If you’re in your mid-30s, menopause is probably the last thing on your mind — just a distant, «I’m 40» thing, like buying reading glasses or watching HGTV. But if you notice your period starting to stray from the schedule, or you’re having trouble sleeping, breaking out like a teenager, or feeling cranky, you may be entering «perimenopause.» that is to say the prelude to the big M.
Also known as the “menopausal transition,” perimenopause encompasses the years of hormonal fluctuations leading up to the day you went 12 months without a period. (Incidentally, that one day is called menopause—yes, just that day.) It usually begins in women between the ages of 40 and 44, but it can start in your 30s and last an average of four Eight years.
In most cases, starting the transition in your mid-thirties isn’t scary, says Suzanne Gilberg-Lenz, MD, author of Menopause Bootcamp. “Just know that another phase of development is coming, and it’s a natural process. Having said that, [symptoms] that are very disruptive or uncomfortable are worth addressing. Your primary doctor or gynecologist might be able to help with those growing pains, and you also want to rule out any unrelated medical conditions that might be causing problems, she explains. But first, the facts:
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1. Perimenopause is essentially adult puberty
During the transition from menopause, your hormones, especially estrogen and progesterone produced by the ovaries, fluctuate rather unpredictable, eventually diminishing and disappearing completely. Think of it like the hormonal chaos that happened in high school, but instead of preparing for your reproductive years, your body is gradually shedding them, says Jen Gunter, MD, author of The manifesto of menopause. This “midlife puberty,” as Gilberg-Lenz likes to call it, can manifest itself in a whole host of bothersome and unpleasant symptoms that vary widely from person to person.
Here are a few you can experience:
- Irregular periods
- Heavier or lighter periods
- Hot flashes or feeling hot in general
- Insomnia
- brain fog
- Dry and/or spotty skin
- Anxiety and/or depression
- Vaginal dryness
- Worsening of PMS symptoms (bloating, breast tenderness, food cravings, mood swings, etc.)
Many of these symptoms are comparable during midlife. But if you’re younger, your doctor will likely screen to make sure nothing else is going on. For example, irregular periods and dry skin could be a sign of a thyroid disorder, says Gunter, and heavier bleeding could indicate you have a fibroid, says Gilberg-Lenz, adding that «it’s important to s associate with a competent doctor to help you. unzip it all.
2. You can’t really test it
There are several home blood tests sold online claiming to analyze your hormonal balance and tell you how close you are to menopause. They typically monitor estrogen, luteinizing hormone, and follicle-stimulating hormone levels, all important for ovulation. But just like you didn’t need a lab to know you were going through puberty, you don’t need it to tell you you’re in perimenopause, says Gunter. Perimenopause is usually diagnosed clinically, she adds, which means your doctor will consider your age, medical history, family history and symptoms.
Plus, a single blood test won’t explain the unpredictable rise and fall of hormones during your transition. «So when you’re doing it, you never know where you’re catching someone,» says Gunter. «You could literally catch someone in their very last menstrual cycle and they could have totally ‘normal’ hormone levels, or catch someone who ‘looks’ like they’re in menopause and then three months later. later, he ovulates.»
3. Genes and race can impact the timing, duration and severity of symptoms
Recent studies have watch that genetics and family history play a major role in determining the age at which you reach menopause. «If everyone in your family went through this early on, chances are you will too,» says Gilberg-Lenz. Women of color also tend to start perimenopause earlier and have more severe hot flashes than white women. according to the SWAN study, which followed a racially, ethnically and geographically diverse group of 3,302 premenopausal women. On top of that, black and Latina women experience perimenopause symptoms about two to four years longer than white women.
The reasons for these variations are complex, since factors such as socioeconomic status, quality of life, access to education and immigration status all play a role. And in general, stress and anxiety have been known make hot flashes worse. Fortunately, there are more and more networks of POC physicians dedicated to serving their communities.
4. Perimenopause disrupts your libido
So you haven’t felt it with your partner lately. Part of the reason may be that testosterone decreases during the menopausal transition, but «boiling libido up to testosterone is ridiculous,» says Gilberg-Lenz, who points out that libido has many facets: it’s affected by your energy and stress levels and the feeling of connection (or lack of connection) you have with your partner.
Perimenopause can also make sex less enjoyable or even uncomfortable. Estrogen helps keep the vagina lubricated, so when it drops, intercourse can be painful, according to the American College of Obstetricians and Gynecologists. As if that weren’t enough, changes in the blood flow and nerves of the vagina can hamper her response time to pleasure, says Gilberg-Lenz. Fortunately, there are easy solutions. Lubricant can help add moisture and vibrators have proven themselves effective in improving blood flow to the vagina. In case of extreme dryness, you can ask your doctor for vaginal estrogen in the form of a suppository or cream.
Talking to a shrink can also do wonders, says Gunter. Cognitive-behavioral therapy and mindfulness-based therapy can help you stay present during sex and deal with any triggering thoughts or emotions that arise and kill your mood. Research shows that both methods are «better than any libido-specific medication,» she says.
5. It goes hand in hand with lower fertility
We now know that women can conceive in their late 40s, and sometimes beyond. “I had patients at 46, 47, and I had perfectly healthy pregnancies,” says Gilberg-Lenz. That’s why, if you don’t try to have children, you continue to use birth control until your period has stopped.
But we also know a parallel truth: that your chances of carrying a baby to term gradually decrease after the age of 35. In fact, not only does the number of eggs you have decrease, but your ovaries become less sensitive to the hormones that make you ovulate, according to the Women’s Health Research Institute. The bottom line: «If you’re 35, don’t wait until you’re 43 to have a conversation with a fertility specialist,» says Gunter. «It’s good to be armed with information.»
6. Regular exercise helps offset health risks
These risks include bone disease, heart disease and dementia. Yeah.
If there’s one piece of advice Gunter could give anyone in their 30s, it’s to start strength training now, while you’re still producing estrogen, a hormone essential for maintaining health. bones. When levels drop, your risk of developing osteoporosis – a condition in which bones become brittle – increases, according to Endocrine Society experts. Your risk of diseases such as dementia and heart disease increases during perimenopause due to various changes that occur in your circulation and brain.
The good news: «If you look at all the conditions that increase with menopause, almost every one improves with exercise,» says Gunter. Weight-lifting or weight-bearing exercise (such as walking or doing push-ups) can strengthen your bones well into old age, so try to train at least twice a week. In addition, the Department of Health and Social Services suggests moderate cardio (such as walking) for at least 150 minutes per week or vigorous cardio (i.e. a kickboxing class) for at least 75 minutes per week.
7. You don’t have to suffer in silence
Although perimenopause is not a disease to be treated, there are many things your doctor can suggest to make driving a little smoother. For example, studies showed that birth control and antidepressants can help reduce heavy bleeding and hot flashes. Stress reduction (via yoga, meditation, or working with a therapist) can also relieve symptoms, according to Mayo Clinic experts.
Whatever your symptoms, keep your doctor informed and don’t minimize them. The more aware you both are of the changes taking place in your bodies, from the most annoying to the most debilitating, the better equipped you will be to navigate through this hormonal storm to calmer shores (we promise!).