The Beginning of the End: Is There an Upside to Perimenopause?

At first, I thought my friends and I were simply using perimenopause as an excuse for bitchy attitudes. But the more we experienced unusual periods, sporadic cycles, and surprising symptoms, the more it appeared that a genuine physiological phenomenon was at play.

After having our babies and heading into our early 40s, we noticed that our bodies were changing and that we were going down the long, hot-flash-ridden path to the "change of life," or menopause.

It's a long path. Perimenopause can begin as early as a woman's mid-30s and can last anywhere between two to eight years as our bodies begin to wrap up the reproductive years.

News stories about late-in-life pregnancies, such as Kelly Preston's, had me thinking that my fertility would stick around for a while. So when I started experiencing hot flashes at night, I thought, "Nah. Not me."

Then, I saw perimenopause everywhere (including Sex and the City 2).

We, the formerly fertile women, were picking up ibuprofen and "super plus" boxes of tampons to deal with abnormal periods, signing up for yoga classes, and ingesting more soy than ever before—anything to alleviate the continued onset of perimenopausal symptoms.

Though perimenopause may seem like a less-than-comfortable transition, I learned several surprising facts and some nice upsides to this time of life.

How Does Egg Quality Play a Role in Perimenopause?

Our ovaries start running out of eggs as we age. As their number decreases, their quality can deteriorate. This deterioration can cause unpredictable cycles for a decade before we can be pronounced menopausal.

"As some of the poorer quality eggs start to develop, they may not develop normally and may not be released in ovulation," said Alicia Stanton, MD, former hormone health expert, who was located in Hartford. If this occurs, Dr. Stanton explained that it may upset the hormonal balance, which may result in a skipped cycle and perimenopausal symptoms.

As eggs aren't released as often, progesterone levels drop, and this can cause estradiol levels to fluctuate, said Dr. Stanton. "This might lead to symptoms of estrogen dominance—heavier menses, bloating, irritability, PMS, breast tenderness, anxiety, hot flashes, heart palpitations, and fibroids," added Dr. Stanton.

Because these symptoms can often be confused with other health issues, women may overlook perimenopause as a cause.

Furthermore, one poor-quality egg isn't the end. A better quality egg may be released the next month, and the cycle may resume to normal. According to Dr. Stanton, many women "may have [perimenopausal] symptoms off and on for up to 10 years prior to having no menses for an entire year."

Lower egg quality and hormones aren't the only factors that could trigger the onset of perimenopausal symptoms, however. According to Kent Holtorf, MD, an expert in natural bioidentical hormone replacement, things such as genetic factors, weight gain, insulin resistance, and even environmental toxins—like plastics and pesticides—can also affect the timing of perimenopause and menopause.

Is Our Mood Really Affected?

The Endocrine Society lists a number of perimenopause symptoms on its Perimenopause Conversation Starter form—including mood changes such as depression and irritability. So can we pin our bitchy attitudes on perimenopause? As it turns out, yes, we can.

"This bitchiness (as well as weight gain and depression) is typically due to a combination of progesterone and thyroid deficiency," said Dr. Holtorf.

Thus, it might be worth having these imbalances treated. "When these [deficiencies] are addressed, the overwhelming majority of women will find significant improvement in symptoms," said Dr. Holtorf.

What's the Good News?

If you find yourself trying to figure out how to deal with perimenopause, you'll be happy to know that there are options to pursue.

In order to alleviate the overwhelming host of symptoms that come with perimenopause, Dr. Holtorf advised testing your hormones. "Most doctors fail to detect the causative hormonal imbalance because standard blood tests generally miss the hormone imbalance causing the symptoms," said Dr. Holtorf.

As mentioned, low or improper ratios of hormones can cause perimenopausal symptoms, and low-dose birth control pills are sometimes prescribed to address this imbalance.

Still, after learning about all these symptoms that could be heading my way, I felt desperate for even more of an "upside" to perimenopause. Dr. Stanton had some reassuring news for me: "It usually signifies a time when a woman can start thinking more about herself."

She explained that a woman going through perimenopause has fewer responsibilities to others, the wisdom that comes from her 40 to 50 years on the planet, and children who can take care of themselves. "I find that this is the time when women re-evaluate their lives, jobs, and relationships and finally get the strength to do the best for themselves," said Dr. Stanton. And, she added, because you don't have to worry about pregnancy once you're actually menopausal, you can really have fun with sex!

I knew those ladies in Sex and the City were onto something. Perimenopause may be nigh, but I feel prepared, and even intrigued, by this next chapter in our lives.

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