Perimenopause – Smoothing out a bumpy transition
“My friend was diagnosed with perimenopause. Do I have that?” -question from my patient.
What is Perimenopause?
Perimenopause is defined as the period of life that occurs shortly before a woman enters menopause. I find this a vague and not so helpful definition and an even less helpful diagnosis. Every woman will go through perimenopause at some point. The exception would be a woman who has a full hysterectomy, in that case she will unceremoniously be thrust into menopause without this transition time.
Our ovaries are the main drivers of our menstrual cycle during our fertile, menstruating years. They take direction from the pituitary gland (nestled in our head), but the ovaries release the estrogen and progesterone. As ovarian function starts to decline, we can get reduced or erratic secretion of estrogen as well as cycles where an egg is not released (ie. No ovulation). Without ovulation, there will be reduced progesterone. This erratic hormone secretion is the main culprit in the symptoms of perimenopause. During this perimenopausal transition these hormonal changes may also vary from one menstrual cycle to the next, making this time potentially stressful as a woman’s cycle and symptoms become highly variable.
The Timing
Perimenopause usually begins in our 40’s although it may begin as early as the mid to late 30’s. It may be as short as a few years or last up to 10 years. Once you have not had a period for 12 consecutive months, you are officially in menopause.
Symptoms of Perimenopause
- Irregular or heavy periods
- Hot flashes
- Changes in menstrual symptoms like cramping, breast tenderness and PMS
- Sleep disruption
- Mood changes
- Vaginal dryness and pain with intercourse
- Urinary tract infections
- Decreased fertility
- Changes in libido (sex drive)
How do I know if I am there?
If you are experiencing any of the above symptoms and you are in your late 30’s or early 40’s you may be in perimenopause. But the decision on whether to do something about it depends on how much it is affecting your quality of life, your family history and how focused you want to be on the root cause. Naturopathic medicine aims to balance out fluctuating hormone levels and smooth out this transition period to reduce your symptoms. Clinically I have noticed that women with a smoother perimenopausal experience often note a smoother menopausal transition as well.
What will we do?
There are many natural supports and ways to balance out fluctuating hormone levels. Interventions commonly used in my practice include diet and lifestyle modifications, stress management, herbal medicine, acupuncture and bioidentical hormones.
Should my hormones be tested?
Depending on the severity of your symptoms and complexity of your case, testing may or may not be suggested. Testing options include serum (blood) hormone levels, saliva hormone testing and dried urine hormone testing (DUTCH test). During the initial visit we will discuss your concerns and review if testing is helpful in your case.
Let me help
Women’s health and hormone balancing is one of my favorite things to do. It is incredibly rewarding to have a woman shift from feeling like she is bleeding constantly, not sleeping and losing her mind to returning to regular cycle and feeling like herself again. Perimenopause can last up to 10 years. Let’s make it a decade focused on you, not your period.
Dr. Nicole Shortt, ND
Dr Nicole Shortt, BSc, ND is a Naturopathic Physician who is passionate about naturopathic medicine and the choices it gives people in health care.
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