Perimenopause and Beyond

Miriam sank into the overstuffed chair in the corner of the living room. She was about to run some errands and pick up her youngest child from school, a fourteen-year-old daughter, but suddenly felt her cheeks burning, and a warmth that flashed throughout her entire body like lighting. A tingling sweat dripping like a rain forest, but without the accompanying soothing sounds and sights, quickly followed.

"Why are things so stressful now when my day-to-day life is actually so much easier?" she thought, and she began to sob heavily. Miriam couldn't understand why she was feeling this way. She had a beautiful life, a loving husband who made a decent living, she delighted in her children who were, all but one, married. Everyone, thank G‑d, was in good health… at least until now.

She hardly recognized herself in this new emotional state At first, she didn't notice them much, and thought it was the result of a bad dream when she awakened with her nightgown drenched. Then it happened more frequently, and at the same time, her very regular cycles became irregular and unpredictable, mikvah days were variable and lessened.

But it was those crazy, unpredictable mood swings which left her a victim to temperamental whims. "Don't be so edgy, Imma" and "why are you crying?" were the comments from her family that rang in her ears.

She hardly recognized herself in this new emotional state that seemed to take on a life of its own. Her sleep and concentration were less, she would often forget where her keys were or why she had walked into a room, and was plagued by dizziness, weight gain, headache and fatigue. But it was the irritability and nervousness that she particularly wanted to rid herself of, but couldn't. The worst part of it for Miriam was that she felt painfully alone, and too uncomfortable to share with her family or friends, so she continued to anguish silently...

Miriam was suffering from symptoms of menopause which, in her case, were very debilitating and worsened by her lack of support due, in large part, to her reluctance to express herself or seek help.

According to the 2005 US Census Bureau, there are over forty million women in the U.S. over the age of fifty. The time during which all periods stop and hormone levels fall is Menopause, and usually occurs between the ages of forty-five and fifty-five years.

The two to six year transition time when hormone levels are erratic, and one or more symptoms appear, is Perimenopause. Every woman experiences menopause differently. There are women that have almost no symptoms at all while others have severe symptoms. The good news is that there are now many new options to treat and cope with symptoms.

Ladies, listen to your bodies, and don't feel uncomfortable discussing some of these symptoms with your husband or close female friends, but be sure to also get good, professional help. Yet, don't blindly trust your doctors if you feel their medications or advice aren't working. Find someone who understands hormones, and can help you make a treatment plan that is tailored for you.

Some of the various symptoms that women can experience are:

• Hot Flashes
• Night Sweats
• Insomnia
• Headaches
• Depression
• Irritability
• Irregular, lighter periods, shorter cycles until stopped
• Fatigue
• Anxiety
• Memory lapses
• Sore joints and tendons
• Indigestion
• Weight gain
• Hair loss
• Dizziness
• Feminine Dryness
• Decreased Libido

Although menopause is a normal condition, the loss of estrogen that accompanies it can be associated with some health problems.

The field of women's health has been sorely overlooked in the pastThe field of women's health - and particularly that which covers the later years - has been sorely overlooked in the past, as well as misunderstood and given many unfortunate stereotypes. With women becoming more proactive in their own healthcare, as well as the medical mainstream assuming more involvement studying this phase of women's health, a more positive view is being assumed.

What should you do if you think you are going through menopause? First of all, a simple blood test can measure the FSH level, which is elevated in menopause and often in perimenopause. However, not everyone needs a blood test. Lack of menses for six months or longer is usually sufficient evidence that your body is changing. Salivary hormone testing can also be useful in determining a low estrogen level. Remember to always consult your doctor about any tests or treatments to determine what is right for you.

Hot Flashes

75% of women experience hot flashes that can last from thirty seconds to five minutes, but hot flashes usually stop in 75% of women after three to five years. Some women have no noticeable symptoms at all, but understanding changes in hormones is important in order to keep healthy.

Hormone replacement therapy (HRT) relieves hot flashes and other symptoms of menopause, and may be helpful in reducing the risk of osteoporosis and heart disease. However, taking estrogen may increase the risk of breast cancer.

Estrogen treatment can increase the risk of developing endometrial cancer in women who still have a uterus; combining estrogen and progestin lowers this risk. You should not start estrogen replacement if you have a history of endometrial cancer or breast cancer, blood clots or inflammation of the veins or uterine bleeding.

Bio-identical hormones are derived from a natural plant source, usually soy, and are biologically identical or similar to the human form of estrogen and testosterone.

Restoring hormone levels may result in increased energy levels, consistency in mood, relief from anxiety or depression, decreased body fat, and increased focus and mental clarity.

Herbal therapies can be helpful if using only reliable brands that adhere to federal standards on ingredients. Medical literature confirms their effectiveness and lack of harmful side effects.

Using 2% natural progesterone cream can sometimes help hot flashes and migraine headaches. The usual dose is ¼ - ½ teaspoon, rubbed into the skin.

Antidepressants have also been helpful to some women for hot flashes as well as premenstrual syndrome, and studies have shown they're helpful in treating fibromyalgia.

Women can make knowledgeable, informed decisions about their healthWhen considering medications, remember it is important to discuss them with your doctor to determine what would the right choice for you. Here are some ideas that can help:

• Keep track of hot flashes & mood swings — a diary can help. Use this information to find out what triggers them and avoid it.
• When hot flashes starts, go somewhere cool (ice packs work well, too).
• If night sweats wake you, try sleeping in a cool room or with a fan on.
• Dress in layers that you can take off if you get too warm.
• Use sheets and clothing that let your skin "breathe."
• If you feel a hot flash starting, have a cold drink (water or juice).
• Add 45–160 mg of soy isoflavones daily.
• Consume omega-3 fatty acids in your diet (they are found in large amounts in fish).
• Avoid white flour, white rice, soda, alcohol, & sweets.
• Try meditation & relaxation at least 3 times week.

Remember that most women get through menopause just fine. Staying healthy through diet, exercise and a positive attitude are key factors in reducing some of the symptoms of menopause, as well as the aging process in general.

By learning about your body and understanding the changes, women can make knowledgeable, informed decisions about their health, and are able to experience this phase of life with a sense of harmony, joy and contentment. So, embrace your life and your loved ones with a renewed sense of confidence, wellbeing and vigor!