Creating Your Perimenopause Plan

Diving Deeper: The Most Common Symptoms of Perimenopause

2018-09-06 11.26.36

Perimenopause is natural and inevitable--but it can also be unpredictable and uncomfortable. Knowing what to expect can be helpful, so let's dive a little deeper into the most common symptoms:

Mood swings Mood swings are one of the earliest signs of perimenopause, and can begin even before your cycle shortens. Many women have mood swings associated with perimenopause--from feelings of irritability to rage, anxiety to depression. If all of a sudden you find yourself crying on the floor for seemingly no reason (who's with me?), it's probably your fluctuating hormones.

Irregular periods As ovulation becomes irregular, your cycle changes, and your flow may go from light to super heavy and everything in between, as I mentioned earlier.

Cognitive Problems The majority of perimenopausal women will experience short-term memory loss and have a hard time concentrating. They say the effect is temporary, though, and that cognitive function improves back to previous levels once you've officially hit menopause. I'll have to get back to you on whether or not this is true for me!

Insomnia Caused by erratic hormones, hot flashes, heart palpitations and stress. More on this topic in the Sleep section...

  • Hot flashes Or, if you have them at night, they’re called ‘night sweats.’ For something that is such a common symptom of perimenopause and menopause, little is actually known about hot flashes. (I blame the male researchers back in the day, and am confident this will be changing.) About 75 to 80% of women experience hot flashes, which can last from a few seconds to several minutes and be as mild as a flushed face or so intense they can soak your clothes with sweat. They’re caused by blood vessels in your skin opening more widely, allowing more blood into the area. One recent study showed that the parasympathetic nervous system is not working as well as it usually does during flashes. Research also unfortunately shows that the earlier your hot flashes start, the longer they will tend to last: Women who have hot flashes in perimenopause tend to have them up to 12-14 years. (Ugh.) Women who don’t have them until after they go through menopause tend to only have them 2-4 years. Another study showed that women who are more ‘sensitive’ or have a lower tolerance to changes in body temperature (are you the woman who’s always cold?) experience more hot flashes. I’ve also been told by two different sources that the thinner and healthier you are, the better the chance you will have to deal with hot flashes. (Estrogen accumulates in your fat cells, and if you don’t have as much fat, you won’t have as much estrogen.) Hot flashes can be triggered by things like spicy food and red wine (you'll probably be safe if you stick to just one glass). I definitely started experiencing hot flashes later in perimenopause, though I credit a healthy diet for going as long as I did before succumbing to them, and for the fact that they were arguably not as bad as I’ve heard some women complain about! (Don’t get me wrong, they were bad enough.) Just FYI, a hand-held fan can come in really handy.
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Vaginal Atrophy/dryness/infections Yep, this is a fun one. Because of changing hormones, specifically a drop in estrogen, you’re more inclined toward things like yeast infections and UTIs, and uncomfortable dryness that can feel like an infection even though it’s not. You might also experience urinary incontinence, a thinning of the vaginal walls, and loss of lubrication and elasticity, which can make sex uncomfortable. Studies show that sexually active menopausal women have less symptoms of vaginal atrophy—so the advice I’ve seen is “use it or lose it.”

Low libido Between the uncomfortable physical symptoms I mentioned above and the fact that your sex hormones are declining, you may just not have much interest in sex. It kind of seems like a catch-22, but sex keeps your vagina healthy because of increased blood flow, so the advice from the experts that I mentioned above—to basically keep having sex as much as you can—applies here too. (Easy for 'them' to say, I know, but not as easy to do if you're feeling stressed out and exhausted all the time. I'll offer some suggestions on how to deal with stress is the Stress + Self-Care section.)

Heart palpitations This one might not be as common as some of the others, but I have definitely struggled with heart palpitations myself (mainly at night, which unfortunately lead to insomnia) and because I could never find that much information about them, I wanted to include them here to let you know that if you’re experiencing them, they’re normal. Don’t freak out that there’s something wrong with your heart. They have to do with decreasing estrogen levels, but my hunch is that perhaps those of us who have a harder time dealing with stress and regulating our nervous systems experience them more.

Create Your Plan: Symptoms

*Now that we've gone a little deeper into the main symptoms of perimenopause, which of them can you relate to?

*What are you going to be on the lookout for as you head further into perimenopause?


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