Take the Mystery Out of Perimenopause

Question:

I am 44y with crazy periods, hot flashes at all the wrong times,

can’t sleep more than 4 hours a night from the night sweats and have uncontrollable raging angry towards my husband.

What is going on, I am too young for menopause, right?

Answer by Dr Sherry

By the age of 45 or so, most women wonder how “the change will change me? “      

Perimenopause happens when the ovaries don’t function consistently and upset the normal hormonal rhythm.   This hormonal change usually happens within 10 years of menopause. The erratic and disruptive symptoms of perimenopause tend to mark the beginning of menopause. Between the typical 40-something anxieties from divorce, dealings with hormonal or college-bound teens, self-esteem issues, job challenges and other midlife stresses, one’s 40s are challenging enough without the hormonal upheaval. The most common symptoms of perimenopause include irregular periods, hot flashes, sweating, insomnia, depression, anxiety, feeling apprehensive, weight gain or loss, fatigue, bloating, poor concentration, memory loss, vaginal dryness and heart palpitations. These symptoms mimic the symptoms of menopause but tend to come and go unlike symptoms associated with menopause. All of these disruptive symptoms can affect your quality of life.

A thorough medical history should be taken, along with a blood panel and a pelvic ultrasound in order to complete the final diagnosis.

Treatment Options

• Heavy and irregular periods – The best treatment tends to be with hormones. Low dose oral contraception, cyclic progesterone, IUD with progesterone (Mirena) and Hormone Replacement Therapy (HRT) are helpful remedies.
• Hot flashes – Dressing in layers and staying in cool temperature are the first steps in dealing with hot flashes. Avoid hot beverages, spicy foods, red wine and hot climates bring that bring on hot flashes. Herbal remedies may include passion flower extract, ashwagandha, chasteberry for hot flashes and other symptoms of peri-menopause.
• Mood swings – Antidepressants are effective in controlling depression, anxiety and panic attacks. A therapist may also give added support. And, of course, exercise, the elixir to all.
• Acupuncture –Even though the studies are not conclusive, hot flashes and heart palpitations may improve with acupuncture treatment.
• Low sex drive (libido) – Testosterone and the mediation, Addyi, may be helpful for low libido.
• Lifestyle and healthy eating along with a good night’s sleep– Eating a well-balanced and colorful diet of fruit, vegetables, whole grains, and finding an exercise routine and sleeping 7-8 hours a night will minimize your perimenopausal symptoms.

Sometimes what women need most is a thorough understanding of exactly what is happening physiologically, if only to realize that what they are going through is normal and, most important, that we are not crazy.