Just What is Perimenopause? Are you in it?

What is Perimenopause?

Most of us know what menopause is right? It is that special time in a woman’s life……oh lets forget that sweet talk shit.


The actual definition of menopause is when you are finished your child bearing years and you go a full year without having a period.  The average age is 51, but obviously for some women it is earlier and for some later. Menopause before 40 years old is considered premature menopause and menopause from illness, treatment or surgery is called induced menopause.

Put did you know the whole process of getting to the point of having no more periods can start a good 5-10 years beforehand? This is called perimenopause. Some women can sail through this time with very few issues and they don’t really even realise it is happening. More often than not though, most women have some definite notifications from their body that things are changing. Most of these changes are due to fluctuating hormone levels.


So how do you know if you are in perimenopause?

There is no way to really tell if you are in perimenopause, and it doesn’t just come on all of a sudden. Most of the time these changes are subtle over time until all of a sudden you really may not remember when you felt good.

You can get a panel of bloodwork done to measure your hormone levels, but if you are anywhere in your 40’s and you are experiencing any of the following often strange and weird things there is a good chance that you are in perimenopause.

  • Irregular periods.  Your usual 28 day cycle may become kind of unpredictable and come anywhere between 21 and 60 days.  You may notice it is shorter or longer as well its not uncommon to have a your once predictable 5 day period last 3 days or 14. Or start and stop and start again.  Or sometimes if you are really lucky your friend will arrive twice in one month. Often in perimenopause your period can get heavier as well. Anemia and low iron levels can become an issue. This can be checked with a blood test and it may be suggested you supplement with iron pills if you can not seem to get enough from your regular diet. The later in perimenopause you are…. the longer your cycle may spread out.
  • Sleep disorders. Insomnia is not uncommon, either having trouble getting to sleep or staying asleep. Often night sweats wake you up, or anxiety likes to hit at 2 am and your brain will not shut off.  I will discuss some ideas to help with this in future posts.
  • Hot Flashes. This is usually one of the very common symptoms and one that jokes are made of. Only it is not funny if it is happening you to. The hot flashes are due to hormones fluctuating. It can be very embarrassing, uncomfortable and life disrupting. You can also experience night sweats as well, when your hot flashes happen when you are trying to sleep. Some women report having to fully change their pj’s because they are soaked.
  • Moods changes and mood swings. You may get angry quickly and according to your family for no reason at all. ( there is a reason… you are tired of dealing with their shit left on the counter day after day for the last 20 years)  Or find yourself sad and crying at all the sad and sappy commercials. This is usually related to fluctuating hormones, but not always. We can also add forgetfulness, brain fog, and feeling like you are losing your mind into this category.
  • Depression and anxiety- these issues often pop up in peri, especially if it is something that you have always struggled with. This can be hormone related or due to the fact that you are not getting proper sleep. It can be scary and finding someone to talk to about will certainly help. Your Dr. may suggest antidepressants, but it is also important to find the root cause, which may be hormonal imbalances, or some lifestyle changes that may need to be made, such as less stress, better nutrition, more time for things you love to do.
  • Bone loss- it is really important to continue with your calcium and magnesium and well as weight bearing exercise. Bone loss at this time rapidly increases, resulting in osteoporosis in a few years, as well as just more chance of fractured or broken bones.
  • Decrease in fertility. Because of fluctuating ovulation, it is harder to get pregnant at this age, so if you are still on the fence about a baby, now is the time. BUT pregnancy is still possible… we have all heard of those menopause babies. So if you do not want a little surprise for your 50th birthday party, continue to use contraception until you are one full year period free.
  • Changing cholesterol – declining estrogen can change up your cholesterol levels. This puts post menopausal women at really high risk of heart disease, which is called the silent killer. Often you do not know this is happening.  You want to keep your bad cholesterol levels (lipoprotein (LDL) cholesterol) down and raise up your (high-density lipoprotein HDL) good cholesterol. Get rid of the fried foods and increase good fats, such as flax and avocado.  But it is not always that simple, and a whole post can be devoted to this topic.
  • Libido changes- fluctuating hormone levels are responsible for this. Thanks to low estrogen levels  there can be a loss of elasticity and vaginal dryness. You may also be more prone to infections.
  • Bladder issues- there again low estrogen levels are responsible for lack of elasticity that support the bladder, and you may find that when you need to pee, you really need to pee now. A need to get up in the night to pee and  bladder infections may also be happening more often.
  • Weight gain- here again, if you are eating the same and exercising like you  always have and you have started to see pounds creeping on that will not budge, more often than not you can blame estrogen and progesterone.

For the most part… that covers most of the ‘symptoms’ of perimenopause. If you are in your 40’s and not sure what the heck is going on this is probably it. It is not an illness or a health emergency, but a normal change. There are ways to manage these declining hormones and this has become my current main passion in life… so believe me, I am going through this right along with you. Most of it involves dietary changes, exercise and self care. Follow along and we will get through this together.

To join our Facebook Midlife Support Group, come here. This is a fun and informative and very positive place to be.

Read more about the good and bad of estrogen here.

If you are feeling like you need some extra help and support, contact me, your perimenopause doula.

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  1. This was really useful information. I am glad you left out the sweet talk. Just yesterday my 13 year old asked me if the pad companies really thought covering their packaging with flowers really made getting your period any less sucky. Ha! What can people do to manage these symptoms better (besides covering things in flowers?)

    1. I know right! Periods are sucky. Although my husband often jokes that he should try those pads with wings for a week every month. Then he could go hiking and rock climbing and surfing.

  2. I really enjoyed this post. Some parts made me laugh – especially the part about mood swings. LOL! Love the drawing too. I need to frame it and place it next to my husband’s side of the bed for a good laugh.

  3. Lately I’ve been dealing with the perimenopause dizzy symptom and it’s just such a horrible one to have. I would rather deal with the night sweats and hot flashes than this. I feel frustrated and hopeless, wondering when will this end?

  4. Very helpful info! I, also, suggest getting a menopause specialist in your team. This is someone up on the latest info and studies. This specialist will be able to create an individual program to meet your health needs. No need to suffer!

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