Women Are Suffering Silently From Perimenopause. They Don’t Have To.
Women make up half the population, yet they aren’t believed or get the help they need to overcome the detrimental effects of perimenopause.
A few weeks ago, I turned 50.
With that came a whole set of symptoms. I felt faint, dizzy, and couldn’t write due to brain fog.
I’d go blank, unable to recall what I said a few minutes ago. I thought it was early-onset dementia since my dad had succumbed to it.
It was difficult to get through the day because my head was pounding. I felt like insects were crawling all over my body. I felt low, so low I couldn’t concentrate.
There was a knot in my throat, and one innocent comment from my husband would set me off in a rage or make me sob till my eyes puffed up.
It was only when I started experiencing hot flashes that I suspected it was menopause.
I called my gynecologist and explained my symptoms. The next available appointment was in a month. In the meantime, he said to try a herb known to help with hot flushes.
What the fuck.
Peri…what?!
What I had was actually perimenopause.
I knew menopause happens at about 50 and it comes with hot flushes, but didn’t know anything about perimenopause.
Women around me, including my mom, didn’t talk about it. It isn’t a subject of conversation among my 40-something girlfriends, either.
Like me, they had no idea that perimenopause is the final phase leading to the end of the woman’s reproductive life or menopause, which starts when you haven’t had your period for a year.
And that it typically starts in your 40s and could last anywhere from a few months to about four years.
It comes with fluctuating hormones and mental and physical symptoms that are bad enough to send almost 90 percent of women to their doctors.
That’s baffling, isn’t it?
That the doctor wanted me to wait a month to get help for a condition that was so severe that I felt like I was losing my mind.
That most women have no clue their massive hair loss, dry hair, or pain during sex could be perimenopause. Or that their memory loss doesn’t mean they have early on-set dementia.
I mean, women make up half the population worldwide, and one billion women around the world will have experienced perimenopause by 2025.
One billion.
And 85% of women experience menopausal symptoms. So why aren’t they getting the help they need?
Hoping to be believed
Well, there was no way I was going to live like this for a month.
I called my gynecologist again, begging to get an earlier appointment. Luckily, there was a cancellation for the next day.
My doctor is friendly and open to suggestions. He was there when I gave birth to my son, and I trust him.
I started by telling him I had hot flashes and night sweats. I was dizzy, light-headed, and feeling down. And I was pretty sure it was perimenopause.
He said hormone replacement therapy (HRT) is recommended only for severe symptoms, but there is a herb that helps with hot flushes.
I thought, damn it, not again, are you kidding me?
Well, I was determined to leave with HRT. I had done my homework. It was time to put on a show.
I was moody to the point of wanting to strangle someone, I said. Down, no depressed, that I had to lay in bed all day. I couldn’t take care of my little son. I didn’t feel like myself anymore.
I felt like jumping in front of a car. I had more than ten hot flushes a day. I felt dizzy, light-headed and couldn’t function.
The doctor kept saying, “Okay…okay…okay…”
Then I heard the magic sentence: “I think you need hormone replacement therapy” — I felt like I had won the Golden Globe for Best Actress.
The scary truth was, all those symptoms weren’t exaggerated — not one bit.
He prescribed a low dose of estrogen in the morning and a progesterone to take before bedtime.
There are two issues with perimenopause, I realized. 1) It takes a good actress to get the help you need. 2) Many women fear HRT because it’s associated with a high risk for breast cancer.
But most of that has been debunked, this Medium writer told me. Thanks to her, I started researching this further.
This New York Times article helped me understand how miscommunication and the media blowing it up led to many women objecting HRT and doctors not recommending it.
The NAMS (The North American Menopause Society) guidelines also suggest that the benefits of hormone therapy “outweigh the risks for women under 60 who have hot flashes and no contradictions”.
So, I was confident I was making the best choice for myself.
The estrogen gel’s effect was immediate. Brain fog, along with my headache, cleared up like light breaking through a cloud. The side effect is sleepiness, so I haven’t been able to write as much.
Nevertheless, I now feel like myself. It’s known to take about two to three months for it to work fully. And it has alleviated my symptoms by 90% in only a few days.
Menopausal women are suffering silently
I can’t help but wonder how many women must be suffering needlessly because their symptoms aren’t taken seriously or because doctors don’t know HRT has been debunked.
Like this one Medium writer who had to wait six months to get the care she needed. I responded to her article about perimenopause, and she responded:
I had to wait six months — three to argue with my original doc to give me a referral to see a OBGYN who specializes in perimenopause and then I had to find a new doc because she just wouldn’t agree to it, go see THAT doc, THEN get a referral, then wait another three months to see the OBGYN. Ugh. I have another one who put me on a wait list for a year!
Well, our inkling that medical care providers don’t seem to believe menopausal women or see them as needing urgent care is not an exaggeration.
Rebecca Thurston, a professor of psychiatry at the University of Pittsburgh who studies menopause, said it well in an interview with The New York Times.
Menopausal women don’t get the help they need because there’s “a high cultural tolerance for women’s suffering” and therefore, “it’s not regarded as important.”
I totally agree.
It’s like there’s a plaque plastered on our foreheads that says, SUPERWOMAN. But even a superwoman needs help.
Surprisingly, medical schools may not devote sufficient time to menopause education, leaving some healthcare providers without the necessary knowledge to effectively diagnose and treat menopausal symptoms.
Every woman is different, so the symptoms vary. Some women feel nothing, some can’t function. No matter what, no one should have to soldier on with the 33 symptoms that come with perimenopause:
Allergies, anxiety, bloating, breast tenderness, body odor changes, brain fog, burning mouth syndrome, depression, digestive issues, dizziness, electric shock sensations, fatigue, feelings of dread, formication, hot flushes, hair changes, headaches/migraines, incontinence, insomnia, irregular heartbeat, irregular menstrual cycle, irritability, itchy skin, joint pain, loss of libido, mood swings, muscle tension, night sweats, oral problems, paresthesia, vaginal dryness, weakened fingernails, weight gain, osteoporosis.
Can you imagine working with most or some of these symptoms daily?
I work from home, so I’m luckier than menopausal women who work in an office. They have the added burden of having to deal with workplace stigma around perimenopause.
What’s the solution?
Most likely, a woman will come to learn about perimenopause only after experiencing the symptoms herself, mostly because, for whatever reason, it’s taboo.
Luckily, she’ll have a doctor who believes her symptoms and gives her the attentive care she needs.
Unfortunately, most of the time, some doctors still think HRT is dangerous for women and that their suffering is not that bad.
Usually, it’s up to us to educate ourselves and forge on with confidence when face-to-face with a doctor.
There are organizations dedicated to educating women about perimenopause and how to talk to doctors, so I encourage women to utilize that.
Don’t give up. Get the care you need. Write about it, talk about it, and don’t be afraid to ask for help.
This story by guest writer was first published on Medium.com on March 29, 2023. https://medium.com/bitchy/perimenopause-the-secret-no-one-not-even-women-talk-about-16f11815431e
I was lucky to have really great care 20 years ago because the author of a groundbreaking book lived in the next town over. Even so, I just found out listening to Dr. Mary Claire Haver's podcast on Diary of a CEO that estrogen loss may be a reason for tinnitus and frozen shoulder, which I had during perimenopause! So grateful to all the women writing about this here.