WHAT NOBODY TELLS YOU ABOUT PERIMENOPAUSE

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“Menopause” is a dirty word in my book.  Because while I certainly don’t love the monthly ritual of Advil, tampons, and hormonal acne, I’m also not ready to be confronted with changes signaling the end of my youth.

 At 38, I’m not exactly young, but in an era where many women are likely to live to 100, it doesn’t feel all that old, either. So I wasn’t quite sure what to think when I noticed that my body was changing. All I knew was that something was off. I felt bloated, gained almost 10 pounds, started getting migraines more frequently, and I was suddenly racked with anxiety just before my period. 

 I blamed it on my IUD. I blamed it on my diet. I blamed it on stress. Then I described my symptoms to my doctor.

“I think this is just the way your body is going.” She was using a particularly tactful tone of voice, but I didn’t like the way she was looking at me from behind her tortoise shell glasses.

“Do I need my hormones checked?” 

“Well, I’m looking at your records and your thyroid looks normal. We could check your estrogen, but given that you have migraines, we already know those levels fluctuate. So like I was saying….I think this is just the way your body is going.” She was giving me that look again.

“So you’re saying I’m getting old.” 

“I’m saying I think you’re at least approaching perimenopause, if not already in it. But this could go on for 15 years…or even longer. Which is why I’m saying this is the way your body is going. It’s a normal, natural process. 

As much as my doctor tried to reassure me, I heard nothing after the word “menopause.” Could it really be starting already? Was I one hot flash away from having to stick my head in the freezer? Why hadn’t anyone warned me about this?

Welcome To Your Late Thirties

It took a few weeks and a lot of Googling, but my doctor’s reassuring words finally began to sink in. For many women, the hormonal changes preceding menopause (aka “perimenopause) begin in the mid-to-late 30s. These can go on for more than a decade, so they don’t necessarily signal early menopause.  They simply mean the body is changing, which can cause any number of symptoms…or none at all.

The mood swings, weight gain, and headaches I was experiencing were all fairly typical, and there are three schools of though as to how to deal with them: 

  1. Do nothing and just ride it out

  2. Treat the symptoms to improve quality of life. This is not a medical problem to fix, but a normal and natural process.

  3. Treat the hormonal imbalance and ease your way through it.

For now, I’m going with option #2.

How I’m Handling Perimenopause

 I’m not normally a “treat the symptoms” type of person, but when it means letting my body do its thing as naturally as possible, that resonates most with my holistic outlook on wellness. 

 I did flirt briefly with an approach that involved taking naturally derived progesterone, but ultimately decided against it. While rebalancing progesterone levels helps to lessen symptoms by treating the underlying hormonal shift, I can’t fully wrap my head around the idea of messing with my body’s natural processes. Sure, it’s uncomfortable, but discomfort is sometimes necessary. And personally, I don’t feel that my discomfort is great enough to justify monkeying around with my hormone levels, particularly when we don’t fully know the long term effects of hormone supplementation – natural or synthetic – on women’s bodies. 

Instead, I’m opting for an integrative approach involving a combination of supplementation, dietary changes, and Western medicine. Here’s what I’m doing:

  • I’m taking 500mg magnesium oxide and 400mg vitamin B2 (riboflavin) daily to help prevent migraines. I’ve been doing this for about 6 months now, and while it hasn’t eliminated the monthly migraines with aura I get around  my period, I’ve seen a drastic reduction in the headaches I’d get in between cycles. Previously, I was logging about 20 headache days every month. I’m currently down to around five. I’d call that a win! You can learn more about using supplements to prevent migraines here.

  • I’m treating the migraines I do get with triptans. These drugs are still our best defense when we actually get a migraine. Sadly, my insurance will only pay for sumatriptan, which is the most basic of the bunch and tends to cause rebound headaches. But until that changes, I’ll take what I can get.

  • I’m using NSAIDS preventatively. Non steroidal anti-inflammatory pain relievers aren’t great for us, but I’ve come to see them as a necessary evil. They’re the most effective weapon I’ve found when it comes to combatting the systemic inflammation I experience around the time of my periodl. I take them mostly as a companion to the triptans I use for migraines, but they also have the welcome side effect of reducing the size of acne cysts. 

  • I’ve reduced caffeine and alcohol intake, and cut way back on nightshades, chocolate, peanut butter, red wine, gluten, and dairy during that time of the month. I’ve replaced them with anti-inflammatory turmeric, gut-soothing bone broth, and omega-rich foods like walnuts and salmon. The combination seems to have helped with bloating, migraines, and skin issues.

  • I’m drinking A LOT more water. I’ve always been good about drinking my 8 glasses a day, but I feel my best when I double that amount. Dehydration has also been linked to migraines, so it also counts as preventative medicine. Bonus: I’ve noticed that the skin underneath my eyes is a lot smoother since I upped my water intake.

Real Talk: PMDD

I mentioned earlier that I was experiencing premenstrual anxiety, which can be one symptom of Premenstrual Dysphoric Disorder (PMDD). I worked for an OBGYN while I was in college so I knew what PMDD was, but I’d made the misinformed assumption that it meant depression or rage. Instead, it’s more like postpartum mood shifts in that it can cause a range of disruptions including OCD-like symptoms, anxiety, depression, anger, and insomnia. 

Mine mostly manifested as anxiety. To put it bluntly, I felt like I was losing my mind for 5-10 days of each month. For example, one day I was driving James to soccer practice when I was confronted by an intrusive thought: he could be struck by a passing car if I didn’t watch him closely after parking on the busy street near the soccer field. While the worry itself was normal and healthy, my body took it to a place that was unmanageable. My heart raced, my palms got sweaty, and I nearly started to cry. For several minutes, I was consumed by the scenario of screams and screeching breaks. I could almost feel it happening. When I described this to my doctor, she put me on a low level antidepressant, and that has helped tremendously. 

My point: if you’re suffering to the point where intrusive thoughts are interrupting your daily life, GET HELP.  There are plenty of people who will share their Prozac horror stories and tell you how such and such a supplement or dietary change fixed everything, and I’m truly happy for them! But no one else’s experience or opinion should ever prevent you from seeking help when you need it. Talk to your doctor and explore EVERY solution, even the ones that don’t align with the latest wellness fads.

The cumulative result of these supplements and medications: I feel a lot more like myself. I’m more mentally focused, have fewer headaches, and my energy levels are back up.  That said, I realize this is a journey and I’m continuing to investigate additional, natural methods to support my body during this change. I’ll be sure to keep you in the loop as I learn more!