When I heard about perimenopause, the first thought I had was perimeno-what? A friend sent me an article about it 18 months ago describing the many things about this phase I could look forward to including things like this: ‘You may one day find yourself curled up on the floor in the bathroom, bawling your eyes out and wondering why you feel this way? Why is everything your loved ones do so irritating and why are you hiding in the bathroom for a good cry now?’ Needless to say, I was not thrilled about these future prospects. I already knew about menopause, had seen my Mom go through it and was not excited for what was ahead. To learn that perimenopause comes before menopause with it’s own menu of things to experience was something I’d never heard of.

Fast forward about 6 months… We were on an amazing trip to New Zealand and we’d just arrived at a new location on our itinerary. The hotel was not exactly what I was expecting and the city looked more like my childhood town (think: auto-parts store and strip malls) than what I was expecting… something more like Whistler, Canada. I was doing some mental gymnastics and trying to adjust my expectations but for some reason, I COULD NOT. Everyone else was happily settled in the hotel room, watching a movie after a long drive and I moved to the bathroom for what can only be described as the most epic crying episode of my life. I was quiet about it because I didn’t want to distress my kids but for real, it was quite an overreaction and not something I’d normally do. I came out 30 minutes later with bloodshot eyes and my husband looked at me like ‘what has happened to you?!?’

You know what had happened? Perimenopause. I just didn’t know it yet. I started feeling irritated about almost everything my favorite people in the world were doing for 2 weeks out of every month. When Covid hit in March, I thought maybe I was just feeling the frustration of everything that was happening… school at home, husband working from home, everything cancelled. Yes, that was also irritating but what I was feeling was like papercuts for days on an emotional level. By mid-April, I knew for sure that something was going on so I scheduled an appointment with my naturopath. We did hormone tests and my results were surprising even to my doctor. I was firmly in perimenopause.

It’s funny because I feel that at every juncture of my life as a woman, there was not a lot of dialogue to help me as I made the transitions. Starting my period was very weird and my Mom didn’t talk much about it which created the feeling that this new thing happening to me every month was something to not talk about, but rather, something to be embarrassed about. Pregnancy was very much focused on the baby, the nursery and new motherhood while the hormonal shifts that went along with that were brushed under the rug. I really could have used some support post-partum as I definitely struggled but I didn’t even know what to call how I was feeling. And perimenopause… I’d never even heard of it until that fated article my friend sent me.

Knowing about our bodies and normalizing the hormonal changes that all women experience is really important. The more I have learned about my own body has actually made me appreciate it so much more and helped me to overcome a lot of shame I felt through my teens and 20’s for things that are simply normal in a woman’s body. I mean, how amazing are our bodies?!?!

Instead of rambling on forever about my own experiences, I figured it would be helpful to get some real information on perimenopause from someone who’s educated in this area. I spoke to Dr. Camille Koontz at the Northwestern Clinic of Naturopathic Medicine in Bellingham, WA and here’s what she had to say:

1. What is perimenopause and how is it different from menopause? Perimenopause is the time of transition in a woman’s hormonal life from her fertile years to the time when she stops having periods completely. Once a woman has not had any bleeding for a year, she is by definition in menopause.

2. What are the signs and symptoms that signal perimenopause has started? Perimenopause starts when the ovaries start to make estrogen in less amounts, less reliably, and in different timings. We typically know this is starting to happen when periods start to change. There are some classic symptoms that often start showing up such as irritability, hot flashes, night sweating, weight gain, insomnia, and mood swings.

3. How can a woman tell the difference between regular hormonal fluctuations and perimenopause? By talking to their provider, they may need some hormone testing to confirm the cause of the changes in cycles.

4. What is the age range that this new stage of life can begin? It can happen early such as in a woman’s 30’s, however it is more reliably occurring in their 40’s or 50’s for most women.

5. In your opinion, what are the best ways to treat or ease the symptoms of perimenopause? Perimenopause can be a frustrating and uncomfortable time for many women. In my practice I see many overwhelmed, under-slept women who are feeling vulnerable about the new mood swings and weight gain. Don’t suffer alone! Get in with your Naturopath or other alternative holistic practitioner. There are herbal options to help balance hormones and if needed bio-identical hormones can quickly help a woman feel more like herself again. Strategies you can do right away: regular exercise including 2-3 days a week of strength training, hydration, get at least 25 grams a day of fiber in your diet, and practice sleep hygiene. Sleep hygiene includes the habits and behaviors around your sleep-wake cycle to optimize rest and reduce insomnia.
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Having that all spelled out so clearly kind of takes the mystery out of this whole phase right?  Hormonal shifts don’t need to feel like a dumpster dive into bad days and hating everyone you love. Getting the support my body was asking for helped me get on track (I’ve not arrived yet, according to my husband who is not so helpfully reading along as I write this) to being a nice person again. I hope you found this information helpful and that when you need hormonal support, you can connect with someone who will help you navigate this very normal phase of life.

xo Bonnie