Perimenopause and You
If you have spent any amount of time on a social media platform lately, as a woman in midlife, you have probably received a targeted ad about perimenopause care. These bright, cheery banners can make anyone wonder if they might need specialized supplements to weather the coming storm. Perimenopause has long been an under-researched and even taboo life transition. Businesses eager to jump on a money-making opportunity are springing up to take advantage. Some of those doing the marketing are full of well-educated, helpful practitioners and treatments, though many are just hoping to make a quick buck. How can you navigate this life transition (and these easily-clickable options) with a cool head?
Just as menarche, the start of a young woman’s menstrual cycle, is a major life transition, her entry into years of fertility, so is her exit from that phase. What is menopause? Most gynecologic specialists consider a woman to be in menopause when she has had full cessation of her menstrual cycles for 12 months. The average age for menopause in the United States is 51, though it can occur from 42-55. In very unusual cases it can occur much younger. For some, this transition between regular menstrual cycles to their terminus is quick, and nearly symptom-free. For others, it can last as long as 8 years, and have complications such as changes to cognition, insomnia, hot flashes (known as vasomotor symptoms) and even mood and anxiety disorders. One of the biggest factors in age at menopause is nicotine use - so talk to your doctor or go to smokefree.gov to begin your quit journey if you are a current smoker.
For many women, perimenopause does not require any specialty care at all! Yes, your body is changing, but if you are experiencing mild and even moderate-but-manageable symptoms, you can predict that the hormonal fluctuations will regulate within a few years. Our grandmothers went through this change for generations without the aid of online medical services for guidance, and for many, just talking with a friend, accepting minor body changes, and perhaps adding in some silicone based lubricant is enough to navigate this shift.
If you are wondering if you might be in perimenopause, the first thing to do is begin to track your periods carefully. Note your sleep, focus, and vasomotor symptoms, and any physical changes. Keep track of any medications, over the counter agents, or supplements that you are taking. Experts in perimenopausal health recommend against St. John’s Wort and cannabis, as there is little or no positive data, and they can cause problems that can worsen underlying menopausal issues. Some other treatments are promising for certain symptoms associated with perimenopause, but need more study, such as omega-3 fatty acids, yoga, exercise and acupuncture.
For some, talking with a mid-life gynecologist (or a thoughtful primary care provider) can be helpful. This is especially the case for those who have symptoms like moderate or severe physical or emotional changes. Those with significant vasomotor symptoms are more likely to have significant mood and anxiety challenges - so consider reaching out to your GYN or a psychiatric midlife specialist if you are experiencing some of these complications. Sometimes hormonal therapies are helpful; sometimes they are not the panacea that we wish. Other strategies can assist too in finding regulation and balance through what can be a turbulent time.
You have gotten to this point in life, you have come through many challenges thus far. This, too, is time limited. There are supports that can help, pharmacological and non-pharmacological.
Dr. Brynes and the team at Ripple have a particular interest in perimenopausal psychiatric care. They are happy to talk with you and your GYN or PCP if needed, to design a plan that is right for you.
