By Nathalie Daudet
Perimenopause is just another stop along a woman’s reproductive journey, and it presents a transition time, just like puberty or childbirth. Perimenopause is the period of time before menopause when your cycles stop entirely. If you've charted your fertility up until your cycles begin to change, many of the skills you already use will come in handy.
When does it start?
Perimenopause typically begins in a woman’s late ’40s, but can start as early as 35 and is characterized by a series of cycle changes and symptoms. Tracking your cycle can be incredibly valuable as you will be able to monitor things like cycle length, ovulation, and luteal phase length.
Rather than feeling overwhelmed by this life transition, you’ll be in the driver's seat.
Cycle changes in perimenopause include more frequent anovulatory cycles, cycle irregularity, and a shorter luteal phase.
You can also begin to track the presence of other symptoms that may indicate that the process of perimenopause has begun. These are symptoms that you can start to track in your cycle chart, and they include:
- Hot flashes
- Night Sweats
- Difficulty Sleeping
- Changes in libido
- Change in menstrual flow
- Weight gain
- Swollen breasts
What’s up with our hormones during perimenopause?
The ovaries, sensing a decline in ovarian reserve, begin maturing and attempting to release more eggs during each ovulation event (twins can be more common during this phase of life). One article calls this the ovaries’ “frustrating grand finale” (Dr. Jerilynn Prior, 2019). This extra activity causes higher levels of estrogen, unopposed by the calming effects of progesterone. We know that estrogen unopposed by progesterone can cause some unpleasant side effects, including increased menstrual flow, fibroids, tender breasts, and PMS.
Progesterone is our anti-stress and calming hormone. When progesterone levels are low, and estrogen is high, this can increase anxiety and feelings of stress. During perimenopause, we may not feel like we can cope with stress like we used to. Naturopath and women’s health expert Lara Briden suggests several strategies to help our systems adapt to stress during perimenopause. This includes:
- Supplementing with magnesium, taurine, and ashwagandha (an adaptogen that helps our body respond to stress).
- Avoiding or reducing cow’s milk and alcohol.
- Lifestyle changes, such as increasing self-care and introducing strategies that help you reduce stress.
Hormone replacement therapy
There has been a long-standing debate about hormone replacement therapy (HRT) and its value for perimenopausal women. Studies have shown the reduction of symptoms as well as significant risks of hormone replacement therapy, so it is important to educate yourself around your decision as well as the type of HRT you decide to take, this way you can make an informed decision.
The Centre for Menstrual Cycle and Ovulation Research (CEMCOR) takes the stance that bioidentical progesterone can be beneficial in reducing symptoms and balancing unopposed estrogen. One trial done by CEMCOR demonstrated bio-identical progesterone contributed to a reduction in hot flashes, and another showed a decrease in sleep-related issues. One thing is sure though, not all HRT is created equal, and side effects vary depending on which you decide to take. As with other hormone balance issues, addressing the root cause of the problem will be the most sustainable long-term at creating any change in symptoms.
A note on the societal pressures of age
We will spend about one-third of our life post-menopausal. Let’s challenge the long-held notion that post-menopausal women can’t offer anything of value to the world.
In our culture, a woman’s worth is determined by their ability to procreate. When we no longer have this ability, or we feel like our fertility is dwindling, that can be directly attached to our worth.
The journey of perimenopause, menopause, and post-menopause is to come into our own and to measure our worth internally rather than relying on external validation. For example, we may want to start thinking about what fills our cup, rather than doing things for the benefit of others. Older women have wisdom, experience, and steadiness in their sense of self that is incredibly valuable to our families and communities.
For further information regarding HRT or any other supplements mentioned in this article, please consult with your doctor or another healthcare provider.
Nathalie Daudet is a social worker and FEMM instructor based in Winnipeg, Canada. She discovered fertility awareness after searching high and low for a non-hormonal method of birth control. After learning the magic of fertility awareness and the gift of body literacy, she decided to pursue formal fertility awareness training and share the knowledge of fertility awareness with women looking for a natural birth control option. Fertility Awareness Project is the hub for Nathalie’s FEMM classes in both group and individual formats, online and in person in Winnipeg. If you love this post and would like to thank Nathalie, shop Tempdrop with Nathalie's unique referral link.