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It can feel pretty shocking, to say the least.
By Kimberly Rae Dixon — Written on Aug 30, 2022
About six months after my son was born, I started to grow increasingly moody and forgetful. I was lashing out at my husband and my children over things that normally wouldn’t have bothered me, and I was constantly forgetting appointments and other commitments that I’d made.
My periods, which had returned to normal not long after giving birth, became heavy and irregular. On top of it all, I started to experience PMS symptoms before my periods that I’d never had in my 20-plus years of menstruating.
After several months passed and my symptoms showed no signs of easing up, I made an appointment with my doctor.
I'd recently had my fallopian tubes removed and was expecting her to tell me my symptoms were related to my surgery. After some blood work and an ultrasound, she offered a diagnosis that was completely unexpected, considering that I was only 33 years old at the time.
My symptoms were the result of early perimenopause. Chances are, I’ll experience early menopause, too.
Luckily for my inquisitive (and slightly anxious) mind, far more information about women's health is readily available on social media and the Internet than our mothers and grandmothers had access to in previous generations.
In addition, women seem to be talking to each other more openly and judging each other less about such topics, which makes it easier for those of us going through these changes to speak honestly about our experiences without feeling body or age-shamed.
So off to conduct research and find out more about what perimenopause means and what I could expect I went.
What is Perimenopause?
Before a woman enters menopause, the stage of life when she no longer has periods and becomes incapable of reproducing, her estrogen levels begin to slowly decrease. This stage of transition is known as perimenopause.
The hormonal changes occuring produce a range of symptoms that may include any of the following:
- Lighter, heavier, or irregular periods
- Worsening PMS symptoms
- Weight gain
- Headaches
- Breast tenderness
- Loss of bladder control
- Hot flashes
- Insomnia
- Low sex drive
- Vaginal dryness
- Inability to concentrate
- Forgetfulness
- Mood swings
- Difficulty conceiving
Different people might experience these symptoms differently. Often, the first sign of perimenopause is heavier periods that occur at irregular intervals, as well as spotting.
As estrogen levels decrease, more symptoms are likely to appear. Perimenopause usually lasts between three and four years, but for some, symptoms can last up to ten years.
Perimenopause vs. Premenopause
The terms perimenopause and premenopause are often used interchangeably when in reality, the two are somewhat different.
During premenopause, which occurs before perimenopause, some people experience changes in their periods or worsening PMS symptoms due to fluctuating estrogen levels. However, as noted in Healthline, most people experiencing premenopause won't notice any marked changes.
During perimenopause, estrogen levels begin declining continually and you begin experiencing symptoms of menopause, although menopause doesn't "officially [kick in until] the ovaries produce so little estrogen that eggs are no longer released."
Living with Symptoms of Perimenopause
For many of us, perimenopause comes with a feeling of incredible sadness and loss.
For women like myself who are diagnosed with perimenopause earlier than anticipated, it can leave us feeling shocked and uncertain about what lies ahead.
Although it doesn’t make conception impossible, perimenopause does make it more difficult. For those who are actively trying to start or grow their family, this may send them into a state of mourning.
While my husband and I have happily decided that we’re done having children, perimenopause has still taken its toll on me emotionally.
Although the physical symptoms are inconvenient and, at times, uncomfortable, it’s the mood swings that I find the most difficult to deal with — and I’m sure my family would agree.
Some days I’m happy, productive, and easy to be around. Others, I’m not.
I’m irritable, depressed, and anxious. I get frustrated with my children and I nag my husband. I hear myself doing it and it only makes me feel worse. I actively try to change my attitude only to find myself feeling worse as the day goes on.
Photo: Author
According to The North American Menopause Society, mood swings are common during perimenopause, though a causational link to clinical depression has not been established.
"It’s thought that these mood swings are related to the fluctuating levels of ovarian hormones during this transition to menopause. Plus, if a woman is not sleeping well due to night sweats, her mood would no doubt be affected, too."
"Women who had severe PMS in their younger years may have more severe mood swings during perimenopause," they explain. "Also, women with a history of clinical depression seem to be particularly vulnerable to recurrent clinical depression during menopause."
Coming to terms with the aging process isn’t easy, either.
When I was in my twenties, I never thought about getting older. Now, at the age of 34, I’m forced to realize aging is, in fact, inevitable, and it comes with many discomforts.
Physically, I feel okay most of the time. Symptoms like breast tenderness, cramping, and insomnia seem to be the worst about a week before my period. Hot flashes and night sweats are infrequent at this point.
Perhaps the worst (and most embarrassing) of my symptoms is occasional bladder incontinence. A simple sneeze, cough, or laugh often sends me running to the washroom to change my underwear.
Premature vs. Early Menopause
According to the U.S. Department of Health & Human Services Office on Women's Health, a woman has officially reached menopause once she has gone a full 12 months in a row without any bleeding or spotting.
Most women experience menopause in their early fifties. In the U.S., the average age at which a woman reaches menopause is 52.
Cases in which a woman’s periods come to a complete stop before the age of 40 are known as premature menopause, whereas menopause that happens between the ages of 40 to 45 is known as early menopause.
Early or premature menopause may occur due to external factors such as smoking, chemotherapy or pelvic radiation treatments for cancer, surgical removal of both ovaries (bilateral oophorectomy) or the uterus (hysterectomy), or certain health conditions, specifically:
- Autoimmune diseases, such as thyroid disease and rheumatoid arthritis
- HIV and AIDS
- Chromosomal abnormalities
- Myalgic encephalomyelitis/Chronic fatigue syndrome
In cases where no other cause can be determined, it’s often assumed that early menopause is caused by hereditary factors. Research has found that people who have a sister, aunt or mother who experienced early menopause are more likely to go through menopause early.
Although every woman reacts to menopause differently, symptoms may continue to last between four and five years after periods stop. Typically, symptoms begin to gradually ease up and become less frequent.
Getting Treatment for Perimenopause and Menopause
Treatment for perimenopause will vary depending on the symptoms and the level of discomfort they cause.
While many women don’t require treatment for perimenopause or menopause symptoms, if your symptoms cause too much discomfort or feel unmanageable, doctors may prescribe medications or other methods of treatment such as the following:
- Low-dose birth control pills or patches to regulate hormone fluctuations and tame symptoms such as hot flashes, mood swings, and irregular menstruation
- Antidepressants to treat hot flashes
- Vaginal moisturizers or water-based lubricants to decrease vaginal dryness and pain and discomfort during sex
- Estrogen creams, rings, or tablets for severe vaginal dryness
If you’re experiencing symptoms of perimenopause or early menopause, it’s best to speak with a doctor to discuss treatment options and rule out other underlying causes.
Based on what I’ve experienced with early perimenopause, I highly recommend reaching out for help.
Even though aging is inevitable, there’s no reason to suffer in silence or without the help of your doctor and medications that can alleviate uncomfortable, and sometimes painful, symptoms.
I’m so grateful times have changed and we are better, as a society, at talking about what are natural, universal experiences for so many of us.
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Kimberly Rae Dixon is a full-time freelance writer living in Calgary, Canada, whose work has appeared on sites including Parents and Explore Magazine. For more, follow her on Instagram.