Is This Perimenopause?

Hi Kat,  The definition you heard is true.  One year without bleeding is the technical cut-off for being labeled "menopausal".  Lots of women are like you, though, will go for months or even a year or more and then bleed again.  Your body is winding down, but not ready to quit.  The symptoms you mentioned can all be related to the hormone changes that your body is going through.  Definitely, you want to talk with your doctor about all of this.  Hopefully, she/he is well-versed in the current information about menopause and hormones and will be very helpful in guiding you.  If this is not the case, find someone who is.  Not all health professionals are interested in or well-educated about menopause.  You will need someone who is to partner with you and give you the information and guidance needed so you can make good decisions for yourself in this very important phase of life.

Good luck!  Sandy

Hi Margot...yes, some of the issues do go away with time.  Like your grandmother experienced, it can go on for many years.  The change is hormones can start as early as 35...the average age for the last period is 51...and symptoms tend to begin to fade away by the early 60s.  These are all averages, of course, but they'll give you a general idea.  The period of time that tends to be the worst for symptoms is the 3-4 years before the last period and 3-4 after.

Take good care of you!

Sandy

Wonderful, thanks so very much!!!  Keep up the good work1

Thanks,

Margot

I've been going through perimenopause since I was 35 and now I'm 45

Hi Cindy,

One of the frustrating things about menopause is the process can be soooo long.  The average age of the last period is 51-52 years old.  What we know from the most recent research is that women who start on hormone therapy either before their last period or within a few years after have the most long term benefits, including lower risk of heart disease, less osteoporosis, better overall morbidity and mortality because we're healthier when we have our hormones and not a significant increase in breast cancer.

Hang in there; one thing I can guarantee is that perimenopause will eventually end and your last period will arrive...just no guessing when.    Sandy

If you haven't yet read my posting about Bioidentical Hormone Therapy, that's a good place to start for information on the type of treatment you need for the symptoms you describe.  Dry skin and hot flashes are a result of low estrogen.  Low progesterone causes poor sleep and mood issues.  Testosterone is responsible for your libido...it creates our sex drive.  Depending on the symptoms you're experiencing, you may need all 3 hormones replaced and the best products for doing so are those that are identical to what your body was producing.  You may need to search awhile for the right clinic, but don't give up.  The results will be worth the trouble.  Find a provider who specializes in menopause who uses bioidentical hormones.  If you're anywhere near St. Paul, MN, I'd be happy to see you.  If you're not, ask friends, Google menopause providers in your area, call women's health organizations in your area, search the yellow pages.  Best of luck to you, Sandy

Being 27-28 years old would be very early to be having perimenopausal symptoms, although I do have 3 patients who finished having periods by age 33 as had their mothers.  So it is possible, but this is very unusual.  I would strongly encourage you to see a gynecologist for a thorough work-up to see why you are having this sporadic pattern of periods for one so young.  It may be perfectly normal for you, but it would be wise to have that verified.  If the doctor who only wants to check for pregnancy is a gynecologist, find another gynecologist or an endocrinologist.  Your concerns need to be addressed seriously.

Good luck, Sandy

If you are not yet menopausal, you may find that progesterone cream which you can buy over the counter can be quite helpful in stabilizing moods.  I recommend you use 1/4 tsp daily 21 days each month, taking 7 days off for period.  Brands that are readily available and are good include:  Natural Woman, Wise Woman, ProGest, Femmenessence, and FemHRT.  There are many; just be sure that whatever brand you try has at least 450mg Progesterone USP.  If this doesn't help, you probably need to get a prescription for a more concentrated dose of progesterone from your healthcare provider.  Good luck, Sandy

Hi Laura,  I agree...cravings are such a drag when you're trying hard to eat well and be healthy.  One important contributor to cravings is low progesterone.  This is why so many women with PMS or who are in the throes of perimenopause/menopause have to battle food issues.  When you are cycling regularly, your progesterone drops prior to your period, actually triggering the bleed, and cravings may come before the period and last until your levels rise again.  In perimenopause and beyond, the cravings are less predictable because your hormones are rising and falling at irregular intervals.  Depending on where you are hormonally, you might find over-the-counter progesterone cream helpful to tame this beast.  Also, the way you pattern your eating, as well as what you eat, can contribute to relief.  It is very helpful to eat 5-6 small meals a day, eating every 2-3 hrs.  No, this won't make you gain weight.  It is actually helpful in losing as it increases your metabolism.  You just have to keep your intake at a reasonable amount.  At each "meal", have some protein, carbohydrate and fat...you will find that before long the cravings will diminish, if not disappear.  Do your best to avoid the high glycemic carbohydrates that turn into fat very quickly in your body: breads, white potatoes, white rice, desserts, popcorn, crackers.  Take a look at nutrition books by Anne Louise Gittelman.  She's an excellent resource for healthy eating, including stopping cravings and losing weight.  Good luck to you!  Sandy

Thank you for so much insight.

Laura

I could weep!  At last someone with the same symptoms as me!.  I start intense cravings 2 weeks after my period and they don't stop till I start the next one.  I will eat anything, and eat so much that I can't sleep at night!  Then I have to try and slim like mad during the two 'good' weeks to try to maintain my weight, but at the moment i'm losing the battle.  Very depressed about it and feel there's nothing I can do.

Hi Barbara,

Yes, what you describe is very typical of perimenopause.  Your symptoms are caused primarily by the lowering level of progesterone in your body, including the irregularity of your period.  If you haven't read my posting on Perimenopause yet, you might find that helpful for knowing what to expect.  Often the symptoms of perimenopause closely resemble those of PMS...irritability, bloating, cravings, tender breasts, sleep disturbance, and changes in your cycle as well as the bleeding itself.

The posting on Bioidentical Hormones might also be helpful as you begin to consider ways to manage symptoms.

Good luck to you,

Sandy

Dear Sandy,

I can't believe you responded to my post.  Thank you for doing so as your response made me feel much better.  I have an appointment tomorrow to get a pelvic exam just to make sure everything is a okay.  I can't tell you how much I appreciate you responding.  I have no one to talk to about this and your response really helped.

Take care,

Barb

You're so welcome, Barb.  Feel free to send questions anytime!  Happy New Year to you, Sandy

Yes, you could definitely go through menopause sooner and/or more rapidly than someone with 2 ovaries.  Since your ovaries produce the majority of your hormones, your supply will be depleted faster.  It you're fortunate, it may mean that the process may not continue on as long as it does for some.

Good luck, Sandy

Dear Anonymous,

Your symptoms sound like they are definitely hormonally-related.  You are young to start these fluctuations, but it does happen early to a percentage of women.  Much of what you describe is brought on by drops in progesterone which happen especially before your period.  This is what causes the PMS type symptoms.  Your estrogen also fluctuates through the month and when it's low you'll have more hot flashes.  One difference in PMS and perimenopause is that PMS is pretty predictable.  It comes the week before your period and goes away when you start to bleed or in a day or 2 after.  With perimenopause, you lose the predictability and your symptoms will follow the rise and fall of hormones throughout the month.  One thing you might find helpful is to try over-the-counter progesterone cream (go to a co-op or good health food market) and use it as directed.  If it is not enough to balance out your hormones, you will need to see a provider who understands hormones and can prescribe progesterone at a higher concentration for you.  Your lab work can show your hormones in the normal range for years before you have your last period, so don't be put off by being told you're too young.  Keep pressing until you get the help you need!

Sandy

It certainly sounds like you're experiencing significant perimenopause symptoms...along with the added stress of remarriage, 2 more kids, etc. which magnifies how much things effect you.

With all the symptoms you're having which are probably related to declining hormone levels, I would definitely recommend you go off the Depo and have your hormones tested.  Depo is good for birth control, but it's not going to help manage many of the typical symptoms of perimenopause/menopause, which you're finding out.  You'd be much better off on bioidentical hormones even if it means you have to use condoms or get an IUD or whatever for birth control (depending on your bloodwork).  Please see my post on bioidentical hormones if you haven't already and see how many of your symptoms are the result of your ovaries no longer producing levels, especially since they are being surpressed by the shot.

Good luck.  Thanks for writing,

Sandy