The span of time between the end of a woman’s reproductive years and the beginning of menopause is called perimenopause. There are blood tests that a healthcare provider can run to check a woman’s hormonal levels. Apart from that, a woman’s age at the time of the arrival of perimenopause and exactly how long it lasts are hard to pinpoint, and vary wildly from woman to woman. 

And even though the exact timing of perimenopause is hard to predict, on average, perimenopause arrives when women are in their 40s and lasts for four years. A number of factors come into play including genetics and there are some medical conditions and treatments that may cause the premature onset of menopause.

But even as vague as the timing of perimenopause may be, there are some symptoms that women commonly report experiencing. During this time, there are changes in the signals our pituitary glands are sending. As a result, our ovaries gradually slow down the release of viable eggs each month. While our pituitary glands and ovaries are busy receiving signals and adjusting the amounts of hormones, the process can trigger a myriad of changes. The changes include weight gain, sleep disturbances, menstrual periods, plus changes in mood and cognition.

Weight Gain

Weight gain is one of many changes that women notice during perimenopause and can it can continue into menopause. As we age, our metabolisms naturally slow down. Similarly, as the amount of estrogen in our bodies decreases as a natural part of perimenopause, it can also slow metabolism, while at the same time causing cravings. Because our bodies are systems, even small changes are interpreted as stress, causing the body to release stress hormones. Stress hormones can cause the weight gain commonly called “middle-aged spread.” 

Changes in Mood and Cognition

In addition to changes in our metabolisms, changes in hormonal levels are also hard at work within the brain. Women may experience bouts of irritability, low mood or forgetfulness that are not clearly attributed to mental health or medical conditions. As with many other phenomena of this portion of a woman’s life, science does not have an exact answer. I suspect that the ongoing adjustment and response to hormones affects the areas of the brain responsible for short-term memory, mood and other functions. 

Period Changes

Just as weight gain and brain function changes may appear and reappear, menstruation can be unpredictable at this time. The official marker of menopause is one full year without a period. It is not uncommon for women to have a number of years where they don’t have a period for six or ten or more months. This is it! Or so you may think. Because, guess what? Aunt Flo/Company/Mr. Monthly arrives for a surprise visit. It’s important to use birth control if you do not want to get pregnant, because tracking your menstrual cycle is no longer a reliable way to monitor your fertility. 

Another condition called “flooding” may occur. Flooding is when a woman’s menstrual flow is heavy enough to soak through a tampon or pad in less than an hour or two. This can be quite alarming! Hormonal activity can cause the vessels and veins that line the uterus to remain stuck in the “open” position. While menstruation usually involves uterine tissue to be shed, when a woman experiences flooding, it is mostly blood passing from the uterus. Because of this, she is at risk of anemia. Periods may also be lighter than you are used to, as the body ramps down its reproductive functions. 

Sleep Disturbances

Insomnia and night sweats are the two symptoms that can lead to sleep deprivation. Again, this is due to hormonal changes. The response to hormonal changes may change from time to time. At times a woman may experience periods of extreme sleepiness. Then at other times, she may lay down, but find she is wired and not at all ready for sleep. Yet another barrier to a good night’s rest is the occurrence of night sweats. This can happen at any time, but if it occurs in the middle of the night it can be very disruptive to sleep. 

Coping Strategies During Perimenopause and Menopause

The weight gain!  Moodiness! Brain Fog! Our Periods! Sleepless nights? Whether you experience one or all of these, they can affect the quality of life and overall health. Just what can a woman do?

Ya’ll do know the origins of the term “hysterectomy,” right? The term came about because, just as in present day, way back in the day, there were often theories, but no definitive scientific explanations, for symptoms women presented with to (mostly male) doctors. Well, unable to find medical causes of many female symptoms, these (mostly male) doctors concluded that these women were just imagining symptoms and suffering from hysteria, a form of mental illness. These (mostly male) doctors resorted to the removal of women’s reproductive organs to treat them. And that’s why these serious medical procedures are called hysterectomies.

By the way, this line of thinking also led to advancements in the development of what we now know as the vibrator. But the point is, that it has not been too terribly long ago in the history of Western medicine that many of these symptoms were regarded as imaginary, a form of hysteria, or proof of insanity. 

Enlist a health care provider. Hopefully, you have a patient provider a provider who is a good listener and can rule out other potential health risks. If you don’t, is it possible for you to find a provider who is a good listener?

In addition, there are other measures that you can take to address these symptoms. Check with a medical provider to see if one or more of these are safe and can help you:

• Regular Exercise
• Practicing Mindfulness or meditation
• Get outdoors for exposure to sunlight
• Eat less sugar and eat fewer simple carbohydrates
• Over-the-counter supplements
• Journaling and/or writing down the next day’s intention
• Eat a small amount of a high-quality protein shortly before bedtime

The Gift of Menopause

Perimenopause and menopause are one of life’s biggest gifts to women in midlife. The symptoms can be annoying or even downright frightening. But many of the symptoms are a call to practice self-advocacy and self-care. You may have spent the last two or three decades caring for others while your own needs dropped shamefully low in your priority ranks. But this is a wonderful opportunity to fine-tune and perfect the care and keeping of your body so that you can enjoy the decades ahead. 

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