After months of sleepless nights, heavy bleeding and raging fights with your significant other, you finally gather the courage to go to a doctor to get some answers. After reporting your long list of symptoms, you perk up in your seat, excited that you’ve taken the first step towards taking care of yourself, anxiously awaiting a solution from your doctor….
S/he looks at his watch, doesn’t order any lab tests, tells you it’s normal and hands you a prescription for an anti-depressant.
But you ask, “What about the heavy bleeding? I can’t sleep! The migraines?” “You’re telling me this is all in my head?”
The sweat starts pouring down your forehead onto your silk blouse and the tears come on like an avalanche. And you come to the conclusion, “Maybe I AM depressed!” Your doctor is halfway out the door and heading into the next appointment…You wonder if you could just stay in the room and roll up in a ball and cry in the corner.
Has this been your experience with your health and with your doctors’ appointments? It’s a little like being told you’re lost, but we’re not going to send out a search party, so just let us know when you make it back. But we can fly a helicopter overhead and drop you a few bottles of Prozac.
OK, so it’s obvious that your primary care physician and maybe even your Ob/Gyn aren’t much help, So what can you do to take control of your health condition? Is Perimenopause even real? Is there anything to do about it anyway? All of your friends seem to be going through this, so maybe it’s just normal?
Whatever your symptoms, it’s time to not settle for anything less than optimal health. Your body is trying to talk to you through your symptoms, so it’s time to listen in. So here we go…
The first thing you need is a good tracking device: A GPS for your ovaries.
Do you have any idea where they are or what they’re up to lately? Are they sleeping on the job? Or did they resign long ago? Or maybe they’ve been punching in overtime hours, and you know how costly those are. Let’s see what they’re doing and what effects they might be having on your overall physical, mental and emotional health. In order to do this, you’ve got to start listening to your body. How in the world do you know what’s going on with your ovaries? Don’t worry, I’m not going to ask you to have a gestalt-like conversation with your inner ovary. It’s really a rather simple task, just get clear on what’s actually happening with your cycles.
1.START HERE: DAY 1
Simply, start tracking your cycles. There are apps that can help you do this. Or, if you’re a low-tech gal then simply mark down the first day of your period every month, and call that DAY 1. Then count how long your period lasts (how many days you bleed). Frankly, doing this for a few months is enough information for the first level of perimenopause knowledge for you and your doctor. Counting from Day 1 to the next Day 1 will tell us how long–and how regular–your cycles are. A normal period is considered to be anywhere from 28-35 days. You’re bound to notice something here: that you actually skipped an entire month, or that every other cycle is longer, or that they’ve gotten much shorter than they used to be. All this is information about the hormonal balance in your body and will help with both perimenopausal diagnosis and treatment.
2. MAP THE ROUTE: YOUR PERIOD
Now track how many days you’re actually bleeding. This is one of the first things that changes in perimenopause. It’ll shift one way or the other. Either you’ll started bleeding more—maybe 7-10 days now, plus that horrendous 14-day flood after the holidays. Or you’ll barely have to use a tampon anymore, and breeze right through, wondering what your friends are complaining about. Yep, jot it all down.
3. CHECK FOR TRAFFIC: PMS
PMS, or Premenstrual Syndrome is that time, 7-14 days before your period starts. If you suffer from PMS, then you hardly need to see this, but here is a list of symptoms:
- Water retention
- Weight gain
- Early spotting (bleeding)
These symptoms occur when your hormones are not well balanced. And in your 40s some of these might sneak up on you without you connecting the dots to your cycles. Start noting these symptoms and add them to your tracker. Even just putting up a frownie-face emoji on those rough days might help you notice that your hormones are the driving force here, and that it’s time to cut yourself some slack. Insomnia, for example is a very common perimenopausal symptom, but if you’re like most 40-somethings you have so much to worry about, that you chalk it up to just having too much on your plate. And your doctor prescribed Xanax after all, so it must just be stress. So you blame yourself, tell yourself you shouldn’t be anxious and that you should be able to handle it all, so just deal with it. Then you wake up exhausted after yet another night of tossing and turning, blame your husband and lose your temper with your kids, all before the school bus even arrives. Yes, worse PMS is a sign of perimenopause.
4. CHECK POINT: OVULATION
The next question to ask is, “Am I still ovulating?” The official way to tell is with blood tests. The best time to have your blood drawn is around day 18-20 of your cycle (remember Day 1 = first day of period). Your doctor should order FSH, LH, Estrogen (total, and/or Estradiol), Progesterone, and Testosterone. Unfortunately, these tests aren’t always conclusive, because they just give a snapshot of that particular month. And you’re likely ovulating a few months on, and a few months off, or every other month now. In a normal cycle, you ovulate from either the right or left ovary on about day 14. Some of you can feel a slight twinge of pain, or notice a change in discharge, or you get a headache, your mood shifts, or you hear the PMS warning sign already. In my experience, only about 30% of women can actually feel when they ovulate, so don’t worry about it if you can’t tell. The cool thing though, about feeling when it happens, is that you can pretty much guarantee that you’re going to get your period 14 days later. Because the egg–or corpus luteum—that you just ovulated only has a lifespan of 14 days if you don’t have sex and get pregnant during that time period. (Yes, you CAN get pregnant during perimenopause!). So this step alone will help you avoid those surprise periods, giving you a 14-day lead time to stock up on tampons.
5. END NAVIGATION
OK, so that’s it, you’ve turned on your GPS and you’re tracking your ovaries. It’s important to do this for 3-4 months in a row, and frankly, until your periods stop and you’re menopausal. By turning on this tracking device, you’ll gain some awareness about your body and probably connect a few dots. The next step will be to list your symptoms and see where they fall in your cycle. You and your doctor can then work together to discuss appropriate treatment options to minimize your symptoms while you’re going through these murky perimenopausal waters.
Awareness is the first step towards change.
Let us know in the comments below how this was for you. Did you learn something about your body, or the body-mind connection?