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Dr. Evans Tells it Like it Is...

Is it Perimenopause or PMS on Steroids?

Are you in your 40s and your PMS has made a comeback after 20 years of you living a relatively calm hormonally-stable adult life?  Have you been acting like a raging teenager, losing your temper with your kids, threatening to kill your husband, and almost losing it at work? And if you’re super-duper lucky, your teenage daughter’s periods are in sync with yours and the two of you are getting in to hair-pulling screaming matches every month. Or worse yet, she’s hormonally healthy and she looks at you with that condescending look, saying “Chill, Mom!” and you know she’s right, you’ve got to get a grip, but if you were only sleeping through the night…

Welcome to one of the possible signs of Perimenopause. Yep, it can be like PMS on steroids. And sometimes it seems to last all month long!

One of the trickiest aspects of Perimenopause is that your symptoms might be subtle, to the point of not really recognizing them as a medical issue. Either you haven’t even thought to mention it to your doctor, or you have and you’ve heard these responses:

  • “That’s normal”
  • “Have a glass of wine”
  • “You’re just stressed”
  • “Maybe you need to be nicer to your husband”
  • “Here’s an antidepressant”
  • “Here’s some Valium”
  • “You’re too young to have any symptoms”
  • “You’re getting old”
  • “I can’t help you”
  • “OK, well, see you at your next annual visit”

Since the first major sign of Perimenopause is a change in your periods—or to put it simply: bleeding more or bleeding less each month. They might be coming every 2 weeks and lasting longer, or there might be a month or two where you don’t get a period at all. And if you’ve started tracking (see GPS your ovaries) this has become evident to you. However, if you’re in your early- to mid- 40’s, your periods are probably still hitting like clockwork, but your PMS symptoms are what’s gotten out of control. Let’s look at some possible signs of perimenopause that disguise themselves as PMS one to two weeks before your period:

  • Headaches
  • Migraines
  • Painful, swollen breasts
  • Bloating
  • Water retention
  • Weight gain
  • Irritability
  • Anxiety
  • Anger, rage
  • Panic attacks
  • Insomnia: trouble falling asleep
  • Insomnia: waking during the night
  • Insomnia: waking and having difficulty falling back to sleep
  • Hot flashes or night sweats
  • Spotting before your period

For some of you, this is business as usual, you’ve suffered from PMS your whole life, but it has gotten worse lately. For others, it’s a whole new, hellish phenomenon that you never experienced in puberty.  Without some intervention, this could continue for another 10 years until the typical age of menopause at 51. That is, if you don’t end up in jail for spousal abuse or in the unemployment line after storming out of a business meeting. So it’s time to wake up and pay attention, because your body is trying to tell you something:

  • Your hormones are out of balance and there are solutions.

Awareness is the first step, and you’ve already taken that by connecting with us at The Hot Flash Movement. It’s important to declare that you’re not willing to put up with these symptoms anymore and to start demanding—and committing to—optimal health in midlife and beyond. I’ve seen too many women put up with perimenopausal and menopausal symptoms for far too long, so congratulations on taking the initiative to educate yourself and find solutions.

There will be future blogs addressing each of the above symptoms and the possible treatments. No bandaids or quick fixes here, but real, permanent get-to-the-root cause solutions.

Now you and I may never meet in person, but I’m going to do my best to listen to you and address your needs.  Let’s start now, by having you reflect on your situation and tell us your main concerns. I read and will respond to any comment below.

  1. What is the most confusing aspect about this perimenopausal time for you?
  2. What are your worst physical symptoms?
  3. What are your worst mental symptoms?
  4. What are your worst emotional symptoms?
  5. What professional help are you lacking?
  6. Anything else?

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I feel like a mess. This article describes exactly what I am going through. 20 years of calm adult life and then this. I’m now 46 and suddenly over the last six months I’ve experienced tons of angry emotions, panic, anxiety. It is confusing because I shouldn’t feel this way. This coincides with my change in periods. They are now heavier than ever, erratic, painful fibroids – I’ve never had spotting in the middle but I do now. I don’t know what to do.

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