You've Arrived

What happens when you reach perimenopause

But first, an announcement…

Last week, I mentioned the U.S. government’s new menopause training course for physicians, nurses, and pharmacists, and how this is an indicator of interest and need among clinicians for this education.

More good news! The Menopause Society announced yesterday a $5 million anonymous grant to help support their mission of education through their NextGen Now training initiative. The Society is “committed to reaching 25,000 healthcare professionals within the next 3 years,” with the knowledge, tools, and support needed in order for them to support midlife women patients. You can read more about it in their press release.

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How Did I Get Here?

Every single day, more and more women reach perimenopause and begin asking that infamous question, “What the heck is going on?”

With symptoms that feel like they popped up “all of a sudden” and are totally confusing (it’s like your body doesn’t know how to function sometimes), it’s no wonder we spend countless hours trying to figure out what’s going on (hopefully I’ve saved you at least a few hours!).

The average age of women entering perimenopause is 45. This means that 50% of women are in perimenopause upon reaching 45, but it can start earlier or later.

If your doctor tells you you’re too young after 40, that’s incorrect. Women reach menopause most commonly between 46 and 58 (although 90% of women are menopausal by 55), so any age after 40 is not too young for perimenopause. And reaching menopause at 46 is also not considered “too young.” If you’re a paid subscriber, I answer this question of what’s considered too young for menopause.

Early perimenopause starts with subtle changes that you may or may not begin to notice or associate with perimenopause. The process starts when you begin to stop ovulating regularly, which means that the hormone progesterone stops being produced. This begins the cascade of irregular ovulation, fewer periods, and then menopause.

When you’re born, you're born with millions of eggs that eventually dwindle down from age or being used in pregnancy or ovulation. At menopause, you’ll have about 1,000 eggs or fewer left.

I’m Here; Now What?

If you’re just starting perimenopause, you’re probably wondering what to expect going forward. Everyone is different, but after talking to so many women about this, I see the same trends repeatedly.

In early perimenopause, you may not see any changes to your period yet, but it’s also common to notice that they start to come closer together. If you feel like you’re starting another period and you just wrapped one up, this may be a sign (especially over 40) that you’re starting perimenopause.

Here are some other things you may notice:

• Night Sweats
  I’m in the process of preparing a survey about this, but I’ve been noticing a trend that more women develop night sweats before hot flashes. Hot flashes usually begin a little later in the perimenopause process (they typically aren’t the first symptom, but can be). My opinion is that night sweats can start in early perimenopause.

• Colorful Blood
  While you may be used to seeing dark cherry-colored blood during menstruation, you might begin to notice unusual blood colors in early perimenopause, such as orange, brown, pink, and purple. Each type indicates something different, as outlined in the book In the FLO by Alisa Vitti.

• Intensive PMS
  Another first symptom may be that you notice an intensification of your PMS symptoms. Look for more cramps, super tender breasts, hyper mood swings, ravenous hunger (hungry horrors!), and bloat, to name a few.

• Increased Migraines/Headaches
  If you already suffer from migraines, you may experience an uptick in the frequency or intensity of them. If you’ve never suffered from migraines, you may get your first one. Increased headaches may also pop up now.

• Increased Allergies
  Have you developed a sudden sensitivity to products you’ve been using forever? Do you notice more seasonal allergy symptoms? These can both be related to early perimenopause.

• New Intolerances
  Maybe it’s coffee or alcohol, but all of a sudden, these things don’t make you feel good anymore and become more trouble than they are worth.

• Increased Chronic Illness Symptoms
  If you feel like you’ve been doing a good job managing your chronic illness and then find yourself in an unexplainable flare-up, it may be because you’ve reached perimenopause.

• Mood Changes
  Sudden anger in perimenopause was nicknamed “perimenopause rage.” You might find yourself laughing one moment and crying the next. You may also cry about things that wouldn’t normally move you to tears. I’ve cried at strangers’ graduations on YouTube that I just happened to stumble across.

• Sleep Issues
  Sleep issues during perimenopause often involve waking up in the middle of the night and struggling to fall back asleep or waking up too early. If you have difficulty falling asleep, it may be a sign of insomnia. Your doctor can diagnose that for you.

• Feeling Pregnant
  Because our estrogen levels can spike 2 - 3x higher than normal in perimenopause, you may start exhibiting typical pregnancy symptoms like nausea, vomiting, swollen breasts, and food aversions. You may develop a crazy strong sense of smell, too. If you’ve been pregnant, it’s not unusual to experience those symptoms you had when you were pregnant. And, a reminder, that you can still get pregnant in perimenopause, so continue to take precautions if that’s not your goal.

You’ve Arrived

You’re not losing your mind. What you’re experiencing marks the start of important hormonal shifts that touch every cell in our body. These changes might surprise us in the most interesting ways! From mood swings to fatigue or shifts in appetite, these hormonal fluctuations bring along a mix of emotional and physical experiences that can sometimes feel new or unexpected.

If you’d like to learn about all of the phases of perimenopause, read my article The Musical Dynamics of Perimenopause.

Understanding this process can help you navigate the transition more smoothly. That’s what I’m here for! 👇

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I’m a peri-pro! Trying to figure out perimenopause on your own?

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Be well, stay cool…

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

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