Am I in Perimenopause? Changes Worth Discussing With Your Doctor
If you start to realize that your body has turned on you, your brain suddenly is in a constant state of fog and mental acuity has decreased, not to mention, your periods, sleep, mood and energy are different, you may find yourself asking a surprisingly difficult question:
Am I in perimenopause?
There is not a single moment when perimenopause begins. It is a transition toward menopause, and the experience varies considerably from one woman to another. Changes in the menstrual cycle are common, but other changes often occur such as abdominal weight gain, sleep disturbances, unprovoked mood changes, or something as frustrating as irregular periods.
That's one reason a conversation with your doctor can be helpful. Rather than trying to diagnose yourself from a checklist online; you can discuss what has changed, what may be contributing to those changes, and whether further evaluation is appropriate.
What is perimenopause?
Perimenopause is the transition leading up to menopause. During this time, hormone levels fluctuate and menstrual cycles may begin to change. Medically speaking, menopause itself is reached after 12 consecutive months without a menstrual period. However, for women who have had a uterine ablation or partial hysterectomy and still have your ovaries, you can still have the hormonal fluctuations associated with perimenopause.
Many women begin noticing changes during their 40s, although the timing varies, sometimes as early as 35. Some women may experience noticeable perimenopausal symptoms, while others have relatively few.
The most important thing to remember is: there is not one universal perimenopause experience.
What changes can happen during perimenopause?
One of the most recognizable changes involves your menstrual cycle. Your periods may become less predictable, cycles may become longer or shorter, and bleeding may become heavier or lighter than what has been typical for you.
Other commonly reported changes can include:
Hot flashes or night sweats
Difficulty sleeping
Vaginal dryness or discomfort
Mood changes
Changes in sexual health
Changes in urinary symptoms
Weight gain especially around the abdomen
Brain fog/decline in mental acuity
Not everyone experiences the same combination or intensity of symptoms. It is also important to remember that not all midlife symptoms are caused by perimenopause. Sometimes, serious medical conditions can produce similar changes.
That's why an individualized conversation with your healthcare professional can be more useful than simply matching your symptoms to a list.
How do I know if I'm actually in perimenopause?
There isn't necessarily one test that answers the question.
A healthcare professional may consider several pieces of information, including: your age, menstrual history, symptoms, overall health, and other changes you are experiencing. Hormone levels fluctuate unpredictably during perimenopause. This makes it difficult to determine the actual onset of menopause since some women transition to menopause within a year while others will remain in perimenopause for 10-15 years. The good news is there are some specific lab tests that, if routinely tested, give a good indication of the transition to menopause.
Your individual circumstances matter, however, and your doctor can determine whether testing or additional evaluation is appropriate.
When should I talk with my doctor about perimenopause?
You don't have to wait until your periods stop.
If changes in your cycle, sleep, temperature regulation, mood, sexual health, or other areas are affecting how you feel or function now, they are worth discussing with your healthcare professional.
Changes in menstrual bleeding should also be discussed with your doctor rather than automatically being attributed to perimenopause. Changes such as particularly heavy or prolonged bleeding, bleeding between periods, unusually frequent periods, or bleeding after you've gone 12 months without a period warrant medical attention.
The goal isn't to assume every midlife change is a problem. It's to understand what you're experiencing and determine whether anything deserves further evaluation.
Do I have to wait until menopause to discuss treatment options?
No.
Conversations about managing bothersome symptoms can begin during perimenopause. Depending on your individual circumstances, that conversation may include lifestyle approaches, nonhormonal options, hormone therapy, or other strategies.
Hormone therapy can be used for certain symptoms associated with perimenopause and menopause, but whether it is appropriate depends on factors including your symptoms and personal and family medical history. The potential benefits and risks should be considered with a qualified healthcare professional.
In other words, you don't need to arrive at your appointment already knowing which treatment you want.
The conversation can start with something much simpler:
“Something has changed, and I'd like to understand why.”
What does individualized perimenopause care mean?
At The Natural Path Health & Wellness Clinic in Tucson, Dr. Alena Papenfuss takes an individualized approach to conversations about perimenopause and menopause.
That means looking beyond one symptom or a one-size-fits-all solution. Your health history, current concerns, lifestyle, and goals are all part of the discussion.
Depending on your individual needs and desires, conversations about healthcare may include nutrition, lifestyle changes, exercise, stress management, herbal medicine, hormone therapy, or other appropriate options.
The objective is to help you better understand what's happening to you and help you participate by making informed decisions about your health.
You don't have to figure it out alone
If you've found yourself wondering whether the changes you're experiencing could be related to perimenopause, you don't have to wait until menopause—or until your symptoms become overwhelming—to start asking questions.
A conversation with your healthcare professional can help put those changes into context and determine what, if anything, should happen next.
If you're in the Tucson area and would like to discuss perimenopause or menopause care with Dr. Alena Papenfuss, schedule a consultation with The Natural Path Health & Wellness Clinic.