Thursday, July 18, 2013

Perimenopause: What's Going On?

Image by Coffeelatte.
I have long known that night sweats,  mood swings and crying jags were signs of menopause. I also knew that 51 was the average age that women experience menopause.

But I still was blindsided at age 49.5 when the first dramatic symptoms showed up.

It was the fall of 2011.  I was 49 years old, closing in on 50. I had experienced some subtle changes to my cycle for years prior, so I was already describing myself as perimenopausal.

Then the subtlety ended.

Night Sweats. One night that fall, I woke up to discover that my palms were soaking wet.  I was still groggy from sleep, so I was wondering if I had somehow dipped my hands in a basin of water. Then I noticed that my scalp was drenched.

From hearing others' talk, I expected to sweat under my arms and on my torso. I expected to feel on fire from head to toe. It took me until the cold light of day to conclude that my wet palms and soaked scalp were my version of "night sweats."

Sleep Disorder. I only experienced night sweats four or five times that fall. However, my ability to sleep my regular 7 hours was severely compromised.  I either had trouble falling asleep or had trouble staying asleep. Too often, I was trying to function on a mere 3 or 4 hours of sleep.

Mood Swings. I am an extrovert and a compulsive talker. I am also a bit dramatic. These traits served me well when I gave college lectures on American and world literature. Over 30 years of teaching, my students' evaluations of me were filled with adjectives such as "energetic, animated, entertaining, engaging."

Less charming is my hypoglycemia, which can include irritability if I go too long without food. Another negative: my longstanding anger management problem. So add dramatic mood swings from hormone changes to the mix, and the result was a firestorm of emotion.

That fall, I was often at the extreme end of the spectrum of emotions: not just happy, but effusive. Not just angry, but livid. Not just sad, but brokenhearted.

Mental Fog.  My core identity is bound tightly to the traits of "bright" and "articulate." So when I started having problems concentrating, I really got upset. Multitasking was nearly impossible. Even without the menopause affecting my mind, my hypoglycemia---if I go too long between meals--also affects the ability to concentrate. Also, women and men 40 plus start showing signs of cognitive slowing.

I didn't realize that shifting hormones also affects the ability to concentrate until it started happening to me.

Sleeplessness, hypoglycemia, age-related cognitive slowing, mood swings, AND hormone-related cognition problems?  For much of that fall, I really struggled when faced with complex mental tasks.

In addition to all my responsibilities of wife and mother, I was taking two graduate classes and working with the children's program at church. I kept forgetting things. I had poor conentration.  I ended up dropping one of my classes and asking to be released from my committee assignment because I just didn't have the mental capacity for these additional responsibilities.

My Response.  Every woman should work with a medical professional to choose a response that works for her.  I am not going to dictate a specific course of action.  I am not a medical professional or a menopause expert. But I do believe in the power of personal narrative, so I will share my approach.

In talking with my physician (who incidentally is a woman), I discovered that I could experience these and other symptoms for 3 to 5 years. Also, my symptoms were just a handful of many possible symptoms. Yes, some women take vitamins or hormones (and there are various types).

When I have a physical complaint, I prefer to first alter my diet and to increase my exercise. I found that when I was particularly struck by symptoms, I could manage them if I went to the gym for an hour in the early morning and an hour in the evening.   I also increased my intake of whole foods and decreased processed foods.

I was used to being responsible primarily for others from 5 am to 10 pm. However, perimenopause forced me to spend more time on self-care, to set priorities so that I could scale back, and to surround myself with people who offered me comfort and support.  

Support women through all stages of hormone changes.
Photo by Velovotee.
Teen girls struggle with hormone changes, and we support them. Pregnant women struggle with hormone changes, and we support them.

Likewise, midlife women struggle with hormone changes, and we have a choice to support them.

Too often people assume that midlife women will take care of everyone else without declaring their own limits and needs.  Midlife women are smart, strategic, and strong, but they are still human.

Fortunately, my intense symptoms dissipated after about four months.  But I'm not done yet. At 51, I still have a fairly regular cycle. So I am looking over my shoulder, wondering when these symptoms might hit again. It may be another half decade before I move through the most dramatic part of the change to cessation. Next time, I won't be so disoriented. I hope.

After maiden & mother comes crone.*
After the roller coaster that was Fall of 2011, I am better prepared with a strategy that works for me and better able to offer compassion to other women entering perimenopause for the first time.

Thank you to all those who serve as midwives to me when I moved into adolescence and when I moved into motherhood.

And thanks to those who are attending the birth of my emerging wise woman. 

 I look forward to returning the favor by offering compassion to women going through periods of dramatic life change -- hormone fueled or not.

(*Psychologist Carl Jung describes these three stages of a woman's life by using the archetypes maiden, mother, and crone. For him, crone is a positive term. Our youth-obsessed culture has disparaged the power of post-menopausal women. Some are trying to reclaim the term and reinstate the powerful roles that older women can play in our society. I'm one of them.)

There are several midlife bloggers who write about perimenopause and menopause.  Here are a few blogs to get you started. 

Ellen Dolgen: Menopause Awareness Expert.

Barbara Younger: Friend for the Ride.

Magnolia Miller: The Perimenopause Blog (She has a great blog roll.)

Healthline's List of the 13 Best Menopause Blogs of 2013. (Ellen, Barbara & Magnolia plus 10 more.)


Tip-of-the-Tongue Syndrome


  1. Karen, thanks very much for this post--it's thoughtful and honest and helpful!

    1. Thanks for reading. I figure forewarned is forearmed. I had read about menopause prior, but (like labor and delivery), it's really not something I understood until I get there. May all the women in your life be blessed with easy transitions into adolescence and through menopause (and when the time comes for your girls, into motherhood).

  2. I have been going through menopause for 10 years now. We are all different. We all progress on our own time table. Great post!

    1. Ten years! Maybe my doctor knows this and didn't want to discourage me. Wow. Hang in there.

  3. My husband asked me to describe my menopause symptoms. I said: "Imagine that you arrive at the grocery store and as much as you try - tug, rattle, jerk - you cannot get a single grocery cart to let loose from the cart stand. Then as you're watching, someone comes along and with one gentle swoosh takes a cart. you either want to kill them or cry hysterically. That's menopause."

    1. That sounds like a reasonable explanation to me, Kim!

  4. My description of "anger management issues"? I felt like I would have to start killing people! That's when I knew I needed help!
    I found my estrogen patch to be the PERFECT solution.

    1. I haven't talked to anyone who has used the patch yet. Thanks for the insight about its effectiveness.

  5. Thank you for sharing your experience. I can relate. I had early menopause at 44, after having peri-menopausal symptoms from age 38. I was not expecting everything this soon! I am 2 years post-menopausal, and still younger than some friends who are going through it now in their 50s. All my menopausal symptoms were severe. As a student, however, having brain fog and tip-of-the-tongue incidents can be annoying.

    1. Hugs to you, Koko. I am just now seeing this comment. I'll tweet a thanks to you, also.

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