Handling the Ups and Downs of Perimenopause

Let’s face it, perimenopause is hard. Between not knowing if you will have a cycle at all, when you will have it, how long it will be, how heavy it will be, and when you will finally get to the other side when menopause begins – it’s daunting to handle.

Every single health challenge you have had in your life may get slightly to significantly worse when your hormones decline. Hormones go up and down during perimenopause, but they also go up and down based on your diet, emotions, and stress.

I often tell my patients that during perimenopause, you need to slow down, get enough rest, and make more time for yourself. When you start menopause, you are either making cortisol or estrogen/progesterone and testosterone due to the conversion of your adrenal hormones to sex hormones. This is why you can’t do as much before feeling tired.

A lot of women think they need to jump to hormone replacement when they start perimenopause, but this can lead to health issues like cancer and clots if you begin too soon. If hormone replacement isn’t the answer, what else can you do to manage your symptoms and get your life back under control?

Learning about perimenopause, managing expectations, and listening to your body

Half of your stressors as a woman during this time come from your doctors, work environment, partner, and kids. Explaining something you can’t even explain to yourself is hard.

During perimenopause, you actually lose vaginal tissue. Without this knowledge, it is difficult to explain the consequences of losing vaginal tissue.

This is why I teach my patients to notice their body and symptoms without dismissing them – your felt sensations are telling you what you need to know. If you bleed right after intercourse, it hurts to make love, or you are not orgasming your body is trying to tell you something.

Seeing your gynecologist is a great idea if your symptoms are changing. Pushing through when things hurt creates more problems, such as vaginal or bladder prolapse. Ignoring the pain can lead to these problems and more.

I went through several phases where a different health challenge was front and center. Initially I had hot flashes and night sweats, painful intercourse, and serious depression. Then I transitioned into another phase with heavy bleeding, and another phase brought breast distension and tenderness.

Overall, my quality of life is good, but I’ve had to adjust things. I can no longer work long hours at my job, and I really prioritize resting at night to support my healthy adrenals and detox when needed.

Reset expectations around your schedule with work, family, friends, and yourself. Prioritize your time to take care of yourself and get enough sleep.

Tracking your cycle is the number one thing you need to do

Record day one of your period, the first day you bleed, with any symptoms you have and anything that relates to your health challenges. Because I prefer paper records over an app, I have four years of calendars with information about what day my period started and what symptoms I had on those days.

If I’m skipping periods, I go back to my last period and count out a normal 28-day cycle to determine if I might be ovulating, or if I might get a period. I use this tracking to manage anxiety around my cycle and tell me what to expect.

In consulting with my patients that I see by zoom for coaching around hormone strategies, I often have this calendar in their file. I look at it to help me figure out how to fix their current health concern.

The healing power of herbs and supplements

I am a very big advocate for natural methods that treat your symptoms through supplements and herbs. As a trained Chinese medicine provider, I often turn to these classical formulas that have been used for thousands of years to safely help women feel better.

I fixed my own significant health challenges fairly quickly – I was feeling much better within 3 months. My husband and I discussed what was changing in my body and started investing in the herbal formulas and supplements to correct it.

Herbs seem to be the missing piece in overcoming perimenopause symptoms for many women. These are the first tools you should use, and there are ways to evaluate your current supplement plan yourself.

Try to take a consistent protocol on time and keep notes with your tracker if you start something new or stop a product. Use my tool for self-evaluation to determine if you need help from me during this process.

If you find yourself stuck, since things change so much in this phase, then I suggest you schedule a 1:1 Functional Medicine appointment with me where I review your labs, symptoms, supplements and medications to help you make a new plan and stick with it until you feel better.

I have helped so many women to navigate this challenging time of our lives successfully and feel their best. I practice as an acupuncturist, herbalist and natural functional medicine provider in Lakewood, CO, and I also have been an expert in the online Perihub Community for the past several years. I am published in Chapter One of The Aargh to Zen of Perimenopause by Emily Barcley and the Perihub Experts, a great resource for learning about your perimenopause journey.