Part I: What Perimenopause is and Isn’t. and Why it Matters.
“I wasn’t expecting this.”
Gen X and Elder Millennial women have or are entering perimenopause, and so many of us didn’t even see it was coming.
We were minding our own collective business and then, BAM.
Enter the mood changes, the insomnia, the unpredictable menstrual cycles. Enter the brain fog, hot flashes and so many other symptoms we had never even heard of.
Can I get a collective: WTF? …
For many of our generations, the topic of perimenopause/menopause was never discussed, and if it was, it was hush-hush, referred to cryptically or as fodder for jokes. Talking about perimenopause openly in the context of women’s health is a new development. And long over due.
This is the first of a series of blog posts that will explore cultivating wellness during perimenopause and reclaiming a rite of passage that has been minimized and/or over-medicalized.
I hold the hope that Gen X and Y can reclaim this important transition and, in turn, feel more empowered and cared for than generations before.
Let’s get started.
Peri-What, now?
First things first: Perimenopause is a developmental stage in a women’s life. It is not a disease or a disorder. In fact, it is more akin to a second puberty. Believe it or not, your body is doing exactly what it should be.
Perimenopause, meaning “around” or “surrounding”, is the time leading up to menopause and it can last up to 10 years. So it’s important we learn how to care for ourselves and love ourselves and each other through it.
If you have a uterus and live long enough, you’ll experience perimenopause
Most women begin to experience signs of perimenopause in their 40s, but some women enter this transitional period as early as their mid 30s or as late as their 50s. Eventually we enter menopause, another developmental stage, when our menstrual cycles stops completely.
During perimenopause a lot is happening in our body. I mean A LOT. But you probably sense that intuitively.
One of the most common sentiments from women during early perimenopause is: I just feel off.
Of course you do. The perimenopausal transition is one of mind, body and spirit. We need and deserve to be held in that process.
Perimenopause & the Mind
During perimenopause our hormone levels fluctuate at unpredictable intervals. Estrogen and progesterone are linked to our body’s ability to produce serotonin and dopamine. These neurotransmitters, you may know, are responsible for feelings of ease, calm, motivation and pleasure.
For some women mood changes may be mild and for some, extreme. Emotions like anxiety, sadness, irritability and rage are common and may feel heightened.
Many women actually report liberation in feeling their feelings fully, and simply not having the ability or desire to filter their emotions. This may be one of the biggest gifts of perimenopause.
It’s important to note that if you have a history of anxiety, depression, PPMD or other mental health challenges, you may be more vulnerable to hormonal fluctuations. In turn, if you are taking medication for anxiety or depression your medication may feel less effective at times as you enter perimenopause. Again, this is because of hormonal flux.
If you notice a significant change in mood or efficacy of medication please reach out to your doctor. A modification may be needed.
Perimenopause & the Body
Physical and mental health are inherently linked. In later posts in this series we’ll talk about the importance of having an integrative team of providers and how to choose them, but for now I want to touch on some common physical symptoms that may come as a surprise to folks.
Estrogen and progesterone play important roles in multiple systems of the body, so when levels dip and spike, as they will in perimenopause, the rest of our body responds accordingly.
Some lesser known physical symptoms of perimenopause may include: Body aches and pains, heart palpitations, dry eyes/mouth, excessive bleeding during periods, vaginal dryness, changes in body composition and skin itchiness.
There are many treatment options available to ease difficult symptoms. If you are interested in learning more about these options now. I highly recommend Hormone Repair Manual: every woman’s guide to hormones after 40, by Lara Biden, ND.
Lastly, it’s important to note it’s common for women to report feeling gaslit and dismissed in their doctor’s office when raising concern about symptoms. There is a bigger cultural issue here of mistrust when it comes to women and their bodies (ahem, patriarchy), but there is also a lack of education around cultivating wellness during the perimenopause transition. I’ll talk more about this in the third part of this series.
Meanwhile, please trust yourselves! If something feels off, it’s usually because it is.
Perimenopause & the spirit
Let’s, at last, name and normalize the existential rub that women may experience as they enter this new stage of life.
The truth is fear, rage and grief may surface as we reckon and reconcile with one phase of life, and prepare to enter another.
You may feel:
Lost and without purpose
Shame and fear related to aging
Spiritual disconnect or questioning
Trouble accessing or trusting your intuition
Grief or ambivalence related to the end of menstruation
Questions around identity
Unexplained emptiness or despair
Asking the big questions and feeling the big feelings now, makes sense. This is a time of in-between, a time of intense change on all levels. Moving forward without a safe container to explore our experience can feel disorienting. But with the right support this journey can be empowering and deeply transformational. In my therapy practice I integrate a psychospiritual approach to support women who want to explore their own spirituality, which is particularly helpful during times of transition.
Closing Thoughts
Each woman will have their own unique journey through perimenopause.
I am so excited to share this first, of three blog posts, in my series about perimenopause and mental health. As well, I’m excited to announce my new speciality offering supporting women navigating perimenopause and midlife transition.
While this post focused on the the basics of perimenopause and what you may expect, next we’ll explore flipping the narrative and reclaiming perimenopause as a rite of passage. And in week 3, we’ll talk cultivating wellness and finding the specialized support you deserve.
Lastly, I’ll add that if you find your feelings to be overwhelming, you do not have to go through it alone. Having a guide and witness, like a therapist, can make all the difference in your journey. I offer specialized holistic therapy for women in California and I would love to support you.
Let’s move forward educated, confident and cared for.
