Are you moodier or more forgetful than usual? Having too much hair fall or extremely dry elbows? Suddenly having bouts with insomnia or anxiety for the first time in your life? Telling yourself, “It can’t be menopause because I’m too young, still years away from turning fifty and my period is still regular.” So, what’s happening? Are you sick? Should you worry?
If you don’t have any medical conditions that are causing these symptoms, you might be experiencing that natural transition phase in a woman’s life before menopause — and that, I learned while I was in my mid-forties and confused about my symptoms, is called perimenopause.
IN MY FORTIES AND PERIMENOPAUSAL? WHAT DOES IT EVEN MEAN?
“Perimenopause: When you experience menopausal symptoms due to hormone changes but still have your periods, which are changing in nature or frequency”
Preparing for the Perimenopause and Menopause, by Dr Louise Newson, Penguin Life, 2021
I imagine that many Gen X women like me didn’t know the term perimenopause until we were in our 30s or 40s. Some may have only heard about it fairly recently. Sure, we all knew about menopause while we were growing up, how it means a woman is no longer having her period and that it usually happens when you’re 50 years old or thereabouts. So when you’re a woman in your 30s or early 40s, it seems too early to even think about menopause, right?
3 Surprising Truths I Learned about Perimenoause:
- It can be happening now, whether you’re in your late 40, early 40s, or even in your 30s.
- It affects you mentally and emotionally as much as it does physically.
- Its symptoms can be managed naturally (with exceptions), but also individually and not perfectly.
Perimenopause usually starts in your mid to late forties, but it can start earlier.
About 4 years ago, when I was 46, I had a strange episode in a crowded restaurant when, for the first time in my life, I suddenly felt panicked and anxious while sitting alone at a table as my husband went to order our dinner. The chaotic noises and random movements around me felt overwhelming and I only started to calm down and feel normal when my husband got back to our table with our food and I had someone to focus on and something to do. I was freaked out by this; I thought that something might be wrong with me. Was I developing an anxiety disorder? I told two close female friends and immediately, they both said, “Oh, that’s perimenopause. Don’t worry; it’s normal. You’re 46? Yeah, that’s normal.”
I was dumbstruck. It was the first time I heard the word. My friends were older than me and they said they are going through it, though not necessarily with the same symptoms. Until that conversation, I thought that I was too young to even start thinking about menopause. Besides, my periods were still very much regular. Isn’t menopause something that happens when you’re 50, and so perimenopause as a precursor should still be a few years and many skipped periods away? (BTW, it was only when I started reading up on perimenopause that I learned that menopause is when you have not had a period for 12 consecutive months.)
Mayoclinic.org
I started learning about perimenopause, and I was quite shocked to read that it’s normal for women to start experiencing symptoms in their mid to early 40s, some even in their 30s. I read up about it and talked to a few more friends. I started to notice the vertical ridges on my now-brittle fingernails, the increased amount of hair on the shower drain after every shower, and the recently recurring dry skin on my elbows. Yep, all typical symptoms of perimenopause. I started paying more attention to my menstrual cycle, making notes every month. Still regular, but maybe with a little bit more back pain than what I was used to.
Perimenopause is more than hot flashes and dry skin; it’s also anxiety, migraines, low mood and low body image.
Maybe three years ago, when I was 47, I started having occasional migraines after being exposed to sudden bright lights. I distinctly remember one day when, after walking under the bright afternoon sun while on my way to an MRT station, I got into the train and suddenly there were shimmering lights in my vision. I kept my eyes closed for a while and eventually the spots of light disappeared and my vision thankfully went back to normal. On other occasions, after I was exposed to bright sunlight while outside, I ended up with zigzag lines in my vision and a headache. These migraine episodes lasted for about an hour each time. When they happened, I closed my eyes, laid down in a quiet room, sometimes with a dose of paracetamol, and waited for the symptoms to go away.
In recent years, I also started having what I would call my version of hot flashes – sudden sweating around my torso, with beads of sweat suddenly appearing and dripping down. These episodes would happen daily for a few consecutive days or up to two weeks, then disappear for months, then come back again.
“During your perimenopause and menopause, hormone levels fluctuate greatly, leaving you with a hormone deficiency. I tend to liken it to a car running on empty. And it is this hormone deficiency that can trigger a range of symptoms, from the hot flushes that everyone associates with the menopause, through to joint pains, mood changes and even memory lapses.”
– Preparing for the Perimenopause and Menopause, by Dr. Louise Newson, Penguin Life, 2021
My most recent symptoms, which I think go hand in hand in making things feel worse for me, are weight gain, belly fat, and low body image. In the last two years or so, I’ve noticed how my years-old jeans didn’t fit me anymore, how I seemed to look so much better in my thirties when I was thinner (jeez, I was a lot thinner even soon after I gave birth to my children!), how I really started to not like seeing myself in photos, how my body didn’t seem to respond anymore to the same yoga and weight training that shaped my body and boosted my self-image a few years ago.On most days, I harbored thoughts about being unfit and unpretty; I was on that slippery slope to thinking I was ugly and unworthy.
In retrospect, I think that the hormonal changes during perimenopause may have had a hand in my loss of confidence in my work and worth as a writer, replaced by a constant desire to pull away from the world and debilitating self-doubt that led me to stop writing — one of the things I’ve always loved to do. I made several attempts to get back to it, only to shoot myself down again and again.
While discussion of perimenopause tends to focus on the physical sings, the mental and emotional symptoms can creep in silently. In fact, in the early stage of perimenopause, when periods are normal and you might not know anything is even happening, the psychological symptoms can be at their most pronounced.”
The Perimenopause Solution, by Dr Shahzadi Harper and Emma Bardwell, Vermillion, 2021
Perimenopause is a normal transition phase that can be managed with knowledge, compassion, and support.
I was so relieved to learn that I wasn’t sick or becoming paranoid. Perimenopause is like a woman’s grown-up version of puberty – a natural transition phase that, while there are tens of symptoms that are common to all, is also a unique experience for each one of us and is something that we can learn to accept, understand, and manage.
With information I’ve gathered from books, websites, and conversations with a few trusted friends (I recommend looking for several credible sources so you can compare the quality of information and you can find what works for you), I have come up with my own Peri Plan so far:
- Keeping some moisturizer on my bedside table to remind me to moisturize my hands, elbows, and lips every night
- Drinking lots of water throughout the day to stay hydrated
- Taking some supplements to help ease some of my perimenopause symptoms (calcium, zinc and Vit D supplement to help prevent osteoporosis; magnesium to help prevent anxiety and migraines, and to aid in relaxation and sleep; Omega 3 as an anti-inflammatory to help with joint pains, B-complex for better overall energy and mental health)
- Adding more vegetables (leafy greens), fruits, nuts (almonds, walnuts), sources of fiber into my diet; cutting back on sugar, chocolates, caffeine after lunch; learning about intuitive eating and gentle nutrition so I can take care of both my physical and mental health in midlife and get away from diet culture
- Trying to get at least seven to eight hours of sleep every night (putting that book down before 1am!)
- Bringing AirpodsPro (with noise cancelling feature) and Loop earplugs with me whenever I go out so I can tune out noise when I need to (before perimenopause, I did not have a habit of using earphones); avoiding using the vacuum cleaner as much as possible, confessing to my family that I’ve become more sensitive to sounds and noise so they understand why I sometimes ask for a lower volume on things
- Continuing my yoga-at-home practice (something I’ve enjoyed in the last 10 years), and enjoying outdoor running by going for a run in the park once or twice a week (more like jogging, but as Coach Bennett of the Nike Running Club says, running takes all sorts of forms)
- Talking with a few trusted friends about our perimenopause experiences and sharing knowledge and resources
“Although perimenopause is a natural process, you do not have to put up with everything it throws at you. By understanding the changes and being aware of your symptoms, you can make positive lifestyle adjustments and optimise your experience of this time of your life. Our message is: take control of your perimenopause, don’t let it take control of you.”
The Perimenopause Solution, by Dr. Shahzadi Harper and Emma Bardwell, Vermillion, 2021
MY ONGOING PERIMENOPAUSE JOURNEY at 50
I turned 50 this year. The golden year, the year I had thought would also be the menopause year. So far, it’s turning out to still be part of my perimenopause years. My period is still very regular, occasional hot flashes and sleeplessness still there, days of low mood, low confidence and low body image definitely still in the calendar every now and then.
I’m still reading up, learning, talking to close friends and sharing knowledge, trying to improve my nutrition and fitness habits and strengthen my mindset and my self-compassion.
Are you going through perimenopause now? Have you noticed your symptoms? Are you worried about how it will change your life, are you confident in being able to manage it well, or are you able to hold space for both your worries and your ability to take control? Perhaps we can learn from one another and walk this journey together. Let me know in the comments if you have questions, reactions, or your own stories that you’d like to share. I hope to write about this more as I learn new and helpful things.
Featured Image Photo by Eunice Lituañas on Unsplash
Last Updated on October 20, 2023 by lea