Are you experiencing Pre or Perimenopause?

 Are you experiencing Pre or Perimenopause?

By E. Conrad Hicks, MD and Valerie Otto


As a healthy young woman in your mid-30s, you may not have thought about the “M” word (the other “M” word – menopause, not marriage!) Chances are that you don’t need to concern yourself with menopause yet, or worry that you won’t be able to have children, but you may want to be aware of how the transitional perimenopausal period (PMP) could affect you. By taking care of yourself now, your aging process will happen later in life and aging will be more graceful and less painful.

Although all health experts don’t concur on an exact time frame in which the symptoms associated with PMP begin, according to the World Health Organization, it can range anywhere from two to eight years before a woman’s final menstrual period and continue for a year after that. Other doctors say it can begin 10-15 years before the final menstrual cycle and end some time thereafter. Women often experience some kind of hormonal shift beginning around the age of 35. While it’s important to keep in mind that every woman’s pathway will differ, PMP can present a whole host of symptoms that are related to irregular fluctuations of hormone levels such as estrogen, progesterone and testosterone. There are ways to help create more balance in your life to mitigate the symptoms, but first, if you are in your mid to late 30s, taking this quiz could help assess PMP at this point in your life.

1. If you are not on the pill, have you noticed a change in your menstrual flow? (heavier / lighter, longer/shorter)

2. Do you tire more easily, even with enough sleep? Do you not bounce back as easily from a long trip or a night out?

3. Your PMS, once mild, is now much more uncomfortable and you’ve been considering taking something?

4. Do you find you don’t sleep quite as soundly, wake up during the night or require more sleep?

5. Are you not the tigress you once were? Has your joy of sex decreased? Are you less lubricated? (Unrelated to relationship issues)

6. Are your breasts much more tender or lumpy before your period?

7. Do you find yourself snapping at people and then are surprised you just did that?

8. Do you ever wake up in the morning or during the night and the back of your neck is wet and your pillow is moist?

9. Without drastically changing anything, have you found that your normal way of eating and working out doesn’t quite keep the weight off?

10. Are you moodier than you used to be?

If you answered, “yes” to three or more of these questions, you are most likely experiencing mild to moderate symptoms of PMP. There are some simple life style changes that will not only help mitigate or eliminate these symptoms but will also help you feel your overall best. You are in the prime of your life with youth on your side along with some acquired wisdom. Enjoy it all! It is also a perfect time to reevaluate your lifestyle and perhaps make some revision that will support your hormonal health and well being for the next decade to come. In many cases a well thought out diet, exercise program and supplement regime will do wonders to restore a needed sense of balance in one’s life. Beginning with diet, think about eating as having a specific effect on your moods and hormones. Pay attention to what effect certain foods have on you and eliminate those that make you feel tired, bloated, constipated or uncomfortable. Try to eat organic foods as much as possible – it has been theorized that pesticides and hormones in our produce and meats can cause estrogen dominance. Don’t go too low on fat and eat the right fats -- if you eat too little cholesterol your body won’t have the building blocks it needs to manufacture your ovarian and adrenal hormones. Generally speaking, avoid white foods such as white bread, sugar and white rice. They will wreak havoc with your adrenaline and cortisol levels that will throw the rest of your hormones out of balance. Don’t forget to include fiber, it’s important to eliminate and detoxify. Be cautious of all the hype around soy and stick to fermented products such as tofu, tempeh and miso. For weight control, many women respond better by eating more through out the day and very little at night (after 6).

Vitamins and minerals are very important. Key to hormonal health are Vitamin B’s (magnesium and B Vitamin insufficiencies may decrease the liver’s ability to successfully form estrogen conjugates) – a good vitamin B complex should be sufficient. Folic acid (500 mcg), magnesium 400-600 mg at night, calcium with a little magnesium for absorption (300 mg per day), Vitamin E (400 mg/day) and Vitamin C 500-1000 mg per day. Also important are primrose oil (1000 mg), and Omega 3’s such as flaxseed and cod liver oil (1000-3000 mg). If you have sugar cravings, 200-400 mcg of Chromium should help. Exercise does great things to help maintain and promote health. Your heart and blood vessels are strengthened, so blood keeps circulating throughout the body without as much effort. Risk of heart disease, high blood pressure, diabetes and breast cancer all decrease dramatically. Bones and connective tissues are strengthened (weight bearing) and will help maintain bone density. Exercise eliminates stress hormones from the body as well produces endorphins, which are natural mood enhancers. Stress can easily destabilize hormone levels. Exercise can also sooth PMS symptoms and cramps. Sleep quality generally improves and with more muscle mass you burn more fat.

For those women who need a little extra help, herbal supplements can do wonders for PMP symptoms. The one we like is Oöna, an all-natural herbal combination of black cohosh and chaste tree berry that has been shown to help the body adjust to the hormonal changes that take place during perimenopause, menopause and post menopause. Oona has also been shown to be effective in relieving symptoms of PMS. What distinguishes Oöna is that it is simple yet powerful formulation that is standardized. This means that it has consistent effectiveness in each does. Both black cohosh and chaste tree berry hold significant benefits independently but were chosen for their unique complementary effect. As a result, Oöna tends to offer relief soon than other competitive products as well as relief from a broader range of symptoms.

The most important thing to remember is that this is a great time to begin taking extra great care of yourself. Chances are you are used to taking care of everyone else. These are relatively easy, straightforward changes you can make – hopefully ones that will keep you on the path to wellness and happiness.