Is Perimenopause Sneaking up on You??
13 Jan 2015

Is Perimenopause Sneaking up on You??

My client, Sarah, is ready to kill her teenage children. Her nerves are shot and her patience left the building long ago.

On the days she’s not in a murderous mood, she can barely drag herself out of bed.

And she is wondering what the hell is going on.

If you feel like your once-pleasant personality and your mojo have skipped town together, you’re not alone. The likely explanation is that perimenopause has kidnapped them.

Perimenopause is sneaky.

Some days she’s subtle, but other days she plows through your body like a pack of alien invaders.

AND she is the mistress of disguise.

Signs of perimenopause can start as early as your mid-late 30’s. While you’re in the thick of raising kids (or considering having more), your ovaries may be looking toward retirement.

Maybe you notice that you’re just a little grouchier or that your periods aren’t quite as regular. Your PMS symptoms, which were once mildly annoying, are now raging. You gain weight even though you’re exercising and eating right.

Is This Normal?

Hormones begin shifting naturally around the age of 35 when estrogen and progesterone start to taper off very gradually prior to menopause. Because this is usually such a slow shift, many women may hardly feel this change happening in their bodies. However, for many women, these hormonal shifts may overwhelm the body’s ability to maintain balance. The result is severe symptoms that can go on for years. There are some very lucky women who don’t experience any of this until much later…and their symptoms are mild or non-existent. That’s normal too.

Is It PMS or Perimenopause?

Many of the symptoms of PMS overlap with perimenopause. In both cases, hormonal swings are the culprit. The difference is that PMS happens during the second half of your cycle. Perimenopause symptoms can happen at any time. Keeping a journal of your symptoms may help you sort this out if you’re not sure what’s going on.

How Can I know for Sure if I’m in Perimenopause?

The short answer is…you can’t. Lab tests in perimenopause can be unreliable because your hormones are bouncing around constantly on any given day. A lab test only gives a snapshot of what’s going on, and results can vary depending on the timing of the test. Many a woman has been dismissed with “your lab tests are normal” when she is, in fact, in perimenopause. You know your body better than anyone, so don’t settle for this if you feel like something is off.

If you do have blood tests, your doctor will most likely test your FSH (and maybe your estrogen or progesterone levels). The closer your FSH is to 50, the closer you are to menopause.

It’s a Hormone Problem, not a Prozac® Deficiency

It’s important to recognize what’s going on because many a woman has ended up on antidepressants or sleeping pills because she (and her healthcare provider) did not recognize that these problems were related to a HORMONE IMBALANCE and not true depression. Antidepressants won’t fix the root cause of the problem.

Misbehaving hormones can often be corrected with lifestyle, herbal and nutritional supplements. In some cases, hormone replacement may be necessary, but that’s not usually the place to start. The first step is to get tested to see what your imbalance is. This is important because signs of imbalance overlap. Low progesterone can look like low thyroid; high cortisol can look like low progesterone, etc.

What If That Doesn’t Work?

If changes in lifestyle don’t help, then it may be time to test your sex hormone levels and your cortisol levels. High cortisol levels can keep the rest of the musicians in your body’s orchestra from playing their best, so it’s important to have a picture of how you handle stress and address that first. Testing can be done with saliva, blood or urine (there are plusses and minuses for each method). Knowing your specific imbalances allows your hormone care provider to create a unique management plan for you.

Dr. Anna Garrett


  1. Kim Bracey Says: January 15, 2015 at 1:29 pm

    I have considered seeing a functional m.d.nto get a more thorough going over and testing done to figure out exactly where I am deficient and how I can take the right supplements to treat the symptoms and underlying issue I’m having. Do you feel they can do a better diagnostic of what exactly you are deficient in than a regular GYN? If so, which tests outside of bloodwork could help answer this? I have only ever been prescribed BC to regulate and no addressing other symptoms (hair loss, etc) that could Im hoping be remedied by supplements, diet and lifestyle. I’m hoping this is not IT for me!

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