Anger, fatigue, mood swings, memory loss, heat flickering, itchy ears, inability to fall asleep, loss of sexual desire, thinning hair, depression, weight gain, knee pain, knees, night sweats, incontinence.
These are perimenopause symptoms, or may be just occupational hazards in middle age.
With the convenience of Gen X and millennials in the 40s and 50s, they are ready to get rid of the stigma around menopause, and the time known as the shackles (called the perimeter) and instead support treatment. A group of influencers are pushing for dietary supplements and other products that they hope to help women through this stage.
But how do you know if you are in perimenopause?
Unlike menopause - by the definition of stopping menstruation - Perimenopause can be sneaky and difficult to determine. There is no confirmed test and dissolving symptoms with other factors can be difficult to treat. This is a way to resolve symptoms and consider treatment options.
When Michelle Rockwell began to struggle with sleep, perimenopause wasn't the first thing her primary care doctor suspected. "They said, 'You're too young,'" said Rockwell, 40, who started seeking medical services a year ago. "It's easy to relieve symptoms. Doctors will say 'just stress or anything else.'
Rockwell doesn't think her life is stressful - she works full-time as a forensic scientist, raises her daughter, and participates in weightlifting competitions. But she said something felt very wrong.
"Literally, I feel that way, I don't know who I am," she said. "I was thinking, I didn't know myself. Since then, I've figured out that we have these hormone levels and that it will affect your brain."
Rockwell saw two different providers - primary care physicians and a full-scale practitioner before finding a doctor specializing in menopause care online. The Menopause Association provides this online database of doctors who are trained and certified to treat menopause and perimenopause.
After a lot of course corrections and fine-tuning with experts, Rockwell is now using hormone therapy, which she says helps. "I feel better now than I have been in a long time," she said.
Monica Christars, PhD, deputy director of the Menopause Association, said GPs usually don’t have time to thoroughly evaluate their patients.
She said that experts not only have a better understanding of this situation, but are not limited by the same time.
Christmas says menopause is often considered an estrogen deficiency problem, but it is not necessarily the case. She explained that the transition to menopause is characterized by fluctuations in hormones, which is why many people’s experiences can be contradictory and difficult.
Christmas says: “For many people, the perimenopause is the most turbulent time.”
Christmas says once people enter this stage and enter menopause, when their ovaries no longer produce any estrogen, “many people actually feel much better.”
Furthermore, she notes that it is impossible to escape from the circumference of the overall aging process, which could be a period of major physiological changes. In addition, career, family, caregiving responsibilities, financial stress and middle-aged stress can be roller coasters of uncertainty and stress.
Christmas warns that having a certain acceptance of this chaos is a necessary condition to solve the problem. She said some of her patients told her: "You told me that these mood swings and brain fog are real, and I didn't imagine it, and that's actually enough for me."
Others will continue to seek treatment options. "Some people have few symptoms, if any," while others "may think of every possible symptoms. Most of us are in between."
Some clinicians recommend strategies to first test other conditions for the first time before considering whether perimenopause is the culprit.
"The 40s were an era in life where many different autoimmune diseases can begin to appear," said Nanette Santoro, a gynecologist in Colorado. Typically, other diseases may have symptoms similar to those of perimenopause -- many of which are easier to diagnose.
"I often do micro-checks to make sure there are no signs of early diabetes," Santoro said. She said thyroid problems can also occur during this time, as well as rheumatoid arthritis, osteoporosis, hypertension and fibromyalgia.
Mental health issues such as anxiety and depression are also worth considering.
Santoro said she is usually more inclined to test and treat these conditions than to measure hormone levels, which is not necessarily helpful. “If it’s not timing well with the menstrual cycle, you can get misleading tests, and even then you can still get misleading tests because they’re different every month,” she said.
Hormone treatments to treat particularly distressing symptoms such as severe hot flashes and cruel mood swings have caused a lot of debate in recent decades. While many menopause providers say it may be helpful for some patients and may even change lives, many stress the need for more research.
"I would love to say that hormone therapy reduces cardiovascular risk or cognitive decline in later life," said the Menopause Association's Christmas.
She said some evidence suggests that hormone therapy may have long-term benefits, but studies are not sufficient to accommodate all women who are perimenopause.
In 2002, the Women’s Health Program study stopped hormone therapy in participants due to concerns about the risk of cancer and increased stroke. But since then, scientists have reevaluated the data and can use new hormonal therapies.
As a result, many experts now say that past concerns about these escalating risks have been exaggerated.
"This is a low risk, but not zero," Christmas said. Clinicians warn that people need to consider family history and other cancer factors when considering hormone treatment.
Hormone therapy is not for everyone either. "I have patients who have tried hormones for a few months and then come back and say - we are doing other things," said gynecologist Santoro. Some patients complain about weight gain, breast tenderness or "all kinds of annoying symptoms of PMS."
Hormone therapy may be especially beneficial for those who arrive at the fence early in life. Krista Russell-Adams said: “It has been helping a lot.
Christmas said she prescribed other medication options to address specific symptoms. For example, frequent, heavy bleeding during the period (which may cause anemia and fatigue) can be resolved by birth control or IUD, and may even stop its period.
“I think it’s a really good way to deceive the menopause transition,” she said.
Some symptoms related to perpendicular may be related to the aging process. Studies show that in men and women, the jumps of aging are about 45 and 60 years old. “A lot of women will notice changes in their metabolism,” Santoro said. “This is not all menopause.”
Santoro said that due to these changes, it is particularly important to double down on healthy habits, including diet, exercise, and especially drug-resistant training, maintaining muscles and a healthy sleep. "What your mother told you was almost done," Santoro said.
Christmas advised her patients "to be very meticulous about what we are cheering on our bodies. As we get older, we never get another one."
She said those who can “get rid of not having that much exercise or eating anything we wanted when we were young” may have to make some major changes to keep fit.
She said these behavioral adjustments could have far-reaching effects that “just give someone a drug” would not match.