Perimenopause: How women can speak up and get support

I recently asked about perimenopause on social media. The answers are best characterized by frustration, anger, and the question, “Why didn’t anyone tell me this was going to happen?”

Several problems complicate diagnosis and management of perimenopause – the age range for onset of symptoms is not well defined; and symptoms vary, sometimes not specific to the disease, and can last for several years.

There is also a possible timing in healthcare. When women rely on family doctors for well visits and routine Pap smears, they miss opportunities to communicate with an obstetrician / gynecologist who is better prepared for the transition into perimenopause.

“There was no support from my PCP, which is usually great,” said Christie Getto Young, a 52-year-old mother of two from Arlington, Massachusetts.

“Since the guidelines for Pap screening – which are based on valid evidence – suggest screening every three to five years, there is less incentive to meet with a gynecologist annually,” noted Dr. Caryn Dutton, family planning medical director at the Beth Israel Deaconess Medical Center Center’s Department of Obstetrics and Gynecology and a senior lecturer at Harvard Medical School. “Patients see us about pregnancy and birth control and have not had a chance to hear about symptoms of perimenopause or menopause.”

The non-specific nature of some perimenopausal symptoms can lead to discharge.

“The first things women speak to their doctor about perimenopausal symptoms often have to do with energy and mood,” said Emily Roach, women’s health trainer and patient advocate, via email. “Doctors will dismiss their concerns and say it’s only part of getting older. They don’t delve into any potential thyroid health issues, low B12 levels, or bowel problems.”

The downside of the layoff can be an undue focus on the perimenopause.

“Doctors were certain I had perimenopause after my breast cancer treatment and would be in menopause for the next 12 months,” said Tomika Bryant, a 49-year-old mother of two from King of Prussia, Pennsylvania. “It never happened and they tried to call it another name. Now they’re telling me to prepare for perimenopause at every appointment.”

Outside of the doctor’s office, women feel isolated in their experience. “I feel like I’ve been mugged. By myself,” said Monica Sakala, a 46-year-old mother of two in Washington, DC.

The lack of conversation unsettles the 51-year-old Deborah Reber from Brooklyn. “I felt incredibly let down by all of the women who came before me. If I understood why I went through what I went through, I would probably have coped better with it.”

So how can women get active in this normal phase of life?

Talk about your experiences

Break the cycle of stigma and shame through conversation. “We tell teenage girls what’s going to happen,” said Stephanie Pitney, a 48-year-old mother of two from East Granby, Connecticut. “Why don’t we 45-year-old women tell what’s going to happen? Why is it still taboo to talk about?”

These conversations may feel awkward, but vulnerability can strengthen relationships. “Being specific about our physical ailments – rather than being vague and dismissive – can actually deepen relationships and help us all feel less isolated in the process,” said Laura Tremaine, author of Share Your Stuff. I’ll go first. 10 Questions to Take Your Friendships to the Next Level. ”

Take notes

Write down the date, time, symptoms, and other life events to provide specific information to your doctor.

“It really helps when a patient comes in with notes on their phone or calendar and can say, ‘I didn’t sleep well and my hot flashes were worse the next day.’ It helps narrow down the triggers and spot patterns, “Dutton said.

You can also discover patterns for yourself.

Sakala began struggling with insomnia a few months ago. “For a while I thought it was related to a pandemic. Then I realized it was hormonal; two weeks before my period, like clockwork. Got up at 3am every night, ”she wrote via email.

Roach also encourages the use of food diaries as a tool for identifying food intolerances. She wrote by email, “Our digestive systems change as we age and we don’t make food the way we did in our 20s and 30s.”

Look at your medical history

Your medical history can reveal unexpected connections. “I lived with epilepsy when I was 20 and had two children in my 30s while continuing on epilepsy treatment,” said Julia Beck, a 54-year-old labor attorney and strategist from Chevy Chase, Maryland. When Beck had her IUD removed at the age of 40, she suffered two severe attacks.

Beck learned the connection between epilepsy and menopause from a neurologist and gynecologist in Boston. “I underwent a number of tests and inpatient diagnostics. They started tracking and seeing patterns that ended in perimenopause, ”she said.

Drugs that took Beck from perimenopause to menopause helped get her seizures under control, but then insurance problems made her medication out of reach. “As soon as I stopped the medication, the seizures started again,” she said.

Prepare to stand up for yourself

Women have to stand up for themselves. “I pushed my PCP to treat me for my symptoms and hypothyroidism,” said Rebekah Dunkley, a 46-year-old mother of four from Boise, Idaho.

“I asked my PCP to refer to an endocrinologist,” said Dunkley. “I needed the help of a good endocrinologist to manage my symptoms and I had to deal with some disagreement between my endocrinologist and obstetrics / gynecologist. It’s amazing how much better I feel with the right treatment!”

Roach encourages women to ask questions and seek alternatives and second opinions if necessary. “If something doesn’t feel right to you, trust your gut instinct and then work with a health advocate who can help you.”

Dutton recommended looking for doctors with perimenopause and menopause among their interests. “You can also find a certified menopause practitioner with the North American Menopause Society,” she said. Subscribe to CNN’s Fitness But Better newsletter: Back into the groove. Sign up for our series of newsletters to find a healthy routine supported by experts

Make lifestyle adjustments

Basic preventive measures are important. “We know that diet, sleep, and exercise play a big role, not only in most chronic diseases, but also in minimizing the symptoms associated with the transition into menopause. For example, exercise can reduce the severity of hot flashes, ”said Dutton.

Small adjustments are worth investigating. “Perimenopause made my inattentiveness, concentration, and productivity worse,” said Julianna Miner, a 48-year-old mother of three from Cincinnati, via email. “I switched to a different type of planner and found that a bullet journal helped me stay focused and organized. I also gave myself the freedom to measure my productivity differently. I see what gets done in a week instead of beating myself up when I’m having a bad day. “

Miner also prioritizes taking multivitamins, eating a healthier diet, less caffeine, and more outdoor activity. “It was important because the perimenopause made my blood sugar fluctuations worse, which made me dizzy, foggy, and moody,” she wrote via email.

The pandemic forced the cancellation of medical appointments at an early stage. Now as we are trying to recover, it is not surprising that we are questioning ourselves.

“Do I feel bad enough to warrant more testing, more appointments, especially during a pandemic when everyone is fighting?” asked Arlington’s mother, Getto Young.

If you don’t feel like yourself, the answer is likely yes.

Christine Koh is a former music and brain researcher who has now become a writer, podcaster and creative director. You can find her work on christinekoh.com and on Instagram, Twitter and Facebook at @drchristinekoh.

source https://dailyhealthynews.ca/perimenopause-how-women-can-speak-up-and-get-support/