Do you sometimes feel like your body is waging a war against you? Perplexed by weird body changes, symptoms and sensations like nothing you’ve lived through since puberty? Many of us “middle-aged” women live in fear that these shifts might in fact herald the arrival of … THE CHANGE. In an exclusive article for MumAbroad Life, Amy Harris, MS, RN, CNM, certified nurse-midwife and women’s health writer demystifies body changes and menopause. Her passion is helping teach women how to live their healthiest lives. Amy lived in Barcelona for two years where she started a freelance health writing business, developing health-inspiring content for international and multilingual health and wellness companies.
We have all heard the whispered warnings of how our body will someday shrivel up into a wrinkled mess of fiery hot flashes, be swept away by emotional tornados, or exhausted by sleepless nights and forgetful moments. Is it menopause or are your current weird symptoms just caused by the change in seasons, weathering the stress of a global pandemic, or navigating life as a “Mum Abroad”? Are you experiencing any of the following:
Don’t freak out…just because you might feel like the list above describes your body’s current state of affairs, does not mean you are going through menopause. The crazy-making variety of symptoms that women experience during the perimenopausal transition can be physical, emotional and mental. Falling levels of estrogen (or changing levels over time) are the culprit for all these symptoms, including the 10 less common symptoms of menopause above.
Menopause is clinically defined as that point in time when a woman goes an entire year without a menstrual period. Perimenopause is the confusing time women have to live through BEFORE menopause happens. It can last between 4-8 years. Most women experience symptoms beginning in their 40’s and the average age of menopause ranges between 50-52 worldwide. Menopause and its associated hormonal changes are a normal part of every woman’s life cycle, but one which each woman may experience differently.
The most common symptoms of perimenopause are changes in your menstrual cycles, hot flashes, mood changes, vaginal dryness and difficulty sleeping. Nearly ⅔ of women will experience hot flashes at some point during their menopausal transition. The frustrating part is that symptoms can come and go, be very bad for several months and then disappear altogether. It is enough to drive a woman crazy, literally.
Hot flashes (and many other perimenopause-related symptoms) are inconsistent because our ovaries do not decide to “close up shop” overnight. Instead, they gradually decrease the amount of estrogen they produce and every so often might be able to squeeze out an egg (and the accompanying burst of estrogen), relieving our estrogen-deficiency-related symptoms.
Some healthcare providers use blood tests to try to diagnose menopausal status, but unfortunately, your hormone levels fluctuate inconsistently over the entire menopausal transition. Follicle-stimulating hormone (FSH) is one of the hormones most commonly tested, but one month your FSH level might indicate you are “menopausal” and then the following month is back in a premenopausal range. For this reason, it is better to look at all of your symptoms and especially your menstrual cycle, to try to get a better sense of where you might be in your perimenopausal transition. The North American Menopause Society (NAMS) has a free online menopause symptom tracker or keeping a diary of what symptoms you experience, when, and at what severity can help you and your provider make sense of your weird menopause symptoms.
Keep in mind that perimenopause is the single biggest hormonal change in your body since puberty. We all remember (unless we have blocked it out) how traumatic and painful puberty was, so give yourself a little bit of leeway as you go through this next transition in your life. Try to go easy on yourself.
It can be confusing, especially in a foreign country as a mum abroad, with so many life changes, to try to puzzle out what is actually going on with your body. No wonder that so many of us struggle with mood changes, anxiety, depression, and anger during these years. Who wouldn’t be depressed or feel slightly crazed if they were faced by all of these changes in their body, coming and going without rhyme or reason, for 4-8 years?
Research has shown over and over that stress makes the symptoms of perimenopause worse. The more that you can do to try to build in self-care and ways for you to relax, the better you will feel. Take care of your mind and your body through mindfulness activities, meditation, yoga, exercise, and eating a healthy, well-balanced diet.
1. Misery loves company. Remind yourself that many other women are experiencing similar symptoms and struggling as well.
2. Perimenopause has an end. Whatever weird menopause symptoms you might be suffering through right now will not last forever.
3. Don’t be afraid to be honest with the people in your life about how you are feeling. Get support from friends, family, or a counsellor.
4. Empower yourself through knowledge. Seek out well-researched books about menopause like this list, and reputable websites such as Menopause Matters (UK), The Menopause Directory or the NAMS website. Be cautious reading online forums, social media posts, and internet articles about menopause that have not been reviewed by medical providers. Become an expert in your own symptoms by tracking them and noting triggers. You will feel more in control and less like the helpless victim of ruthless hormonal fluctuations.
5. Ask for help. Talk to a health care provider. This can be tricky in a foreign country as an expat, but fortunately, the International Menopause Society and the North American Menopause Society have online directories of country and region-specific associations of specially-trained menopause providers. Different providers approach the perimenopausal transition from different perspectives. Just like it was important for you to find a doctor or midwife you trusted when you were pregnant, you need to find a provider (or maybe more than one) who helps you to feel heard, supported, and empowered.
6. Build your menopause support team. Massage therapists, acupuncturists, yoga teachers, reiki practitioners, nutritionists, exercise trainers, sex therapists, mental health counsellors, and so many other complimentary and alternative types of providers may be able to offer you relief at different times in your perimenopause transition. Broaden your horizons beyond the medical management of menopause.
Ageism and sexism make us feel that we need to hide that we are going through perimenopause, but the cultural silence around menopause limits women’s ability to find strength, support, and inspiration from one another. Don’t let yourself be shamed into not talking about your menopause experience. I won’t tell you that you need to embrace and celebrate the changes happening in your body. I am trying, and I don’t always succeed, to see menopause as a normal part of every woman’s life that I can use to teach me how to be more connected, healthier and happier for the next chapter of my life.