Why everyone is talking about perimenopause
It seems like a lot more of us are talking about perimenopause and I for one, am here for it.
For too long have women and people AFAB have been kept in the dark about the changes that occur during this time.
First things first, what is perimenopause and how is it different from menopause?
Perimenopause: is essentially the process where our reproductive years come to an end.
Menopause: lasts for a single day and is marked by the one year anniversary of our last menstrual cycle. If you don’t know when that is, you’re probably with 99% of the population on that one.
Post-menopause: Is then anytime after our the one year mark of our last menstrual cycle.
How is peri-menopause characterised?
Perimenopause is often referred to as puberty 2.0.
It is not a random chaotic hormonal fluctuation but actually is a sequence of events prior to menopause. It often starts with high estrogen levels coinciding with low levels of progesterone. This is due to the body trying to increase estrogen in an effort to keep releasing eggs.
Progresterone is largely produced as a result of ovulation. If less eggs are released there are less progesterone available in the body in relation to estrogen.
Next we move into a state of low estrogen and low progesterone.
Why does this matter?
Receptors for estrogen are found on every cell in the human body. It doesn’t just play a role in fertility and the menstrual cycle. It impacts quite literally all of our systems and therefore impacts our heart health, brain health, bone and muscle health etc
Progesterone also impacts other systems in our body and often try to even out the responses to estrogen. For example, estrogen is anabolic aka helps muscle growth, progesterone is catabolic which means it aids in muscle break down. So when we have high levels of estrogen and low levels of progesterone, our systems can sometimes begin to feel out of balance.
What are the symptoms of perimenopause?
Mood and sleep disturbances
Hot flashes and night sweats
Migrains
Vestibular disturbances and vertigo
Migraines
Heavy and painful periods
Irritability and mood changes
Swollen and painful breasts
Variable menstrual cycle lengths
Brain fog
Changes in metabolism and weight distribution
Loss of libido
Pelvic floor symptoms such as increase in leaking
What can I do to help?
Not all people going through the menopause transition will experience perimenopause symptoms.
20% of women will breeze through it with no symptoms, 20% will experience severe symptoms and the rest are in between.
But if you are one of the women experiencing distress and bothersome symptoms there are things to help.
First things first, to figure out if symptoms are related to perimenopause, track your cycles. I cannot emphasise this enough.
Apps such as the Balance app are designed to help track symptoms directly related to perimenopause and menopause. It then creates data in which you can share this with your GP.
I would also read up as much as you can about this time so you are educated about your options. The New Menopause by Mary Clare Haver, The Menopause Brain by Lisa Mosconi and The Hormone Repair Manual by Lara Briden are great places to start. Knowledge is power and it can also take away the fear of the unknown.
If you want HRT, I believe all women are owed a conversation with their GP about options for hormone therapy. There are some brilliant doctors in Geelong who are open to this conversation.
If you are unable or do not wish to do this it doesn’t mean there isn’t anything you can do to help. HRT can obviously provide huge relief for women experiencing bothersome symptoms around this time, but lifestyle, diet and our active stress management techniques can also play a huge role in how we experience menopause.
Why do women’s health physio’s care so much about perimenopause, isn’t it all about the pelvic floor?
Yes, our expertise lies in the pelvic floor. But we know that hormonal fluctations directly impact pelvic floor symptoms.
And perimenopause and hormonal transitions are women’s health issues and we are passionate about providing the best care to women.
We also know that how you feel day to day can directly influence your pelvic floor symptoms. For example. if you come to see us because you have stress incontinence. We may ask you about hormonal changes and symptoms related to this. if you are experiencing hot flashes and night sweats and you aren’t sleeping, this is likely to impact how you feel, what you eat and how you move your body throughout the day. If you aren’t as able to eat well and can’t exercise because of fatigue, this can impact your bowel function and lead to constipation. Chronic constipation has been shown to be a driver of stress incontinence.
If we didn’t ask you about your hormonal health, we wouldn’t get to the driver of your issue!
We hope this sheds a bit of light on the changes that occur during perimenopause. At Kin Physio we have a deep understanding of the hormonal changes that occur during this time and are here to support you through it!
