Am I Experiencing Menopause or Peri-Menopause?

It’s confusing, isn’t it? Unless you read up on the difference between menopause and perimenopause, or you have someone mention the term perimenopause to you, many women are left in the dark. “Wait — What? — Perimenopause?” Wondering what I’m talking about? Not sure if I mean irregular periods or foggy brain? Or is it the calm before the storm or the storm before the calm?

It’s not surprising that so many women don’t know the difference between the two phases and more so, what’s happening in their body. For so long such discussion was confined to the private sphere of home-life and even then dialogue was often minimal. Publicly, anything to do with women’s bodies, particularly around menstruation, has been hushed, shamed or misinformed.

Clearly, this needs to change. It’s long overdue for women to feel comfortable to not only talk about the changes happening in our bodies but to embrace and celebrate the transformation, or as Dr. Lara Briden (see more below) calls it — the recalibration.

What is menopause?
One of the most misunderstood facts about menopause is when it occurs. Most people think menopause is when a woman’s reproductive hormones are decreasing; she’s having hot flashes and the rhythm of her menstrual cycle is all over the place. When in fact, that’s PERIMENOPAUSE.

A woman enters menopause when she has experienced one year without a bleed.

The chaos of perimenopause
Generally, perimenopause begins with an irregular menstrual cycle which you’ll most likely start experiencing in your 40s and for some, your 30s. Most of the chaos of symptoms occur during the perimenopause phase which can be two to twelve years away from menopause. I know, right? This totally changes how most of us talk, if we talk at all, about menopause.

As I mentioned, menopause is the phase one year after your last period where symptoms have usually settled down. Another misconception is that our hormones such as estrogen, progesterone and androgens like testosterone slowly decrease throughout perimenopause when in fact, what we know is that a woman’s hormones go on a roller coaster ride from high levels to low levels — up and down, up and down.

Explaining perimenopausal symptoms
Perimenopause comes from the words Peri meaning about/around, Menos meaning month and Pause meaning cease.

As you move through perimenopause (if you’re not one to simply flow through the changes with very little symptoms) you may experience:
● Irregular periods
● Heavy periods
● Tiredness
● Breast tenderness
● Fuzzy head/thinking
● Headaches/migraines
● Hot flashes and night sweats
● Vaginal dryness
● Uterine bleeding problems
● Sleep disturbances
● Water retention
● Mood symptoms, including anxiety and depression
● Painful intercourse (dyspareunia), or
● Other problems.

In an interview with the ABC, Dr. Rosie Worsley, an endocrinologist from Jean Hailes for Women's Health explains that ‘for the 20 percent of women who experience moderate to severe symptoms of perimenopause, the symptoms can often come in waves…What's happening during this time is that your hormone levels are fluctuating wildly, so sometimes you have super high levels of estrogen and progesterone, and other times you have practically none at all.’

This means that ‘sometimes you can have symptoms of excess estrogen, like real breast tenderness, and then other times you've got symptoms of estrogen deficiency, like hot flushes’, says Dr Worsley.
What can I do if I’m in or approaching perimenopause?

“It’s just menopause, deal with it.” “Your symptoms will pass, you just have to wait.”

That just doesn’t seem to cut it, does it? It angers me that this is what women consistently still hear when they turn for help during perimenopause. It’s simply not the truth. There is much we can do to smooth or ease the ride. The 20 percent of women who are experiencing moderate to severe symptoms throughout perimenopause need to be heard and taken seriously. In fact, each and every woman going through the change has an opportunity to embrace greater connection, understanding and love for their body. Together, we can start by changing the perception of and the knowledge around the change. Thankfully, there are many expert practitioners in the field of holistic health that are listening and showing women ways in which they can smooth the ride of perimenopause and menopause.

Doctor Lara Briden, Naturopathic Doctor and Evolutionary Biologist, is an industry leader in women’s health and in particular, reproductive health. Dr. Briden explains that ‘contrary to current medical belief, your estrogen is probably not on a slow, gradual decline in your 40s. In fact, it would be a lot nicer if it was (read more in ‘Low-Estrogen Type of Perimenopause’ on her website). Instead, it’s fluctuating wildly. It’s soaring to levels that are almost twice what you had when you were younger—only to crash down again to almost nothing. (And then to do it all over again the very next month.) I call this the estrogen roller coaster of perimenopause, and it’s very unpleasant.... If you work now to reduce estrogen spikes, then your estrogen receptors can more easily adapt to the permanent decline in estrogen that’s coming in your fifties. In other words, if you treat perimenopause now, you’ll have an easier menopause transition later.’

Which is why we need to be talking about perimenopause and bringing it out in the open. There needs to be a shift in the way we use pharmaceutical drugs— that the use of such drugs are informed by the latest research of what’s actually happening in women’s bodies rather than simply trying to control them or further exacerbate the roller coaster ride and then suffer the side effects. There needs to be more education and awareness about the option to use bioavailable/bioidentical drugs and natural medicines that look to balance a woman’s system rather than bandaid or disrupt it.

The use of Complementary Medicine for perimenopause and menopause
Complementary medicine focuses on supporting women to prepare for perimenopause and menopause and to learn more about what’s happening physically, physiologically, mentally, emotionally and spiritually. For example, Dr. Briden explains how to use diet and natural progesterone) to transition and recalibrate gently and smoothly. Click here to link

There are also many highly beneficial complementary medicine modalities that support women through perimenopause and menopause such as Kinesiology, Naturopathy, Western Herbal Medicine, Homeopathy, Acupuncture and Osteopathy. As a Kinesiologist, I often see women coming in unsure and unsupported. However, once they begin to understand more about what’s happening from a holistic perspective, supported with some beautiful balances and given tools to use at home their experience of perimenopause and menopause can be transformed.
Look out for my next article when we explore the spiritual and energetic side to the change.

If you’re nearing or in perimenopause or menopause you don’t have to do it alone. There is help out there for you. And lastly, let’s start talking about it. Start by sharing your story or ask the women and girls in your life about their story because this, our bodies and our shared experiences is OUR STORY. One that we can embrace and celebrate.

Resources for further reading

● The Period Repair Manual by Dr. Lara Briden
● The Wisdom of Menopause eBook by Dr. Christiane Northrup
● Jean Hailes for Women's Health

By Kate Pamphilon