WTF is Peri/Menopause anyway?

But I’m still getting my period!

How the heck can I be in menopause?

Menopause as most of us thought we knew it to be, means that our period at one point stops and the need for further birth control is over. Just like that, nasty periods done, PMS and cravings are a thing of the past and the clock that was ticking suddenly goes silent. Maybe we might get hot flashes and mood changes, not least of which we turn a blind eye to the midlife weight gain.

And on with life we go.

Ooooohh….how we were misinformed…..

Remember those classroom sessions we got when we were younger, where we were told what would be happening to our bodies as they changed before our period started? Well…looks like we could use a bit of that classroom talk again, since our periods stopping in our early 50s is just the tiny tip of the iceberg of what happens to our bodies as we transition through menopause. (note my language here…I’m going to normalize this right now. Menopause is a transition, it is normal and anyone wth a uterus and ovaries is going to go through this. It is also a time of change and can be empowering. We’ll get back to this - but I’m going to plant the seed for now).

With little to no information about what is going to happen to our bodies through this transition, I see many women gleefully head into their 40s blissfully unaware.

And all of a sudden, these same vibrant and active women come into my office and it’s a if the ghoul from some horror movie starts laughing as it watches us manage periods that have no rhythm and insist on creating chaos making us wonder if we are going to be older mothers (gasp!!! I’m late! I’m can’t possibly be pregnant…can I?!", periods that look like murder scenes (omg the blood!) or taunt us with the thought that we are abruptly in menopause (wait what…! I didn’t see that coming!).

If you are one of the lucky ones that seems to be missing out on the carousel of period fun, then its the night time waked up drenched in sweat making you gasp at how you could possibly wet the bed to that extent. Hot flushes that have you second guessing what to wear..all. the. damn. time., brain fog - wait, what?! In case that wasn’t interesting enough, hello joint pain, changes in body composition - where. did. this. belly. come. from? And where are my muscles going to!? Enough to add to the anxiety and depression that can rear its ugly head during this time of our lives not least of which a dry vagina. (whaaaaa…!?!).

Ok. Deep breath. We are going to tackle this. Promise

I am a firm believer that knowledge is power.

Back to basics people.

Menopause is divided up into three stages.

Perimenopause is the menopause transition during which we go from our normal reproductive cycle of 25-40 days, lasting 5-7 days to a very inconsistent cycle. We may miss periods of have heavy bleeding. Perimenopause can start as early as 36 but it typically begins around 45.

So what the hormone is going on?

Basically, the sex hormones that have orchestrated our cycle are now in flux. Estrogen and progesterone are driving the changes. During our cycling years, estrogen is secreted by the ovaries - kinda like someone tapping on the door of the ovaries to release an egg “Hey!!! come on out, needing you here!”

Then the egg that is mature is released and in a feat that only the body can do, that little “egg nest” starts to secrete progesterone. Kinda like it is saying “hey there estrogen…I’ve got this, settle down now, going to accompany this egg to the uterus”.

Well, in perimenopause, our “Marco Polo” of estrogen and progesterone starts to go a off kilter. During the years leading up to menopause, we may not have as many eggs and they don’t release like clockwork.

This means that estrogen is still released by the ovaries, but if no egg is released, then that little “egg nest” and the resulting “progesterone call back” isn’t happening. This means there is an imbalance of too much estrogen and too little progesterone.

The next month, it might be normal!

The next month, or two or more might not be!

Generally, the imbalance tends towards estrogen dominance and can lead to the host of symptoms that women can feel including headaches, mood swings and more. As with any good rule, there are exceptions and not all women will pass through this experience the same way.

Often these symptoms are most keenly felt the 4-5 years leading up to the change. In addition, you might be feeling like “hey…what the heck, the things I was doing before aren’t working anymore, I can’t lose the body fat as quickly as I could before or lean into the training I am so used to!”, “My training feels flat, I’m sooo tired”.

Menopause is the day where you haven’t had a period for 12 months. It is just one specific point in time. It’s not uncommon to think you’ve rounded the corner to wake up one day to see you have to reset the timer - damn her “surprise Aunt Flo”. On average the age of menopause is 51-52.

Postmenopause is the hormonal state for the rest of your life. At this point our ovaries no longer produce estrogen or progesterone the way they used to, their star power fades and they move towards more of a flatline performance.

What does this mean? Hormones are the chemical messengers that affect almost every cell in our body. The changes that we feel during the perimenopause period are what often throw people off track, and yet there are things that we can do to help ourselves.

The North American Menopause Society as well as the European Menopause and Adropause Society both have recently updated their position statements (2022)on the menopause transition as it relates to Hormones Therapy (another blog post, I’ll keep you posted) and “Essential Curriculum for Pealthcare professionals” respectively. Both societies include lifestyle factors that include a healthy balanced diet with an increase in healthy fats, complex carbohydrates and protein, regular movement and stress management are equally important factors that can help with symptoms. Hormone therapy is highlighted in various forms to help with and including but not exclusively, vasomotor symptoms, sleeplessness and mood changes as well as genitourinary (fancy word for vagina and bladder) problems.

There has been evidence to show that those women who are active tend to move through the transition well and may suffer less. Having said that, I have also met women who have felt like they ran into the brick wall of symptoms at 100mph while cranking out the miles, hitting the gym and eating in a way that would make the Blue Zone Octegenarians proud. It depends and each person is different is the ultimate take home message here.

Mindset is another big one, culturally in the world where aging is revered, menopause symptoms are less reported. This isn’t to say it is all in our head, but to note that our minds and bodies are inextricably connected and what we believe can have an impact on our experience.

What I want to land on is that menopause is a transition. Anyone with ovaries and a uterus will go through this (note not all those with these organs identify as women, and this is an inclusive space). We aren’t deficient, we aren’t hormones void, we are Not Less than. I am determined to normalize this conversation, promote healthy and empowering tips to this transition so that you can continue to feel your best throughout your life. As with any transition, it is change, but also an opportunity to decide to alter the path which will enable a better, stronger, and more vibrant you.

Stop Playing Small.

You’ve got this.

xoxo Karin

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