Perimenopause is described as the time leading up to menopause, and menopause is defined as not having had a period for a year. So, perimenopause is that length of time that leads up to that when your hormones haven't really settled down yet. In fact, they're going crazy; your hormones can be higher and swing lower than they ever did during your entire reproductive life.
So, you get these vast swings. If you end up up here, where do you have to go? You're gonna fall. So, when the hormone levels then fall, you're hot flashing and having night sweats, and your mood may be all over the place. It's a time of great transition, both in terms of what's happening hormonally and what's happening physically.
Well, we know that exercise has had mixed effects on these hot flashes and night sweats. It certainly does help with health in general. It makes you feel better, it makes you sleep better, your quality of life is better, so it's a good idea. But also understanding that the rules of your body change during perimenopause and entering menopause.
So, we know now some very interesting things: that your metabolism actually slows a little bit, but also women going into menopause don't move as much, so that can contribute. And then here's the kicker: all the weight that you do have goes right to the middle section. So, it's very frustrating for women because all of a sudden the rules of your body that have governed you for your entire life, they don't work anymore.
Women come in saying, "I'm eating the same things, I'm exercising the same amount, and I'm gaining weight." So, what you really have to focus on is being very careful with your diet, maybe taking in a few fewer calories, and exercising a little bit more than you used to to find that new balance of where that works out.
When you have these hormone levels going all over the place, it's very common to have symptoms of depression or anxiety that pop up during this timeframe, even if you've never had a problem with them the rest of your life.
And for women who have had some issues with mood in the past, for instance, maybe premenstrual syndrome where they get a little moody right before their period, or say right after giving birth like baby blues, those women who tend to have that hormonally sensitive mood can have more of an issue as they go into menopause.
That's a very vulnerable time in terms of mood. And we also know that anxiety symptoms are very, very common going into menopause. They rank among the most typical symptoms.
Some things to watch out for during perimenopause: if you're having some irregular bleeding, that's pretty common. But if you're having really heavy irregular bleeding, you need to go in and get that checked out.
Other things, if you're having hot flashes and night sweats that are just very disruptive and you're having trouble getting through your day, that's another reason to get checked out.
You should get your mood checked out if you are having troublesome or extremely persistent mood swings. And also, if you're experiencing any pain with sexual activity, that deserves attention by your provider.
Sometimes one of the most helpful things is evening out these swings in your hormones, and we can use low-dose oral contraceptive pills in women in perimenopause. For most women who are healthy during this timeframe and are non-smokers, a low-dose oral contraceptive pill is a reasonable option.
That helps even out, stops the irregular periods, lessens blood flow, and it can even out the hormones such that you're not having so much trouble with hot flashes, night sweats, and mood changes.
We all go through this; it's just that we don't talk about it very much. So many women feel that they are suffering through these changes all by themselves and that no one else in the world is experiencing them. But it's really important to know that we all go through this, and some people have more trouble than others, but we're all in the same boat here.
I think the important part for providers is to put that big picture together, and that's what our job is. It's sometimes difficult because women might be coming and saying, "My joints hurt," or "I'm having changes in my hair," or "I'm getting acne that I haven't had before," "I'm not sleeping well," but she might not be describing the typical hot flashes and night sweats.
"I am having more trouble controlling my mood now." As such, it may occasionally be difficult to fit the parts of the puzzle together. But I think it's important for women to educate themselves on this process as well so that they can alert their providers that, "Hey, this may be happening to me, "since it can be difficult to notice at times.
Source: https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666