Emphasis on the PAUSE. This phase in a woman’s life can feel like an eternity. For those of us on the 10 year perimenopause plan it sure can feel overwhelmingly long and drawn out. For those of you that had one hot flash and then your period stopped. God-bless. AND know that you are not the norm.

I remember my first hot flash. Bless my innocent little heart, how cute I was being all hot and bothered thinking “that wasn’t so bad.” Now I get waves of nausea, followed by a volcano buildup that causes me to feel trapped in my blanket, clothes, skin; and then the flush, sweat, incredible heat. And then it’s over; until the next one. My periods used to last 7-10 days and I do believe my perimenopause is going to be a long haul as well.

Some days I think with despair “what happened to my body?” And other days I think in wonder “what an amazing thing this female body is.” The places she has taken me, the ups and downs, the interesting time of puberty, the highs of pregnancy, the years of bleeding with fibroids, the sweet relief of a hysterectomy, and the torments of peri-menopause. All changing my body. Pounds gained. Pounds lost. Pain. Relief. Beauty. Age. Fragility. Loss.

So what exactly is Menopause? Menopause is actually just a day that marks when you have gone a full year without a period. When you are no longer menstruating. The time “around menopause” is called perimenopause. It is the period before menopause when menstrual cycles and hormone levels begin to change and lessen, and prepare you for the transition to menopause.

For those women who have had a hysterectomy it will be impossible to know when exactly menopause is because your periods were stopped the day your uterus was removed. (Same for those undergoing treatment for female cancers, etc.) If your ovaries were removed or are not functioning then you are immediately into menopause because your estrogen factories were removed/damaged.

Women have multiple hormones coursing through their bodies. When perimenopause begins estrogen is lessening. (so is progesterone- the hormone that protects the lining of the uterus, and testosterone- yes women have testosterone) Estrogen is the biggie. With perimenopause lasting 10-15 years for some women, the changes can be subtle at first but as the decline in estrogen becomes greater so do the symptoms. Hot flashes (the most commonly discussed symptom), brain fog, adult acne, joint aches, vertigo, libido changes, vaginal dryness, dry skin and hair, skin sagging, wrinkles, fragile skin, pigment changes, hair loss (body, eyelashes, head), mood swings, irritability, insomnia, incontinence, inability to lose weight, belly fat, back fat, flabby arms, eyelids droop, upper lip disappears, and so on. It is amazing what estrogen is in charge of. She is the queen.

From the beginning of time women have been going to through menopause. From the beginning of time men have not had a clue as to what is going on. Let’s face it, men (for the most part) do not understand periods; they don’t really know what goes on during pregnancy except that they had a big part in it; they do not understand postpartum; and they certainly don’t know what is happening in menopause. But we can’t really blame men for their lack of knowledge, there hasn’t been much out there to find until recently. In fact, a lot of women relied on folklore and stories to understand what was happening in their own bodies. That is changing. The group of women who are hitting the 40-60 year age range right now are not going to go gently into this era. They want answers and they know where and how to find them.

For the entirety of modern western medicine women’s health has not been studied even a tenth of what men’s health has been. Medical studies have been done on while male subjects and if the health issue is a strictly female one then it just wasn’t studied. Traditionally medical school did not spend any time on women’s natural cycles. Even your OB/GYN doesn’t really know what all is going on during menopause. Until now. Women of today are demanding answers and not only that, they want alternatives to feeling the way their grandma’s did in silence.

So, what can be done? What can women do who are starting to notice some signs of peri-menopause? Read. Read everything you can about what is going on in your body. Study what estrogen’s role is in your body and what will change as she goes away. Seek professional help if your hot flashes awaken you at night making you a zombi. If you can’t sleep. If you notice any changes that are disheartening or painful. If you notice any changes in your mental health.

There are a lot of alternative providers out there right now because of the size of the perimenopause community and the way in which they are seeking help. My advice would be to use caution when seeking professional help/advice/care. A lot of providers are working out of spa/salon/plastic surgeon offices/wellness clinics, etc. They see the opportunity to make money and they see a very large group of women who are used to immediate gratification and they are banking on it.

Make sure your treatments make sense. For instance why do I need progesterone when I don’t have a uterus to protect? Why do I need testosterone replacement? Why would I allow someone (and pay through the roof) to insert a pellet of anything into my body that will release hormones at an uncontrolled level? Do I have breast cancer family history? Is my thyroid really a problem? or are you just throwing that medicine in the mix too? Just some examples of things to question as you pursue help.

Menopause isn’t all bad. It is the time in your life when you can throw caution to the wind and never need birth control again. You can get rid of the tampons you have stashed in every conceivable place. It is the time in your life when you realize that being alive is the prize. That not worrying about what others think is just so nice. That not counting every single calorie is OK too. It is the time when, once you get there, you won’t have fluctuating moods and hormone induced behavior. It is the time when you can be the one the young things look up to. It will be sweet when the heat waves are over and the belly fat is where it is meant to be, and the jiggly arms are more accepted and you are just used to them. Menopause and beyond will be great. If we don’t melt away before then.