Heeding your hormones
Five things to know about perimenopause and menopause.
Sleep problems, night sweats and crazy heavy periods – is this menopause already? And you’re only 42? No, menopause may still be a decade away. This is perimenopause or “second puberty”, which is the two to twelve years before periods stop. Perimenopause is different from menopause, which is the life phase that begins one year after the last period. Here’s what you need to know.
1 Second puberty can start as young as 35
Because the normal age for menopause (periods stopping) is anywhere from 45 to 55, the normal age for perimenopause is up to twelve years before that – as young as 35! That’s why perimenopause is not about ageing. Instead, it’s about the recalibration of your entire hormonal system and the support you may need during that temporary process.
2 Most symptoms will be temporary
Just like first puberty, the symptoms of second puberty are temporary. Eventually, you will move out of symptoms and achieve the kinder, calmer phase of life called menopause. That’s according to several lines of evidence, including research from the University of Melbourne, which concluded that the majority of women over 60 report feeling “pretty fantastic”, and the observations of US psychologist Mary Pipher, who says that “a woman in her seventies is likely to be the happiest she’s ever been.”
3 Estrogen has a “grand finale”
During perimenopause, you may experience a slow, gradual decline of estrogen. More likely, you’ll experience up to three times more estrogen than when you were younger. “It’s the ovary’s grand finale”, says Canadian endocrinology professor Jerilynn C Prior. She also describes it as a hormonal “fireworks show”. Symptoms of the fireworks show include symptoms of high estrogen (heavy periods, breast pain and irritable mood) interspersed with symptoms of dropping estrogen (night sweats and depression). Professor Prior recommends treatment with oral micronised progesterone (brand name Utrogestan) to counterbalance the high and fluctuating estrogen of perimenopause.
4 There are lots of ways to feel better
Progesterone is just one of many ways to feel better during second puberty. Other strategies include regular exercise, especially outdoor exercise (what researchers call “green exercise”), as well as reducing alcohol and taking nutritional supplements such as magnesium. In the paper “Magnesium in the gynecological practice: a literature review,” researchers conclude that magnesium is effective treatment for menopause and perimenopause because it helps to “normalise the action of hormones on the central nervous system.” It works well in combination with the amino acid taurine, which helps to calm the brain and prevent hot flushes.
5 Hormone therapy is better now
Finally, if you need support, talk to your doctor about hormone therapy. Modern menopausal hormone therapy (MHT) is safer with fewer side effects compared to the old “hormone replacement” or HRT from the 1990s. That’s because most modern hormone therapy (e.g. brand names Estradot® and Utrogestan®) are body-identical, which means they are hormones that are exactly identical to the body’s own hormones, and therefore safer.