The ( Not-So ) Merry-Go-Round of Perimenopause

Menopausal women get all the hype, but hormonal changes can start in your late thirties. Learn how to navigate the perimenopausal storm.

By Dondi Tondro-Smith

Menopausal women get all the hype—and for good reason. Hormonal changes can cause serious upheavals in a woman’s life. After all, hormones are, in part, responsible for our brain’s view of reality (i.e., our emotions) and our overall health and vitality. Simply speaking, hormone imbalances can rock your endocrine world! For the brave souls trying to achieve balance amidst this midlife transition, much can be done to support the body and mind and to decrease unwanted symptoms.

When we think about women nearing the end of their childbearing years, the archetypal image of a crone, or wise, gray-haired woman of wisdom, comes to mind. But in reality, the road to twelve consecutive missed periods, a.k.a. menopause, sometimes starts in your late thirties or early forties. During this phase, wavering ovarian function is responsible for spikes and dips in estrogen and progesterone levels. This uneven rise and fall of hormones can make you feel like your body is on a (not-so) merry-go-round. Some ladies feel crazed, thinking these changes are all in their head. For others, elongated cycles with heavy blood flow and short, sporadic, or missed periods, leave them iron-depleted or fearing a potential pregnancy. The broad spectrum of hormonally influenced symptoms—declining libido, bone loss, weight gain, hot flashes, night sweats, depression, and erratic mood swings—may necessitate treatment. Luckily, there are tools available to reduce and alleviate symptoms, promoting higher levels of health and sanity.

HRT (Hormone Replacement Therapy)

For decades, women coping with the effects of menopause have been prescribed non-human and plant-based hormones to curb symptoms. Babs Melka, pharmacist and owner of Roadrunner Apothecary in Jackson, says she fills an increasing number of prescriptions for hormone replacement. She stresses that estrogens (manufactured and compounded) need to be balanced with other hormones in order to achieve proper therapy. Melka explains, “When treating hormonal imbalance, there’s always the possibility of turning on cancer receptor cells that then aren’t being allowed to turn off in a natural fashion.” Yet sometimes the benefits outweigh the risks. A woman has to first assess her familial history and her predisposition to certain types of cancer before making a decision.

When people come to Melka with hormonal symptoms, she first suggests herbal supplement blends over hormone replacement. But if you want to take a more natural approach, ask your doctor about using plant-based hormones made from soy or yam and available in most health food stores. These bioidentical hormones are synthesized and mixed with enzymes that break the molecules down into the correct structure. Then they’re mixed into creams, oils, and sprays. But are they safer?

According to Sally Luke, a nurse practitioner in Wilson, “All hormones added to the body increase chances for developing cancer. The term ‘bioidentical’ does not mean ‘safe.’ Eighty percent of breast cancers have estrogen and progesterone receptors just waiting for stimulation.” Make sure you and your health care provider consider many modes of treatment before agreeing to hormone replacement therapies.

Environmental Factors

Man-made toxins in our environment can also disrupt the endocrine system. “In the past, thyroid-related imbalances of estrogen were generally a factor in pre- and post-menopausal women,” Melka explains.
“Alarmingly, though, the instances of thyroid conditions in newborn babies and young children are on the rise.”

Proper functioning of the thyroid gland is key to how our bodies navigate perimenopause, making iodine essential. Yet other elements can mimic iodine in the body, causing the natural element to leach from our systems.
Common offenders include the fluoride in toothpaste, bromine in pesticides, chlorine in the water supply, and fluorine in the manufacturing of plastics. Sunscreens containing tiny zinc and titanium particles, called nanoparticles, can act as endocrine disruptors, too. Chemicals from dryer sheets, clothing made from plastics, and the numerous creams we put on our skin (and our children’s skin as well) can also affect how symptomatic we become in perimenopause.

The Great Masquerade

When analyzing your hormonal health, physicians first review your body mass index, the type and quality of foods you consume, and your overall fitness level. Next, they also consider genetic factors that may influence your body’s reaction to these changes. And they don’t overlook mimicking symptoms caused from stress, heart disease, thyroid issues, depression, or chemical dependence. According to Luke, “You need to start with a full array of reality [to see] what’s really going on in that unique body.”

Claudia Welch, hormonal harmony advocate and author, explains that women are really good at mining their bodily resources and outspending their energy. Cate Stillman, an Ayurvedic practitioner based in Tetonia, Idaho, who has worked with Welch, concurs that bodily imbalances don’t just suddenly appear but, rather, build up over time. She explains, “During perimenopause, there’s a lightening up on our tolerance for imbalance … Perimenopause, and menopause, is a reckoning day for past patterns.
[During this time] a lot of people turn to herbs or pharmaceuticals when things get hard.” She has seen many clients that are depleted, both emotionally and physically, and lack integrity in their “life force” or prana. Stillman discloses that our M.O. as a society is a busy, stressful, wear-out-the-nervous-system vibrational pattern—one that we ultimately pay for as life moves on.

So are our habitual patterns worth our health?

By changing subtle patterns, we have the ability to completely alter our mental and physical experience. Stillman advises giving up wine, avoiding dehydrating drinks like coffee, and simplifying your diet to shift your field of interconnectivity. She asks her clients to make changes in their daily habits in order to achieve a default state of relaxation, ease, and ultimate energetic efficiency. She adds, “We are always in a state of transition. When we get attached to who we were, we create a lot of problems. If you’re trying to make a change by yourself, you’re making it harder.” Empower yourself by seeking out support groups in your community, or online, who are gracefully navigating their midlife transition, too.

The Eastern View

Acupuncturist Angela Tong speaks from the perspective of Chinese medicine: Women go through eight-year cycle shifts. Around the fifth or sixth shift, approximately age forty to forty-five, a woman’s kidney energy begins to decline. This shift in source energy produces the hormonal changes often referred to in Western medicine as a “hormonal imbalance.”
When this happens, inflammatory reactions become more pronounced.

The spleen may also weaken, affecting our digestive energy and sometimes resulting in food sensitivities or allergies. Tong lends insight: “That’s when we need to start addressing our diet and realizing … we can’t do what we did in our twenties.” She suggests watching our intake of dairy, wheat, sugar, alcohol, and caffeine. Not only do these foods weaken our spleen and further tax our digestion, they also add heat and inflammation to the body. She adds, “We can’t prevent the decline of kidney energy … that’s called aging. But we can minimize symptoms.”

The Mind/Body Connection

When we talk about hormones, we must also consider the health of the adrenals. And when we talk adrenals, we must talk about balancing the thyroid and hypothalamus glands. And then if we’re still talking, we cannot leave out the second brain—our intestines and digestive health. Dr. Jim Davis, a Driggs chiropractor well versed in naturopathic medicine and acupuncture, lays it out: “Everything has to do with everything. If you have a heart problem [for example], your hormones are not going to be in balance.”

Dr. Davis also suggests that the subconscious mind plays a major part in our body’s ability to heal and cope with internal imbalances. Deep mental patterns have just as big of an effect on our body as external influences. When we look at it this way, perimenopause becomes an opportunity to check in with our entire sense of life balance and to review how our lifestyle affects our relationship to spirit, mind, and body.

Perimenopausal imbalances can lead to discovery. If we use our midlife as an opportunity to practice aging and to aspire to greater health and understanding, we become masters of our own hormonal fate. Think of it as an array of tools in your pocket. Whichever tool(s) you choose ultimately gives you the power to face this change with healing grace.

Hey fellas …

Ever hear of andropause?

In midlife, men may experience similar symptoms to the perimenopausal changes in women. Yet gradual declines in testosterone can be easy to miss. According to Dr. Jim Davis, fatigue is often the first symptom. As testosterone naturally declines in middle-aged men, the production of estrogen increases, sometimes leading to hot flashes, pronounced physical and behavioral changes—not just in sexual desire—and a decreased desire to participate in what once brought fulfillment.

Do you have the same passions, or has a state of lethargy become your norm?

If your waist has expanded, yet you’ve changed nothing in your diet or routine, a decrease in testosterone may be the culprit. Testosterone levels are measured by a blood or saliva test. But testing isn’t always accurate, since testosterone metabolizes quickly, so talk to your doctor first. And if someone at the gym suggests a testosterone supplement to keep those muscles from going south—think twice. Prescribed testosterone can lower sperm count, affecting reproductive health. Lastly, it’s important to determine if a low testosterone level is due to normal aging or an underlying disease.