What I Wish Someone Had Told Me About Perimenopause
'I felt like my entire body was breaking down, but nobody talked about it.'
One of the biggest complaints that women have during perimenopause — the years leading up to menopause, when you officially stop ovulating — is the sense of isolation. “I felt like my entire body was breaking down, but nobody talked about it,” says Magda P. “I wish I had known that so many other women were suffering in silence, too.”
“The taboo associated with this stage of life is a huge problem in our culture,” agrees Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at Yale School of Medicine and the founder of madameovary.com, an informational website about menopause and other reproductive topics. “People don’t want to think or talk about getting older. We’re also living in a prudish society where it can be uncomfortable to bring up sexual health.”
To shed more light on the experience, we polled women who’ve been through perimenopause about what surprised them the most.
"That my doctor would be so dismissive of my symptoms. I was told that I was ‘too young’ for menopause — all because I hadn’t hit a seemingly arbitrary age." — Claudia G.
Even doctors are sometimes uninformed about perimenopause, according to Minkin. “Eighty percent of ob-gyn residency programs don’t offer any formal menopause education,” she says. But the truth is that perimenopause can hit anywhere from your mid-30s to your early 50s. “The average age of menopause is 51, but five percent of women are done menstruating by age 45, and one percent are done by age 40.” If your doctor doesn’t take your symptoms seriously, keep looking for one who does. You can type in your zip code at menopause.org, the website of the North American Menopause Society (NAMS) to find a NAMS-certified menopause practitioner near you.
"That I would get hot flashes both before and after I stopped having my period. Also, soaking through your pajamas and sheets at night isn't a flash. It's a full-on blaze.” — Leah F.
Every woman’s perimenopausal experience is different, and that includes the age of onset, the type of symptoms, and the duration of symptoms. “The average duration of hot flashes can be anywhere from four to 10 years,” says Minkin. “Even a decade after their last period, about 10 to 15 percent of women will still experience moderate to severe hot flashes.” The good news is that there are a number of treatment options available, so talk to your doctor about the best ways to keep your symptoms in check.
"That my skin would change so dramatically. I always thought that crepey, wrinkly skin was an old lady thing, not a menopausal thing." — JoEllen R.
While doctors aren’t sure why skin changes so much during menopause, it’s likely related to estrogen, says Minkin. “For many women, their skin becomes very dry and therefore ‘older’ looking during this phase,” she says. And by the way, we’re not just talking about the skin on your face. Vaginal dryness is a huge issue that women often aren’t prepared for. Extra moisturizing helps, and “while dry skin is not an official indication for hormone therapy, anecdotally we see that estrogen does make a difference,” says Minkin. For vaginal dryness in particular, there also are a number of topical therapies available.
"That it would be so hard to handle the mood swings. When you go through puberty, people expect you to be moody. Not so much when you’re an adult with a job and responsibilities. Kathy Bates' character in 'Fried Green Tomatoes' is my spirit animal; when she smashes her car into another in the parking lot ... I get that." — Lauren S.
Mood swings and severe PMS are a big part of perimenopause, and they’re often made worse by the fact that many women are stressed out and not sleeping well due to hot flashes. “If your sleep is disrupted, you’re going to feel like crap no matter what,” says Minkin. “Not to mention, women at this time of their lives have crazy amounts of stuff going on. They’re dealing with kids, they may be dealing with aging parents, they may have a stressful job.” Practicing smart stress-relief strategies can help — going for a run, meditating, rolling out your yoga mat. If you’re not sleeping well, talk to your doctor about what can be done to help you get more shut-eye. And consider talking to a counselor or other professional, or finding a support group for menopausal women where you can vent and trade tips for managing stress.