My Perimenopause is Not Your Perimenopause

Calling out the BS

---

Trying something new! I recorded a voiceover of the article. Thought it would be a nice addition to the article to hear me read it instead of the AI voice. A bit of background static for not having professional equipment, but this is how we roll with it.

---

Every week, starting on Friday, I watch and wait for the following week’s article idea to rise to the surface. Sometimes, it comes from within, and sometimes, it’s prompted by something that happens around me.

The inspiration for this article came from a comment I saw on Threads that claimed that if we did “the work,” we would ease into menopause without symptoms.

As you can imagine, this victim-blaming mentality did not sit well with me. I call BS.¹

I think I’m going to change my tagline from “Perimenopause information that doesn’t bore you to tears!” to “Perimenopause information for women who hate BS!” I realize I no longer have the patience for it.

First off, a blanket statement like that is full of shaming women into thinking that they aren’t doing enough or doing enough of the right things to prevent symptoms. This is no time for shaming. Period. End of story.

How Health Works

People often view health as a single concept, but it actually encompasses multiple aspects. Usually, there are numerous factors that contribute to the development of diseases and conditions rather than just one cause. It's often a perfect storm of various elements, and we don’t always know which ones caused the thing that we’re dealing with.

In health, we can only control so much, and we can literally make ourselves sick trying to be perfect all the time and prevent everything under the sun from happening. We’ve known for a very long time how chronic stress affects our entire body and our body’s ability for reproduction.

There are so many factors and influences beyond our control that affect our path to menopause and beyond.

A person who makes such a blanket statement doesn’t understand how health works, let alone how perimenopause or menopause works and the influences involved.

This makes it sound as easy as if you just did everything correctly, you would breeze through your healthy life. That’s simply not true, overreaching, and impossible.

If there has ever been a time when our individual differences are evident, it’s now, during perimenopause. Numerous factors influence our health and perimenopause experiences, making each of us unique.

The themes are the same; our ovaries are retiring, but the individual elements are all different.

Let’s review some of the factors that create this diverse experience in women.²

Access to Health Insurance

Some countries provide health insurance as a government program, but in the United States, the government doesn’t provide health insurance (except for its Medicaid and Medicare programs for certain populations that qualify as well as a few other programs), so individuals must purchase their own health insurance either through their job or on their own.

This leaves large gaps of people without health insurance. People without health insurance often don’t access healthcare services until it becomes an emergency, which means they don’t have access to preventative services like screenings and exams that could identify issues early until it’s too late.

Studies suggest that women who are uninsured have more intense perimenopause/menopause symptoms than women who have health insurance.

A recent statistic says 25 million people in the U.S. in 2023 do not have health insurance.³ Being underinsured is also a problem in this country.

Impact of Race

There are different menopause symptoms attributed to different racial groups, which we are just now learning more about. Plus, it appears that these groups are less likely to receive treatment. This is a double whammy.

“Black women are significantly more likely to experience frequent hot flashes and night sweats than white women, and on average their symptoms last more than three years longer.” (Faubion, see footnote below)

When Black and Hispanic women went to their doctor with this symptom, they were less likely to receive a hormone therapy prescription, according to a study involving 300,000 midlife women veterans.

Baseline Health

By the time we’ve reached perimenopause in our mid-40s, we’ve had a full life.

Midlife is the time when decades of behaviors, both good and bad, can catch up to us. It may seem sudden that some of these health issues come up, but in reality, some have taken years or decades to develop. Take a kidney stone, for example. You may develop one that starts as a grain of sand and turns into the Hope Diamond over years, not giving you any symptoms until one day, bam, off to the ER in extreme pain.

If you already have a chronic health condition, this can have an impact on your perimenopause experience and vice versa.

If you have autism,

Sam Galloway (she/her) 💕

is a fantastic resource for how this may affect your perimenopause symptoms. Sam is the author of

The Autistic Perimenopause: A Temporary Regression

.

Effects of Trauma

Trauma has a huge impact on menopause symptoms, even if the trauma occurred during childhood (research ACE score, Adverse Childhood Experiences, to fully understand the impact).

Trauma and chronic stress may bring on an earlier menopause age and cause more frequent perimenopause/menopause symptoms.

Socioeconomic Factors

Access to income, housing, food, education, and healthcare is important for our well-being. Lower socioeconomic influences have been shown to cause an earlier menopause age as well as more frequent hot flashes, sleep disruptions, and an increase in dangerous plaque build-up in arteries that can lead to a heart attack or stroke.

Reproductive History

Studies have linked the age at first menstruation (younger than 13) to premature menopause. Older first menstruation, older age at last pregnancy, and breastfeeding have been associated with an older age at menopause.

Studies have also shown that the number of live births may affect your age at menopause by showing that women who have given birth to up to 3 children may have a later menopause age than women who haven’t given birth. The age of menopause increased with each live birth up to 3.

Environment

Green spaces, clean air, and other environmental factors also impact our perimenopause/menopause experience. Living in low particulate matter areas (those areas low in smoke, chemicals, and dust) has been shown to bring on menopause about half a month earlier than those living in high particulate matter areas.

Lifestyle Influences

Your lifestyle can be linked to the intensity of your perimenopause symptoms, and there is so much we can do within this category to help ourselves, but trying to be perfect about it and trying to control everything can cause additional stress to be mindful of.

The usual suspects, such as diet, exercise, not smoking, and sleep quality, play critical roles, but again, not all of these are under our control 100% of the time. We do the best we can do with what we have and where we are.

It’s never too late to adjust your lifestyle in order to support your health. Lifestyle factors can influence your perimenopause symptoms and overall health and life span.

Here’s the thing about lifestyle factors: You may already have good habits in place, but feel frustrated that you also struggle with some perimenopause symptoms. Please don’t have the “why bother” attitude that just because we can’t control everything, it’s not worth doing. Think of it as “If I weren’t doing these things to help myself, I’d probably be feeling worse.”

Another Substack author mentioned in an article that she fell recently and was so frustrated that she fell. She was feeling a little hopeless because she’s a fitness instructor and was a little shocked it happened to her. First off, it was her dog that pushed her off balance, and even though she got the wind knocked out of her, she got back up uninjured. I left a comment for her to give her some encouragement and explain that had she not been strength training all of this time, this story could have ended differently. I know women in their 50s who needed hip replacements from falling.

If you need help understanding which lifestyle activities can have the greatest benefit or how you can incorporate them into your life easily, consider scheduling time with me to get some guidance and talk about your concerns.

Your Perimenopause

These are just a few examples of the different types of factors that can impact our experience with perimenopause and menopause and make our experience different from other women's.

Your perimenopause is going to be different from my perimenopause, and that’s to be expected and respected. We all reach menopause in different ways and experiences.

Thank you for reading (or listening)! I know your time is valuable, so I appreciate you choosing to read this out of all the other options.

✨ For an excellent second opinion on this topic, please read the comment posted by Kat below.👇

Be well, stay cool…

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

Disclaimer, Content Use Policy, Privacy Policy

1. BS is abbreviated slang for bullshit.

2. Faubion, Stephanie. The New Rules of Menopause. Mayo Clinic Press, 30 May 2023. AND Cortés, Yamnia I., PhD, MPH, RN, FAHA, FAAN. “The Diverse Experiences of Menopause.” The Menopause Society. Practice Pearl. Released November 12, 2024

3. https://www2.census.gov/library/publications/2024/demo/p60-284.pdf