Perimenopause gives me pause

Did you know that in the US, the average age of menopause is 51 years old?

Did you know that perimenopause duration and symptoms vary, depending on your demographic? For example, Black women in the US can have perimenopausal symptoms for 10 years. (Melting face emoji!)

But at 39 years of age or 41 years, many of us are not thinking about perimenopause if we struggle with fatigue, brain fog, or chronic insomnia. Even worse, our health care providers are also likely not thinking about perimenopause when we present with various symptoms such as worsening PMS or even PMDD (Premenstrual Dysphoric Disorder), a two day headache that doesn't resolve until our period starts, joint pain and achiness (to the point that I took Aleve like a daily vitamin), or difficulty opening jars due to decreased grip strength. For me, it wasn't until hot flashes started that I finally cried "uncle" and started searching for a gynecologist who was willing to prescribe HRT.

The practice that had provided me with OB care suggested I take OTC Estroven since I was still menstruating. I was confused because younger friends were discussing their use of HRT and its benefit to them. But I went along, until I learned that the FDA doesn't regulate supplements and, more importantly, the data from the Women's Health Initiative had been misinterpreted. I would much rather have the proven bone, brain, and cardiovascular benefits of estrogen in patch form (paired with progesterone to protect the uterus from endometrial hyperplasia, a precursor to cancer).

I was so very thankful to have meaningful relief.

Hot flashes even disrupt sleep, which is just wrong. It is also important to understand that hot flashes are the canary in the coal mine. Frequent and/or severe hot flashes represent cardiovascular disease. According to the Study of Women's Health Across the Nation (SWAN), hot flashes are associated with higher LDL cholesterol, higher blood pressure, and higher blood sugar levels. So it is a reminder that our cardiovascular system is in transition and needs careful attention (for me, that is consistent exercise, increased lean protein, increased fiber, increased water intake and 7-9 hours of sleep.)

In the case of symptoms that initially improve and then recur, it is worth getting back in touch with the prescribing provider. The estrogen patch manufacturer may have up to five different doses. If the lowest dose is not be adequate, the prescriber may follow a stepwise progression to a higher dose.

Valerie