How do I know if I'm perimenopausal?

A few months ago a member in the Parenting Membership shared a whole bunch of symptoms she'd had, from fatigue to rage to dry eyes. She'd been on a four year journey to figure out what was going on before finding out that she was in perimenopause, and wanted to save other members from the same experience she'd had.

That sparked a huge discussion in the community, with other members wondering whether the symptoms they were experiencing were also related to menopause - and whether this was going to be yet another thing they were going to have to educate their doctors about to get appropriate treatment.

In this episode we answer questions about:

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• What roles do hormones like estrogen, progesterone, and testosterone play in our bodies?
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• What is menopause, and what is perimenopause?
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• What are some of the most common symptoms of perimenopause? (Hint - it isn't hot flashes)
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• What are the benefits of Hormone Replacement Therapy, and who should consider it?
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• Is HRT dangerous?
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• What impacts does culture have on the experience of menopause?
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In our next episode on this topic we'll look at a non-medical, holistic approach to menopause.

Dr. Newson’s books

Preparing for the perimenopause and menopauseMenopause: All you need to know in one concise manualThe Definitive Guide to the Perimenopause and MenopauseJump to Highlights

01:26 Introducing the topic and featured guest for this episode

03:48 Hormones play a crucial role in menstruation.

08:28 Dr. Newson explores the definitions and challenges of menopause and perimenopause, emphasizing the wide-ranging symptoms and long-term health implications associated with hormonal changes.

12:10 Dr. Newson discusses recognizing perimenopause symptoms amid busy lifestyles and the importance of early awareness, regardless of age variability in menopausal onset.

16:05 Dr. Newson explains how hormonal birth control can obscure natural hormone patterns, potentially leading to misunderstood symptoms like mood changes and reduced energy.

18:26 Women face challenges in receiving timely diagnosis and treatment for perimenopause and menopause symptoms, underscoring disparities in healthcare and the importance of seeking medical help despite societal barriers.

22:46 Hot flashes, often associated with menopause, are not the most prevalent or severe symptom. They result from brain disruptions and vary widely among individuals, with many experiencing cognitive and psychological symptoms instead.

27:28 Perimenopause and menopause often bring cognitive symptoms like memory lapses, tied to hormonal shifts that impact brain function, yet frequently disregarded in medical care and treatment.

33:41 Hormone replacement therapy has been found to be effective in managing menopausal symptoms and offering potential long-term health benefits, despite past concerns about risks associated with older synthetic hormone studies.

44:47 Hormone replacement therapy, especially with natural hormones, is often prescribed long-term for health benefits, contrasting with synthetic hormones implicated in higher risks from the WHI study.

47:43 Dr. Newson emphasizes that while non-hormonal treatments like antidepressants and therapies can alleviate symptoms, they don't address the underlying hormonal deficiency that hormone therapy effectively restores for overall health.

49:41 Jen and Dr. Newson discuss cultural views on menopause, emphasizing the need for accurate medical support over stereotypes or inadequate treatments like antidepressants.

57:21 Wrapping up the discussion

References

Attia, P. (2022, August 20). Menstruation, menopause, and hormone replacement therapy for women.

Carson, M.Y., & Thurson, R.C. (2023). Vasomotor symptoms and their links to cardiovascular disease risk. Current Opinion in Endocrine in Metabolic Research, 100448.

Cramer, D.W., Xu, H., & Harlow, B.L. (1995). Family history as a predictor of early menopause. Fertility and Sterility 64(4), 740-745.

Dominus, S. (2023, February 1). Women have been misled about menopause. The New York Times Magazine. Retrieved from: https://www.nytimes.com/2023/02/01/magazine/menopause-hot-flashes-hormone-therapy.html

Gilberg-Lenz, S. (2022). Menopause bootcamp: Optimize your health, empower your self, and flourish as you age. New York: Harper Wave.

Herstasis (2024). Menopause symptoms. Author. Retrieved from: https://www.herstasis.com/symptoms/

Kolata, G., & Petersen, M. (2022, July 10). Hormone replacement study a shock to the medical system. The New York Times. Retrieved from: https://www.nytimes.com/2002/07/10/us/hormone-replacement-study-a-shock-to-the-medical-system.html#:~:text=A%20rigorous%20study%20found%20that,a%20decrease%20in%20colorectal%20cancer.

Lobo, R.A. (2013). Where are we 10 years after the Women’s Health Initiative? The Journal of Clinical Endocrinology & Metabolism 98(5), 1771-1780.

Manson, J., Bassuk, S., Kaunitz, A., & Pinkerton, J. (2020). The Women’s Health Initiative trials of menopausal hormone therapy: Lessons learned. Menopause 27(8), 918-928.

Mosconi, L. (2024). The menopause brain: New science empowers women to navigate the pivotal transition with knowledge and confidence. Knox, ME: Center Point.

National Institute for Health and Care Excellence (2015, November 12). Menopause: Diagnosis and management. Author. Retrieved from: https://www.nice.org.uk/guidance/ng23/chapter/Recommendations

Newson, L., & Lewis, R. (2021). Delayed diagnosis and treatment of menopause is wasting NHS appointments and resources. Newson Health. Retrieved from: https://d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/632/BMS%20poster%20Louise%20Newson%202021.pdf

O’Reilly, K., McDermid, F., McInnes, S., & Peters, K. (2022). An exploration of women’s knowledge and experience of perimenopause and menopause: An integrative literature review. Journal of Clinical Nursing 32: 4528-4540.

Stute, P., Marsden, J., Salih, N., & Cagnacci, A. (2023). Reappraising 21 years of the WHI study: Putting the findings in context for clinical practice. Maturitas 174, 8-13.