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.
And the signs can be easy to miss.
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?
Hormone shifts can start in your mid-30’s when ovulation becomes less regular. This results in lower progesterone levels which causes symptoms that can be subtle or hit you with the force of a Mack truck. Fatigue, mood swings, insomnia and irregular periods are some of the most common problems. And this can go on for 5-10 YEARS.
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. Keep a journaling 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. Your FSH level does not tell you anything about your specific hormone imbalances.
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. Simple changes such as avoiding alcohol and managing stress can make a big difference. 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. For example, a low progesterone problem can look like low thyroid and high cortisol can mimic low progesterone.
What’s the Next Step?
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.
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