Perimenopause is the period—and associated bodily changes—leading up menopause (prefix “peri” = around). It can start as early as a woman’s late 30s or as late as her 50s. This process varies in duration, lasting anywhere between 2 to 10 years. A common sign of perimenopause is irregular periods due to the hormonal fluctuation occurring. As your ovaries stop producing estrogen and progesterone, levels gradually decrease over this time, in theory; in reality, it’s more like rollercoaster of ups and downs… The good news is that you don’t need treatment for perimenopause…unless, of course, your symptoms bother you. With that said, perimenopause is not something you needed to get tested for, a qualified healthcare provider can make the diagnosis based on your symptom picture.

What causes perimenopause?

The short answer is that “nature” causes it. It’s a natural—and very normal—process at which time your reproductive system gets ready to enter menopause. During this stage, a woman ovulates less often, and as a result, hormone levels fluctuate leading up to unusual, and sometimes unwanted, symptoms until the cycle comes to a full stop. However, some medical interventions can sometimes lead to cessation of your cycle well before you’re due. These can include radiation therapy, chemotherapy, surgical removal of the ovaries.

What are the symptoms?

The most obvious symptoms are usually irregular periods with variable bleeding (e.g. heavy in some woman, light in others) and variable duration (e.g. shorter or longer, or may skip over one to several months). Some women experience one or more of the following:

• severe hot flashes,
• night sweats,
• headaches,
• insomnia,
• palpitations (i.e. you can feel your heart beating really fast and/or unevenly),
• emotional changes (e.g. depression, worry, irritability),
• vaginal dryness, etc.

Are there any changes I should be worried about?

If you notice heavy bleeding, ask your healthcare provider to request blood work to make sure nothing else is going on (e.g. infection, tumor, etc.). Breast changes are common during perimenopause, but they can be rather unpredictable, so if you notice a lump in your breast and/or fluid discharge from the nipple seek medical attention right away.

Will my sex life change?

The good news is that disruption is minimal for most women. However, some women can experience decrease sexual desire. Vaginal dryness is a common complaint during perimenopause, but this is, once again, a normal process due to hormonal changes. There are creams a medical doctor may prescribe, alternatively, a licensed naturopathic doctor may provide you with additional options. When in doubt, just ask.

What can I do?

Estrogen has a protective effect on your health. As you enter perimenopause and finally menopause, estrogen levels will drop giving rise to risks for heart disease, cancer, and/or osteoporosis, so make sure you see your healthcare provider for an annual check-up. It goes without saying that regular exercise is important.

• Aerobic exercises (e.g. mild to moderate “cardio”) helps to keep your heart and brain healthy and strong by improving circulation.
• Anaerobic exercise (e.g. mild weight training) will help maintain your bones strong!

Stress management, limiting caffeine and maintaining proper sleep hygiene will also help you manage unwanted symptoms better.

What other therapies can help?

Always speak with a qualified healthcare professional before embarking on a new regimen—whether it’s “natural” or “over-the-counter”. By doing so you will ensure your safety and the efficacy of your treatment—and not spend money on unnecessary products. If you are seeking care from a licensed naturopathic doctor, you may inquire about products that help rebalance estrogen and progesterone and reducing symptoms of perimenopause (e.g. chaste berry, sage, red clover, black cohosh), and also address the health of your adrenal glands (e.g. rhodiola, licorice, ashwagandha), liver and digestive tract (e.g. milk thistle, boldo, artichoke). As your ovaries stop production of sex hormones, your adrenals take over, and they do so at a time when stress can be paramount. Your liver and digestive tract process food and medications and are thoroughly involved in the removal of toxic wastes. As your body prepares for the next stage of your life, remember to focus on reducing risk factors. This includes:

• Limiting alcohol, caffeine;
• Limiting sugar consumption;
• If you smoke, this may be a great time to consider cessation;
• Look into joining social groups, a dance or cooking class, if that’s not for you, then try challenging yourself with something you enjoy!

Be good to your body, embrace the new journey, and don’t hesitate to ask for assistance if you need it along the way, you’re not alone!

by Sonia Chartier, on 5 October 2015 , co-written by Rick Olazabal, BSc, BN Gleaned from the A.Vogel Blog