play-doh.

This can lead to assorted symptoms:

These symptoms are the direct fallout of the decline in estrogen that happens when the ovaries stop working.

{{These vaginal and urinary symptoms affect 50% of older women.  50 percent!!  But interestingly, only a small percentage of women connect these to menopause.}}

Isn’t this list of things is so unappealing?  Who wants all that?  I know it’s just the natural course of how our body changes, but most of it sounds likes such a drag.  Thankfully most women do not get all the symptoms.  When present, usually the symptoms last for an average of 4 years.  However, in the unluckiest ladies, symptoms can last for decades.  There are many options to addressing these symptoms.  The next menopause article will dive into the solutions.

If you can’t wait for the next post- here’s a mini preview: you can combat hot flashes and night sweats with lifestyle changes like staying hydrated, doing yoga, breathing exercises, regularly exercising, dressing in layers and reducing tobacco use.  Black cohosh works well in a small percentage of women, for a short period of time.  Estrogen therapy (when deemed safe by your doctor, and combined with progesterone if you still have a uterus) is highly effective.  For vaginal and urinary symptoms: vaginal estrogen is also highly helpful.

Also helpful for vaginal and urinary symptoms are:

So there you have it.  Part 1 of Perimenopause.  I’d love to hear your take on perimenopause and menopause.

What has your experience been like?  What’s worked well?  What’s been the most annoying to deal with?

Leave a comment or shoot me an email at kristiangevinemd@gmail.com

Cheers,

Kristi