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MENOPAUSE: WHAT'S HAPPENING
Early Signs of Menopause
Pamela Edwards Christiani
Jan. 26, 2022
How to know if you're in perimenopause, menopause or neither? It's a basic question with complex answers.
Sixty-five percent of women report not feeling prepared for menopause—and everyone experiences the menopausal transition differently, and over different time frames. Part of the reason women feel unprepared is that, often, they may not know they're in perimenopause or menopause.
Technically, menopause is only one day. It marks that one day after 12 consecutive months without a period (not due to any other cause). After that day, you’re officially post-menopausal.
The prefix “peri” means “about” or “around” or “in front of,” so perimenopause is the lead-up to menopause, a transition period between one’s reproductive years and the post-menopausal years.
When does perimenopause start, and how long does it last?
According to the North American Menopause Society, perimenopause usually begins in one’s 40s, but it can also start in your 30s. Most women experience menopause between 40 and 58 and the average age, in the US, is 51.
On average, perimenopause can last from four to eight years. Your mother may have had practically zero symptoms, or severe episodes, but your experience could be the complete opposite. Again, there are multiple variables and each woman’s journey is quite personal, which is why being informed is key.
What common symptoms of perimenopause should you watch out for?
One of the most common symptoms of perimenopause is an irregular period—ovulation is now a little less predictable and the result is a period that’s either heavier, or lighter, briefer, or more frequent—due to fluctuating hormone levels, particularly estrogen and progesterone. As ovulation becomes more erratic, the ability to conceive does decrease, however pregnancy is still possible if you have a menstrual cycle. (So, if you’re not interested in getting pregnant, it’s wise to use birth control until you reach the post-menopausal stage.)
In addition to changes to your menstrual cycle, you could experience hot flashes, night sweats, insomnia, intense PMS, mood swings, vaginal dryness, brain fog, a decreased libido, weight gain, loss of bone density or even depression. This all sounds a bit intense, but know that most people don’t experience all of these symptoms and certainly not at the same time—though that scenario is a possibility.
One’s symptoms of perimenopause could also be quite subtle and possibly confused with the symptoms of PMS or a Thyroid disorder. If you think you’re perimenopausal, especially if the symptoms are interfering with your quality of life, like hot flashes or insomnia, it’s a good time for a thorough examination by a physician, preferably with one who understands how to properly assess this stage of life. Note that even with an accurate confirmation, your doctor may not be able to predict all that’s to come on this very personal journey.
What will perimenopause be like?
"There are so many factors that contribute to how an individual women experiences perimenopause: Lifestyle, sleep, stress, genetics, toxic load, and nutrition all play a role," says Phenology Chief Medical Advisor Dr. Kourtney Sims, a board-certified OBGYN and holistic nutrition expert. "This is why I advocate for a holistic and integrative approach to perimenopause, and why lifestyle, holistic and traditional therapies are all useful in different ways to different women."
Dr. K starts prepping her patients for perimenopause while they are in their 20s. "It's best to be as healthy as possible before menopause sets in, so you're in a better position to deal with whatever comes your way," she says. As part of a holistic therapy, Dr. K recommends her patients practice yoga or other forms of daily movement, take in optimal nutrition and get in the habit of healthy routines that take the whole person into account.
Related: How to Prepare for Menopause
"For example, hot flashes can be exponentially worse for women with unhealthy BMIs. Our hormonal health benefits greatly from a diet rich in fruits and vegetables, essential fatty acids, fiber, and fermented foods," she says. And nature-based ingredients like saffron can help, too. "There is surprisingly consistent evidence on the benefits of saffron on mood, stress, and sleep, areas that are so important for this life stage," she adds. Consider incorporating some of the most powerful, nature-based elements into your regimen to get key nutrients you need and bioactive ingredients that address common perimenopausal concerns, like the Morning+Evening Daily Gummy Duo.
How do you know when you're in perimenopause?
“When it comes to hormone testing, there is no blood test that will tell you exactly where you are in the transition, but elevated levels of follicle stimulating hormone (FSH) and decreased levels of estrogen are two major indicators," says Chloe Giraldi, VP of Nutrition Science at Phenology. “Decreased progesterone levels in the latter part of the menstrual cycle are indicative of a missed ovulation (which tends to occur more frequently during perimenopause), and lower progesterone levels are associated with some of the emotional health symptoms of menopause.”
So while there's no single clear-cut test to determine whether you're in perimenopause, looking your health, reproductive aging, hormones, symptoms and lifestyle can provide a holistic picture of where you may be in your menopause journey.
One quick and easy way to figure out where you are in your individual journey—and the best ways to manage potential symptoms—is with the Phenology Assessment. This industry-leading assessment takes two minutes and can help you see how far along you are in your menopause journey and help you better manage your transition through actionable personal insights. It's based on the STRAW+10, the gold standard of studies that assesses reproductive aging in research and clinical contexts.
Other helpful resources for this transitional period include NAMS (The North American Menopause Society), and The Cognitive Behavioral Workbook for Menopause, by Phenology Scientific Advisor, Sheryl Greene, Ph.D. Familiarize yourself with the terrain, see your doctor if you feel it’s necessary—and know that this is another of part of life that you can handle.
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