Perimenopause: A Transitional Zone for Women

Smiling woman outsideI crossed the threshold to 40 this last year, so I figured I ought to figure out what I am in for hormonally in the years to come. Many women have heard the medical term “perimenopause” and wondered what it means and what to expect. I hope this article serves to assist those curious about this reproductive life stage by providing some information on how to manage mood swings brought about by hormonal fluctuations. It has also been informative to learn more about this stage for myself, a woman newly in the decade of “40-something.”

Just what is perimenopause? Experts define this period as the 10 to 15 years in a woman’s life preceding menopause (the cessation of menstruation). Therefore, perimenopause can begin in a woman as young as 35 or within a few months or years before age 51, the average age of menopause. With the increasingly delayed age of child-bearing becoming common news in the U.S., it is even possible for a woman to become pregnant while simultaneously experiencing perimenopause.

Physically, many (but not all) women experience mild mood swings, fatigue, hot sweats, and irritability during this transitional period. Studies indicate that a woman’s body undergoes just as many rapid hormonal fluctuations during perimenopause as she endured during puberty. Without getting graphically medical, we know that all the hormones in a woman’s body interact in a delicate interplay with the neurotransmitters of the brain that regulate mood (specifically serotonin). When hormones are rapidly fluctuating, it stands to reason that neurotransmitters can fluctuate in response or in conjunction with estrogen and progesterone and the amount thereof in the body at any given time. Suffice it to say that perimenopause can be a tumultuous time of “mood instability.” Furthermore, studies show that women who have experienced depression or anxiety during prior periods of reproductive life events (i.e. menstruation, pregnancy, childbirth, breastfeeding/weaning, fertility treatments, etc.) are more susceptible to depression and anxiety during perimenopause.

Marcelle Pick, RN, at Women to Women (womentowomen.com), who is a colleague of well-known author Christiane Northrup, MD, suggests a holistic approach to balancing out hormones. Good nutrition, appropriate sleep “hygiene,” exercise, and managing stress are essential during this time of hormonal fluctuations. Although I do not endorse her products one way or the other, she recommends various nutrition supplementation accompanied by herbal support. Omega-3 fatty acids are also recommended during perimenopause, according to Pick.

From a psychotherapy standpoint, I work with many women who are in the decade of “the change.” I like to empower women to celebrate the capacity for their bodies and minds to create, whether or not they have chosen to bring new life into the world. Women need to honor the ability for their bodies to create/adopt new life, as well as their ambitions and dreams. In addition, if a woman is perhaps mourning the lost potential to conceive a child, I will work with her via grief therapy and help her with lifecycle role transition. For those experiencing a very physical hormonal fluctuation contributing to negative mood health, I prefer to work closely with medical/ holistic practitioners to be sure my clients are receiving adequate hormone support, as well as the possibility of antidepressant medication if indicated. Managing stress and focusing on self-care is vital for women in this life stage, as in any life stage, but very clearly during a decade where there can be competing demands of raising children and caring for elderly parents, all the while nurturing a career.

Women are, through and through, nurturers, and I feel that careful attention to nurturing oneself as a woman, mother, spouse, sister, daughter, worker, etc., isvital to helping women through this transitional decade of perimenopause. Although potentially stressful and topsy-turvy, this period of life change can be one of transformation and hope for less stressful chapters in the years ahead as children mature, careers blossom, and finances solidify and grow. Many women also report a newfound spirit of confidence and liberation during this time, as prior notions of worrying about physical appearance fall by the wayside and and acceptance of the aging process proceeds. New priorities emerge, freeing up women to embrace their fullest potential.

It is an honor to work with women and their families throughout the lifespan, and it is particularly exciting to help women undergoing perimenopause accept and enjoy the change of life as a welcome transformation. I myself look forward to the possibilities ahead as I carefully place one foot and then the other across that marker that says “You have arrived! Welcome!”

Some helpful books:
The Menopausal Years: The Wise Woman Way, by Susan Weed
The New Natural Alternatives to HRT, by Marilyn Glenville
Homeopathy for Menopause, by Beth MacEoin
What Your Doctor May Not Tell You About Menopause by Dr. John Lee and Virginia Hopkins
Dr. Susan Love’s Hormone Book by Susan Love
Women’s Bodies, Women’s Wisdom by Christiane Northrup, MD
The Wisdom of Menopause by Christiane Northrup, MD
The Power of Perimenopause  by Stephanie DeGraff Bender, M.A.
Self-Nurture by Alice Domar, PhD
The Silent Passage by Gail Sheehy

For holistic health during reproductive life events, check out Women to Women at : www.womentowomen.com

Related articles:
Women Find Relief from Menopausal Symptoms with Mindfulness Therapy
Yoga for Balancing Mind and Body

 

 

© Copyright 2012 GoodTherapy.org. All rights reserved. Permission to publish granted by Andrea Schneider, LCSW, therapist in San Dimas, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Janine

    Janine

    March 1st, 2012 at 5:16 AM

    Oh wow I am there and believe me it is no cake walk. My family hates to be around me these days and quite honestly most of the time I don’t like being around myself either. But I don’t know what to do to deal with the mood fluctuations. I feel like I should be able to better control the things that I say and feel but that has not been that much of a success- just ask my husband and kids! Sometimes I hear myself saying things and thinking that this is not really me but I honestly don’t feel like I have any control over it. And I have tried talking to my doctor and he really has very little in the way to offer me. Help!

  • Racheal

    Racheal

    March 1st, 2012 at 3:15 PM

    What I wish for is for more men to understand the issues that we have to deal with. And we are expected not to complain and feel terrible? How? Most of us think that we are going insane instead of having a true understanding about the changes that our bodies are having to endure as we get older. I never try to make excuses, but it is awfully hard to deal with these constantly fluctuating hormones. Surely if they could live in our shoes for just a little bit they would understand.

  • EDEN

    EDEN

    March 2nd, 2012 at 5:18 PM

    Men are never gonna understand because it is beyond their capability to think like a woman or to feel things the way that we feel them. You can tell them until you are blue in the face what this is like and the things going on with you and still, they are gonna zone out and go to a happier place. Can’t necessarily say I blame them, but for once it would be nice to have a little support. This can be confusing for us too, and it would be nice to know that he wasn’t going to cut and run when the going gets extremely tough.

  • Sophia

    Sophia

    March 4th, 2012 at 8:25 AM

    Perimenopause. . . 10-15 years. . .is this what I have to look forward to?

  • Andrea

    Andrea

    March 6th, 2012 at 11:47 PM

    I think there IS hope, and learning more about holistic interventions can be very comforting and action-based for reducing symptoms. Psychotherapy is great as well for managing mood swings and self-care strategies….Andrea:)

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