Let's Talk About Perimenopause

The post below was written by Mahri Relin, Founder of Body Conceptions, a company that focuses on women's health through various physical transitions including pre- and post-partum and perimenopause. 

When Andi invited me to write a blog on perimenopause, I was honored and excited. Understanding life transitions for women (especially those that are hormone-driven) has been a life-long mission of mine. My fitness company, Body Conceptions, works with women during these transitions with fitness solutions, and I am currently pursuing a masters in clinical mental health counseling to support the emotional side. 

What has struck me the most learning about perimenppause was how every woman goes through it and yet it’s a big black box of unknowns.  We get very little if any education about our own hormones, and I have felt surprised by some of my own experiences even with the education I have received. I have also found that my female friends jump at the opportunity to talk about perimenopause as soon as I mention it (which is a lot!).  Perimenopause can be so confusing, and it’s also so different for each and every one of us. On top of that, our medical doctors receive minimal training on this time of life, and many of them prescribe medication for each separate symptom we experience rather than addressing the hormones causing these symptoms – including my own doctors! 

Again, this is something all women experience, and it can so challenging.  Why do medical doctors pay so little attention to such a pivotal time in a woman’s life?  This is not OK. 

Interestingly, studying and talking about perimenopause has created some amazing opportunity for connecting with and supporting other women as we help each other understand our experiences. We really need to help and educate each other, at least to let our fellow female friends know where to look for legitimate, informed perimenopause support.

I could literally talk about perimenopause for hours, so I wanted to narrow down some key thoughts about it for this post. Before I get into the weeds, let me just define perimenopause. What most women don’t know is that perimenopause is defined by variability in estrogen levels in the midst of eventual decline that can start happening in your 30s. Not everyone starts that early, but it’s important to be aware that perimenopause is trending younger. This period of variability prior to menopause can last from a year to several years depending on the person. The actual definition of menopause (versus perimenopause ) is a full 12 months after your very last period. After that, you are in post menopause. In other wordds, menopause itself lasts one day. 

So what can we expect in perimenopause, and how can our networks of women work together to help each other? I have some ideas, so here goes…

1. Sometimes emotional mood swings are the first symptoms. Most of us assume that hot flashes will be the flagship sign of menopause, but not all women get them, and it can be extra surprising to experience anxiety or depression before hot flashes ever appear. 
2. You don’t always get hot flashes, or they might be less prominent than other symptoms. I just alluded to this above, but it’s really true. Personally, I have not had hot flashes. Migraines and sleep disturbance were my most prominent symptoms. Other symptoms can include vaginal dryness, low libido, fatigue, and brain fog, among other changes to your hair, muscles, skin, and joints. Personally, I had no idea what was happening for quite a while since the symptoms didn’t seem typical and I could attribute them to other things.
3. If your world is feeling extra stressful, you are not alone. This time of life brings a lot of its own challenges, like taking care of kids and aging parents at the same time. Divorce rates also tend to go up, and some women feel like their work is impacted by perimenopause. Just knowing all of this can help you get the help you need and recognize what is going on.
4. Exercise has saved me, so here are some tips. Anything that you can do to relieve stress is wonderful. Do what you love and what feels good in your body rather than pushing yourself to the point of pain that might have been a habit in earlier years. Your joints are a bit more vulnerable, and your body should not be overly stressed.  Along those lines, try not to overdo the cardio if you are experiencing weight gain since too much cardio can work against you. And make sure that you focus on strenghtening your muscles. This will help you on a number of levels heading into your later years.  
5. I have already mentioned stress several times.  Whatever you can do to relieve stress is great since this will ease many of your symptoms.  I particularly love going on walks and breathwork - and therapy has been essential!  
6. I want to be clear that I am not an expert on hormone replacement therapy or hormonal support. But I definitely encourage you to look into all of the many options – which can range from patches and creams to pills and pellets. Your practitioner will determine what’s best for you, and often it comes down to your specific medical needs and what fits best for your lifestyle.

How can we tackle this together?

I truly believe that connection is the answer! I have had the hardest time getting my Kaiser doctors to take me seriously, so I have highly valued the suggestions of my practitioner peers. Some of them have suggested incredible functional doctors and websites that have been great resources for me as well. I thrive on their suggestions, and I also realize that my own experience will be unique – I need to remember that. I have also recognized that my anxiety is much greater than normal, so talking to other women helps me normalize this and avoid making rash decisions while grounding myself in my hormonal experience.  My female friends have helped me advocate for myself and also find great solutions that have eased my symptoms. They have also joined me in creating resources like retreats, panels, and webinars that have provided great forums for conversation and healing.

Above all, I hope women join me in advocating for our fellow women. We should not tolerate the ignorance and resistance we experience in medicine, and we should start recognizing the power that comes with this change. I already recognize the valuable change in perspective that comes with perimenopause, and I feel more emboldened than ever to change the world.  We deserve to feel better, and we also need to embrace this empowering and truly enriching time of life!