Managing Perimenopause: How to Cope with the Changes of Menopause

The old adage ” suck it up” applies to the Change, but a new wave of women, empowered by tools from cutting-edge beauty and wellness companies, is shaking up the way we approach and communicate this pivotal phase of life.

Most women associate menopause with the cessation of menstruation and the onset of hot flashes. However, they may not anticipate all  the other associated side effects, including brain fog, depression, acne, joint pain, mood swings, night sweats, insomnia, dry skin, decreased sex drive, hair loss and more. These symptoms surprise many of the 55 million  women in the United States who are going through menopause (or the estimated 1.3 million who will join them this year).

“Only about 20 percent of physicians receive training on menopausal treatments,” says Houston obstetrician-gynecologist Kourtney Simms, adding that the majority of medical schools and ob-gyn residency programs spend little time on this area of a woman’s life. “If doctors don’t educate themselves on menopausal symptoms and treatment, how do they guide patients through them?”

Another reason women haven’t been prepared for menstruation is that it’s a taboo topic. It’s something that’s discussed in high school health classes, but women aren’t taught much about what happens at the end of the cycle. And then there’s the shame, the fear, and the uncertainty that comes with it. Many women shy away from talking to their doctors about it, or from sharing their concerns with friends and family. Fortunately, that’s changing. Gen Xers, as well as older Millennials, are embracing a more open and proactive approach to managing their hormones.

Patients who are going through menopause are eager to learn more, says Dweck, a New York ob-gyn based in Mount Kisco. She often recommends making small changes to her patients’ day-to-day lives to help them manage the symptoms, such as adopting a Mediterranean low-glycemic diet to reduce weight gain or increasing cardio to moderate mood fluctuations. “A lot of people are confused because they’re still having periods, but they’re experiencing new symptoms like mood swings, and they don’t know what’s going on,” Dweck says.

So, what’s going on? “Your hormones are breaking down at a rate that’s consistent with levels you’ve had for at least 30 years,” Sims says. “So it’s no wonder it’s upsetting.” 

The hormonal rollercoaster typically begins between late 30’s and mid-40’s (although it can start earlier) and can last up to 15 years. 

When women say they’re “going through menopause”, they’re usually referring to the perimenopause stage. That’s when estrogen levels and progesterone levels decline, ovulation becomes irregular, and periods stop arriving on schedule. 

“I didn’t know that brain fog was related to menopause at all,” says Rosie Weitzner, co-founder of menopause-friendly Pause Well-Ageing skincare brand, “I thought I might have early-onset alzheimer’s!”

Some women have even started experimenting with at home tests to check their hormone levels. These kits usually involve taking a saliva sample or a blood sample through a finger prick. The results can then be analysed at home or sent off to a lab.

“Menopause is really one day: the day you go 12 months without a period,” says Weitzner. “After that, you’re postmenopausal, but you’re not symptom-free. Your hormones won’t fluctuate like they did during perimenopause.” Instead, your body has to adjust to lower levels of estrogen (estrogen) and progesterone (progesterone) over time. Some symptoms, such as dry skin and thinning hair, can become chronic issues.

HRT can help reduce symptoms by increasing estrogen levels through a pill, patch or topical cream. However, HRT is not without risks, including an increased risk of certain types of cancer. So it’s good to know that HRT is not the only option for managing menopause. More and more beauty and wellness brands are creating products and tools to manage menopause. “Women want to feel empowered and in control,” Sims says.-