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Perimenopause: Why Your Mid-30s Isn’t Too Early to Talk About It (And Experience Symptoms)
You might hear the word “menopause” and think, ‘That sounds far off for me.’ But the reality is that your body can start gearing up for menopause as early as your mid-30s. It’s called perimenopause. That’s not a bad or good thing. Just an important thing to know about the way your body transitions naturally as you get older. Especially when society has long seen anything related to menopause as taboo.
Because there’s a lack of discussion about perimenopause, many people don't understand what's happening to their bodies when they begin experiencing symptoms. That’s according to OB-GYN Dr. Suzanne Gilberg-Lenz, a partner at medical practice Women’s Care of Beverly Hills in California, and author of the forthcoming “Menopause Bootcamp.”
“Patients were mystified… and worried. Then resentful or angry,” she says. They came to her puzzled — complaining of hot flashes, anxiety, and vaginal dryness.
Let’s start with the basics: What is perimenopause?
Perimenopause is the term often used to talk about “the time leading up to menopause,” Dr. Gilberg-Lenz says. And it can last around four years. FYI: menopause is defined as going 12 months straight without a period. Average age of menopause in the US: about 51. Dr Gilberg-Lenz describes menopause as the “puberty of midlife.”
A time when there’s a lot of fluctuation in hormones and symptoms. It’s when levels of estrogen and progesterone drop, leading to a number of possible side effects, including unpredictable menstrual cycles.
A stage of life that’s not discussed enough. Possibly because women, especially “older” women, have long been made to feel shame over their body parts and functions. A problem related to the scarce amount of info about menopause. One study of medical residents found that only about 7% felt “adequately prepared” to help women going through it. The good news: More people are being open about their menopausal symptoms. We see you, Michelle Obama.
Not a disease. Dr. Gilberg-Lenz doesn’t love using the sometimes-stigmatized word “perimenopause.” Because she thinks doing so “pathologizes it” and “plays into patriarchal and ageism stigma.” Perimenopause isn’t a disease and going through it doesn’t mean there’s something wrong. It's a disruption of what seemed normal before and a part of your body’s natural transition, she says. But at the moment, she says she doesn’t have a better word to use.
What are the most common signs of perimenopause?
Hot flashes. They can feel like heat moving down the body, followed by cold.
Sleep problems. This can be linked to hot flashes, because those interrupt your sleep.
Brain fog. Think: cloudy thoughts, trouble remembering words.
Depression and anxiety. One study from 2000 found that 38% of women in late perimenopause reported symptoms of depression.
“Gnarly” PMS. At least that’s how Dr. Gilberg-Lenz describes the heightened PMS symptoms. “I'm talking everything from bloating to breast tenderness, to mood and anxiety issues.”
Vaginal and urinary concerns. Women might experience vaginal dryness, painful sex, low libido, UTIs, and bladder leakage.
Irregular menstrual cycles. Your periods could get closer together or more spread apart. And they can change from being heavier to lighter — or the other way around. Some have said their periods looked like “crime scenes.”
Weight gain. Changes in women’s metabolism that might lead to weight gain can occur during the perimenopausal period, according to a study published this year. But fluctuating hormones aren’t the only causes. Aging, along with lifestyle and genetic factors, can also play a part. (But quick reminder: The number on a scale isn’t necessarily a measurement of health.)
A number of other symptoms that you might not expect. See: burning mouth syndrome, dry mouth, and dry eyes.
Are there any risks associated with perimenopause?
Chronic Illness. When you're in perimenopause, you could be more at risk for metabolic syndrome. Which signals that some chronic illnesses might be on the way. Think: heart disease, stroke, and diabetes. Not trying to sound the alarms, but you might want to consider prioritizing your health in this stage, if you aren’t already.
Osteoporosis. Dropping estrogen levels can cause bones to lose strength. But it’s hard to know whether you have osteoporosis before those weakened bones fracture, because there aren’t many symptoms related to the disease. So it’s probably not a bad idea to start strength training before you experience perimenopause symptoms.
Dementia. A new study suggests that women who entered menopause before the age of 40 were 35% more likely to develop dementia later in life. And “the rates of dementia in women is two to three times higher than [in] men,” Dr. Gilberg-Lenz says, adding that she’s encouraged by the fact that this kind of research is at least coming out. “The information is much more available now than it was 22 years ago when I finished my residency.”
What should I do if I think I have perimenopause?
Find out if you have a family history of early/late menopause. If you can ask your mom about when her symptoms started, go for it. It could give you a better idea of when you can expect symptoms. Dr. Gilberg-Lenz says she only learned recently that late menopause ran in her family. “At the age of 56, I'm weirdly still perimenopausal,” she says.
Find a doctor who’s knowledgeable. If you’re not comfortable talking to your PCP or OB-GYN about perimenopause, you can use the North American Menopause Society (NAMS) to find a Certified Menopause Practitioner (like Dr. Gilberg-Lenz) in your area.
Consider hormonal treatment. But keep in mind “there’s no one-size-fits-all solution,” Dr. Gilberg-Lenz says. Some people manage hot flashes and brain fog with supplemental progestin or estrogen pills and patches. And there are estrogen creams or tablets that could help with vaginal dryness. Thing to know: Although studies show that Black, Latina, and Native women might experience hot flashes and other perimenopause symptoms more often than white women, they’re less likely to be offered effective hormone replacement therapy. Of course: You should consult with your doctor before trying out a hormonal treatment.
If you’re into herbs, ask about botanicals. Doctors have mixed feelings when it comes to whether herbal supplements help women in perimenopause. Partially because supplements are regulated in a different way than other drugs. But Dr. Gilberg-Lenz, who’s a medical advisor for perimenopause and menopause wellness company Kindra, recommends chasteberry extract for PMS symptoms and Kindra’s vaginal lotion for dryness. “Magnesium, B complex, Vitamin D, Omega-3 fatty acids — these all can be beneficial to us in general,” she says. Again: This is something to discuss with your doc.
Be open to cognitive behavior therapy. Talk therapy can help you work through mood and sleep problems. And really could benefit people during any major life transition.
Prioritize movement and healthy eating. Because perimenopausal women can be more prone to certain diseases and changes in body composition than other people.
Know that there are several new perimenopause brands out there. Menopause has become a growing femtech market. We mentioned Kindra, which just launched a quiz to help women prepare for menopause. But there’s also wellness community Elektra Health, incontinence brand Hazel, menopause wellness company Evernow, telehealth company Gennev, and menopause care company State of Menopause, to name a few.
Follow new accounts on social. Dr. Gilberg-Lenz’s account is a good start. She also recommends taking a look at accounts including Hot Flash Inc, Queer Menopause, Menopause Society, Dr. Arianna, Getting Hotter, Dr. Sharon Malone, Hello Revel, Menopause Nutritionist, Coach Jolinda, Gabriella Espinosa, Mona Eltahawy, Wise Pause, and Loom.
Reframe the way you think about perimenopause. Reminder: Perimenopause is a normal life stage and, as Dr. Gilberg-Lenz says, not a disease to cure.
注释：
Menopause: n
表示“ 更年期”，means " the time in a woman's life in which the menstrual cycle ends“，如：Females in menopause gain weight and get hot flashes. 更年期中的女人会发胖，爱发火。
menopausal: adj. 表示“[生理]绝经期的；更年期的”.
Perimenopause: n
表示“ 围绝经期”，如：The perimenopause women are more easy to occure depression and anxiety disorders. 结论围绝经期女性更容易发生抑郁焦虑症。
Bootcamp: n
表示“训练营地 ”，means "camp for training military recruits “，如：One of his specialities and one of the specialties of this camp is poisons. 他和他的训练营地的一个特殊作用就生产毒药。
pathologize: v
表示“归于病态 ”，pathology 表示“病理学”; patholog表示“病理学”，如：Pathology is the study of disease. 病理学是研究疾病的科学。
patriarchal:adj
表示“ 家长的；族长的；”，means "relating to or characteristic of a man who is older or higher in rank “，如：He is notorious for its patriarchal behaviour. 他搞家长制作风是很典型的。
ageism：n
表示“ageism ”，means "discrimination against middle-aged and elderly people “，如：Ageism is a form of discrimination. 鄙视老人是一种歧视。
stigmatize: v
表示“ 污蔑；使蒙上污名 ”，means " mark with a stigma or stigmata“，如：Stigmatizing the car is the wrong battle. 把问题归咎于汽车是一场错误的斗争。
gnarly: adj
1. 表示“粗糙的；多瘤节的 ”，means "used of old persons or old trees; covered with knobs or knots “，如：Their gnarly horns make the buffalo appear so mean and aggressive, but their eyes tell a different story. 粗糙的角使水牛显得暴躁和具有攻击性，但它们的眼睛却述说着一个不同的故事。
2.表示“很棒的；够炫的 ”，means " great, wonderful“，如：Wow, man! That's totally gnarly! 哇，老兄，那真是太好了！
PMS: abbr.
表示“ 经前综合症 ”，means "premenstrual syndrome “，如：If you have PMS: exercise regularly, limit salt intake to reduce bloating, avoid caffeine to lessen irritability, and eat plenty of fruits and vegetables, If all else fails, consult your doctor. 如果出现经前综合症，那你就应该定期锻炼，少吃盐以减少肿胀，不吃含有咖啡因的食物以避免烦躁，并吃大量的水果和蔬菜。如果的有以上方法都没有效果，请向医生咨询。
Bloat: v
表示“使肿胀”，means "become bloated or swollen or puff up “，如：The planet's heated gases would have then expanded, causing the world to bloat.这个星球上的热气体会随之扩大，最后导致世界的膨胀。
Vaginal: adj
表示“ 阴道的”，means "of or relating to the vagina “，如：This lengthens the skin tube, which will be used to line the vaginal cavity. 这样一来就拉长了阴茎表皮管道，稍后可以用来当作阴道的内衬。
Libido: n
表示“性欲 ”，means " (psychoanalysis) a Freudian term for sexual urge or desire“，如：It is essential to your libido and sexual arousal. 这对维持你的性欲和性唤起至关重要。
Menstrual: adj.
表示“ 月经的”，means " of or relating to menstruation or the menses“，如：The first menstrual period, usually occurring during puberty. 月经初期第一次月经期，通常发生于青春期
Metabolism: n.
表示“新陈代谢 ”，means " the organic processes (in a cell or organism) that are necessary for life“，如：Their rate of metabolism may slow down. 他们的新陈代谢率可能会降低。
Fluctuate: v
表示“使动摇 ”，means " change continually or frequently“，如：Fruit prices fluctuate with the seasons. 水果价格随着季节波动。
Metabolic: adj.
表示“新陈代谢的 ”，means "of or relating to metabolism “，如：Such sites act as metabolic sinks. 这些部位起着代谢废物库的作用。
Osteoporosis: n
表示“骨质疏松症 ”，means " abnormal loss of bony tissue resulting in fragile porous bones attributable to a lack of calcium; most common in postmenopausal women“，如：Why is osteoporosis on the increase? 为什么骨质疏松的发生率不断增加?
Estrogen: n
表示“ 雌激素”，means "a general term for female steroid sex hormones that are secreted by the ovary and responsible for typical female sexual characteristics “，如：Estrogen hormone therapy advice is not yet uniform. 激素治疗意见尚不统一。
Progesterone: n
表示“ 孕酮；黄体酮”，means "a steroid hormone (trade name Lipo-Lutin) produced in the ovary; prepares and maintains the uterus for pregnancy “，如：Blood progesterone remains constant throughout pregnancy. 血液孕酮含量在全妊娠期保持不变。
Dementia: n
表示“ 痴呆 ”，means "mental deterioration of organic or functional origin “，如：Aging does not ineitably lead to dementia either. 同样，老化也未必一定导致痴呆。
Hormonal: adj
表示“荷尔蒙的；激素的 ”，means " of or relating to or caused by hormones“，如：Yet other herbs assist with the hormonal balance of the ascending form. 也有另一些药草是协助来平衡提升身体荷尔蒙的。
Progestin: n
表示“ 孕酮；黄体酮”，means "any of a group of steroid hormones that have the effect of progesterone “，如：Menopausal women who still have a uterus take a combination of estrogen and progestin.仍有子宫的更年期女性应同时服用雌激素和孕酮。
Femtech: n
表示“女性科技，指利用数字化技术为依托，以解决和改善女性生理心理健康问题为中心的一系列诊断工具、软件设备等产品与服务。”，means " Female Technology“,
Incontinence: n
表示“ 失禁”，means "involuntary urination or defecation “，如：What about my incontinence patient? 尿失禁的病人怎麽办呢?