The Totally Unexpected and Rarely Discussed Part of Life that's Been Around FOREVER - for HALF THE POPULATION: Perimenopause

Unexpected, you say? Well, duh, I knew someday I would stop getting my period. I'd heard about hot flashes being a pain. But that was all I knew. And I also was under the impression it would be sometime in my late 40s and last for a few years.

If this is true for you, I hate you. No, of course I don't, but I am jealous.

Before we get started - what IS Perimenopause vs. Menopause?

Menopause is the moment in time when you have not had a consecutive period for 12 months. It will not come with fanfare. For those of us with irregular periods or on medication affecting our periods, we'll never really know when it happens, we will just be perimenopausal and then postmenopausal. At some point you'll figure it out that you've crossed over. Back in the day when my mom was going through this, they just called the whole process Menopause. So Perimenopause is nothing new, it is just a more accurate way to describe the time period leading up to the end of periods.

For me, symptoms started in my late 30s. Here's a brief rundown of my personal experience. I would LOVE to swap stories of unexpected symptoms other readers encountered! The goal here is to make others feel less crazy and less alone - and maybe even help some individuals recognize that perimenopause is contributing to their own issues so they can seek out the help they need!

Mid 30s: NIGHT SWEATS. Huge disruption to temperature regulation in my body. I was also diagnosed with Raynaud's around this time, so I thought it was all just that. But I would go from FREEZING in the evening - wrapped up in bed with a heated blanket and still shivering - to drenched in sweat in the middle of the night (yes, even after turning off the heated blanket and removing layers!). Going on a hormonal birth control (Cryselle) helped with these a TON. However, I had to stop taking that because I was suddenly getting migraines. Now I'm on an estrogen patch and progesterone pill; while some symptoms are being helped by this, the night sweats and temperate dysregulation in general have returned. =(

Late 30s: increased libido, but only periodically and totally out of the blue. This is the one topic in the world I still feel uncomfortable talking about. I should probably unpack this in therapy. For whatever reason, I've been asexual since my late 20s -- that part I'm totally unafraid to admit. But being asexual made the periods of increased sexual desire very disturbing. Luckily since balancing my hormones, it is no longer an issue. Good riddance.

Just before I turned 40: holy BAWKAWK, I don't even know where to start!

• Weirdest thing: my sense of smell is sometimes so sensitive I could be a police doggie!

• Most stereotypical thing : highly irritable at times, like with PMS but worse because my hormones were fluctuating so unusually that there was never a clear pattern to anticipate.

• Hardest thing: I didn't feel like me at all, like I was no longer the one in my head. Not in a "hearing voices" or other clinical way, just like I wasn't grounded in my mind as myself. I still haven't figured out how to describe this. I found a journal entry from one year ago that started with "I feel absolutely crazy today, like my thoughts make no sense even to me." I then went on to blame it first on taking allergy meds (I'm very sensitive to them), then blamed myself (of course) for not exercising enough, not meditating enough, not trying hard enough to get better, etc. If you take one thing from this blog post, please make it this: do not blame yourself for feeling crazy when your hormones are doing batkitty crazy things.

• Funniest thing: HAHAHA, I am literally adding this one day after publishing the original post because I forgot about it - BRAIN FOG! Ironic. Brain fog was at first one of the most upsetting symptoms, because I have always had a mind that worked like a spreadsheet and my working memory was off the charts. For example, I used to teach upwards of 100 students each semester - and knew all their names by midterm. But once Brain Fog took hold, I was lucky if I could remember around a dozen by finals week.

  • I have to point out, however, that there is a difference between Brain Fog (forgetfulness, easily distracted - it's like being ADD, and in fact many women ARE diagnosed with ADD during this time...) and a depletion of Executive Functions. I also experienced this latter symptom, though I now believe it was tied to my C-PTSD, as my executive functions have been returning. What I mean is my skills dealing with decision-making, problem-solving, planning, adaptability, etc. - those all went to absolute BAKAWK right around the same time as all these other symptoms. But thanks to EMDR, they've returned nearly to 100%. So while I'm still forgetful (seriously, I have to laugh at this so I don't cry), at least now I feel like I can function again. In fact, I'm finally thinking about my next career. (SO MANY IDEAS...!)

• What I wish everyone knew: Hormone fluctuations can worsen symptoms of PTSD, including anxiety and depression. And/or having PTSD can potentially lead to earlier onset of perimenopause. There have been so few studies that there are no hard facts on this, but research suggests a link between hormones and mental health. In general I wish more people understood the massive connections between mental and physical health. It's all in one body.

Is this the same for everyone? Of course not. Even now that studies are FINALLY ramping up to better understand Perimenopause, there just isn't enough research to help women know if their symptoms are perimenopausal and/or something else. What I think hurts us the most and slows us down on our paths to getting proper help is the way we compartmentalize healthcare (and knowledge and people and everything...). If you just pay attention to your symptoms separately, you may never see the big picture indicating that your hormones are the problem. That's what I did. I tried to treat my anxiety without even thinking about the other symptoms. It took me two years and eight different doctors - finally I saw an OBGYN who is a member of The Menopause Society. She saw the big picture and the hormones are helping IMMENSELY. And then I assumed incorrectly that my executive function depletion was also due to perimenopause; how awesome was it to learn that they were only gone due to years of ongoing trauma! That may not sound awesome, but at least EMDR helped me a BAKAWK-ton faster than waiting for menopause to be over.

But back to hormones. The biggest thing I noticed within a few days of going on a hormonal birth control was the feeling that I had returned to my head. I was still anxious, but at least it felt like ME again. Anxiety will always be a part of my life; now I am back to being capable of dealing with it.

I still get irritable, but now I understand that it is hormonal and I can arm myself with tools and coping strategies to get through these bouts a little better.

I am sure my perimenopausal story isn't over yet (I have probably another decade? oh geez...). I will continue writing about it and reading about it and telling everyone I meet about it.

If you are a reader, please check out these books:

The New Menopause - Mary Claire Haver (this changed my life)

The Body Keeps the Score - Bessel van der Kolk (so much research and information on how the body and mind are connected - not about perimenopause, but might provide you with insight into mental health)

What My Bones Know - Stephanie Foo (about C-PTSD, and no mention of perimenopause, but she does share a lot about her experiences with body/mind connection and how invalidating some healthcare professionals can be about this)