But Why... Perimenopause?

Answering the big questions

Other than educating women about the mysteries of perimenopause, there’s nothing I like more than answering the variety of questions I receive about it.

This stage of life can bring a range of physical and emotional changes, and I get great satisfaction in providing clarity and support to those seeking answers about symptoms, management strategies, and overall well-being during this time.

It makes me feel like the big, protective older sister.

And let’s face it, at my age, I am. The average age of menopause in the U.S. is 52, and I’m a few years older than that.

There aren’t many of us left at my age who are still getting regular-ish periods. As someone called me on IG Threads, I’m a “Geri Peri,” a geriatric perimenopausal woman. I just love this, and it’s cuter than the name I came up with, “Elder Peri.” It’s like how doctors use the term “geriatric pregnancy” for pregnant 36-year-olds.

Today’s article tackles some keep-it-real questions about perimenopause - because if you’re going to go through this midlife drama, you might as well go through it with your big sister.

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But why do I feel so awful and not like myself?

Your body is used to a predictable pattern of hormones. In perimenopause, your hormone patterns are all over the place.

But why?

Your ovaries and brain are running the show and rely on each other for signaling. This is not just a reproductive thing; our brains are involved. In perimenopause, your ovaries start to release eggs less frequently.

But why?

To put it nicely, your ovaries are aging and are running out of eggs. The less dense with eggs your ovaries are, the less the ovary is able to get the egg ready to be released. It’s like baking biscuits, and they need each other’s support to grow.

But why?

When you don’t release an egg (ovulation), it causes a ripple effect with your hormones and other chemicals, affecting not only this current cycle but also the next one.

Your body is trying to process these changes the best that it can, but until it can adapt and adjust, our bodies can be greatly affected. Things can go haywire, like our temperature regulation (which you probably didn’t give much thought to before perimenopause), your nervous system, your immune system, and your digestive system.

It all can be affected by this wild variance in our hormones.

But why don’t my pants fit?

Midlife weight gain is frustrating!

Our metabolism slows down, yet our appetite stays the same. Our sleep can be interrupted or non-existent, making us want to eat ALL the things.

We lose muscle, and it’s harder to gain when we attempt to build it up, which also impacts our metabolism.

By the time women reach perimenopause, we are burnt out. We’ve pushed through so much and demanded so much of our bodies that when the hormonal stress of perimenopause hits and we lose the protections of our normal hormonal shifts, our bodies can trigger stress more easily.

Stress has all sorts of impacts on our bodies, including weight gain (or loss).

As we age, it may become more tempting to sit on the couch than to exercise or go for a walk. We start to slow down, and maybe we don’t even notice because it happens gradually over the years.

Perimenopausal women are busy with careers and taking care of their families. We’re so used to putting others first that we forget our own needs, and sometimes, we neglect to move, take breaks from sitting, or find time to go for a walk. When was the last time you sat on the floor?

Declining estrogen shifts our weight from our thighs and hips to our belly, changing our shape and how clothes fit. Pants that used to fit fine may not fit the same even if the weight on the scale hasn’t changed.

But why do I have to take progesterone with my estrogen HRT?

If you have a uterus, progesterone is always prescribed along with estrogen as part of your hormone therapy plan because it stabilizes the uterine lining and helps prevent uterine cancer.

Unfortunately, the medical world found this out the hard way when the rates of uterine cancer and uterine lining growth spiked prior to 1980 when they realized that estrogen given without progesterone was causing this. Since then, they have always been prescribed together.

The answer back then was to perform a hysterectomy. The hysterectomy rates have been declining since introducing taking progesterone with estrogen, although this is only one of the reasons why.

For a perimenopause history lesson or to learn how your mother’s perimenopause experience may have been different from your own, read my article Totally 80s Perimenopause.

But why do I just want to face-plant on the couch after exercising?

Perimenopause is stressful for your body. Exercise is stressful. These two things put together, especially if intense, can exhaust you. Use your body as a guide. With some experimentation, you’ll find what works for you and feel energized instead of spent.

Pull it back a notch, properly fuel and hydrate your workout, and know your limits… more is not better.

And if you’re starting a new routine, my best advice is to go slow. Start with walking first and build up. You’re not in a rush, and this isn’t a contest.

But why don’t my friends have the same symptoms as I do?

If there’s ever been a time to realize how individual we are, it’s during perimenopause. We all react to it differently; however, at some point, we’re all going to reach menopause.

They don’t know exactly why one woman could have debilitating symptoms, and her friend could have mild symptoms, but the working theory is that it depends on how sensitive our bodies are to the changing hormonal landscape. The more sensitive our brain and body are, the more symptoms we may have.

This falls in line with my experience. I’ve always been in tune with the ebbs and flows of my body during my cycle, even being able to determine when I was ovulating (which I recently tested during a vaginal ultrasound when I told my doctor I was ovulating and she confirmed it during the exam) and I just “knew” when I became pregnant.

However, there are other possible explanations, such as genetics, heredity (your mother’s experience could be similar to your own and can be a clue as to what to expect), and the big one…. stress levels. Stress plays a large role in symptom intensity.

I hope these answers bring you a little comfort and validation of what you’ve been experiencing. This information is just a small fraction of my perimenopause iceberg of knowledge.

If you have a question that wasn’t answered or need ideas to feel better, consider scheduling an appointment with me using my HIPAA-compliant client portal or signing up for a monthly or annual paid subscription to participate in “Ask Away Wednesdays” (& receive bonus content).

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Thank you for being a reader!

Be well, stay cool…

Shelby Tutty, MHA
Certified Perimenopause Educator
Founder of The Periprofessional, LLC

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