Perimenopause

Most women are used to experiencing hormonal fluctuations. Since puberty, our bodies become accustomed to the ebb and flow of estrogen and progesterone that guide the reproductive cycle. The changes are routine and familiar. We come to know what to expect. But perimenopause can change that, as it introduces new and foreign hormonal states.

Menopause is a normal and expected part of every woman’s life. But too often, women are taught to believe that because menopause is a natural transition, their symptoms are inevitable rather than something that requires medical intervention. For many, this damaging belief leads to unnecessary suffering.

A lot has been said about menopause. There is a seemingly infinite number of books offering advice. Films and TV shows use it as a plot point. Thousands of memoirs, both humorous and serious, investigate this critical transition point in a woman’s life, and it’s a regular topic of conversation in lifestyle columns and magazine articles. In other words, menopause is an undeniable part of our cultural conversation. But what about perimenopause?

According to CDC research, 25% of perimenopausal women have trouble falling asleep more than four nights per week. Even more have trouble staying asleep, and over 50% of surveyed women don’t wake up feeling rested during most of the week. These numbers are powerful confirmation that sleep duration and sleep quality are often serious concerns during the transition to menopause, and they’re affecting huge numbers of women across the globe.

Menopause can be a difficult time. Intrusive symptoms like hot flashes, night sweats, painful sex, and sleep problems can create physical discomfort and emotional distress. Meanwhile, the transition out of your fertile years can be a time of introspection and give rise to complex feelings about your sense of self and your place in the world. For some, it is also a time when the symptoms of depression emerge, either for the first time or more severely than in the past.

When you struggle to fall asleep at night due to racing thoughts, you might brush it off as just another side effect of stress. When you wake up every morning feeling dread for the day to come, you might think it’s just because of your tight work schedule. But when you start feeling anxious for no reason at all, you might start to worry that something’s wrong. As those worries compound exponentially alongside uncomfortable physical and emotional symptoms of hormonal change, you finally realize that you need outside help to escape this painful cycle.

Kim experienced the worst cramps of her life on the day she turned 46. She’d never really dealt with PMS before—only the occasional moody afternoon or minor breakout, nothing debilitating. But from that cycle onward, she had all the symptoms she’d watched her “unlucky” friends struggle with: bloating, breast tenderness, cravings, irritability, and severe menstrual cramping that seemed to press pause on her entire life. Kim went to her doctor seeking answers and was surprised to discover that her PMS symptoms marked the beginning of perimenopause.

Watching women go through menopause, you understand immediately why hot flashes are such a big deal. The rush of heat, flushing and blotchy skin, and perspiration can be distressing and embarrassing at the best of times—and when these moments occur at night, they may be even worse. Menopausal women often deal with the rapid heartbeat and uncomfortable flushing multiple times per day (or per hour) and can experience chronic insomnia as a result. Depending on the woman, this perfect storm of discomfort can last anywhere from five to ten years or more. Combine hot flashes with the mood swings, vaginal discomfort, and other widely varied symptoms of menopause, and it’s no wonder women are seeking relief.

As we age, we’re often left trying to understand what is going on when our bodies start to undergo natural transitions, and the transition to menopause is often one of the most puzzling. Women often understand what to expect from menopause itself, but many aren’t as informed regarding the changes that they undergo in the years leading up to it, also known as perimenopause.