Too Young for Menopause? It Might be Perimenopause

Are you experiencing irritability, mood swings and irregular periods, but you think you’re too young for the Big M? Can it be PMS? Or is it perimenopause?

Signs of perimenopause

Symptoms of perimenopause can bring about many difficult questions because this has not been a stage of women's lives much talked about, and a woman can find herself experiencing puzzling changes.

Perimenopause is a change in hormonal functions leading up to menopause. It is a wake-up call for your body. The symptoms of perimenopause begin years before your period ends, although some women experience no symptoms at all. A primary symptom is irregular or erratic periods, but many other symptoms can be present, including:

• Hot flashes
• Night sweats
• Heart palpitations
• Migraine headaches
• Breast swelling and tenderness
• Very heavy or light menstrual periods
• Irregular periods
• Increase or decrease in libido
• Dry skin, eyes and vagina
• Mood swings
• Insomnia
• Fuzzy thinking/short-term memory lapses
• Joint pains

Perimenopause is a process, and similar to puberty, it doesn't happen overnight. As menopause approaches, women gradually go through changes physically and emotionally. For many women, perimenopause can last anywhere from five to 15 years. Perimenopause occurs typically around age 45, but for some women it can begin in their early 40’s. Physiologically, estrogen production and cycling is decreasing, which leads to less ovulation, which affects many of the hormones in the body and the brain related to female reproduction.

Ways to find relief

Jane Guiltinan, ND, clinic professor at Bastyr Center for Natural Health, often reminds patients that, “Perimenopause is a normal natural transition, not a disease. But if your symptoms are making you uncomfortable or disrupting your life, seek guidance from a knowledgeable healthcare practitioner. There are many options that may help you, and one size does not fit all. Your treatment decision depends on your individual symptoms and health risks, in addition to your personal values and beliefs.”

Acupuncture and Chinese herbal medicine can also provide relief of perimenopausal symptoms. Depending on each individual, symptoms can range from having one primary symptom to having multiple symptoms simultaneously. Regardless of the number of symptoms, from a Chinese medicine perspective the result is an occurrence of imbalance between yin and yang with an underlying energetic deficiency. “During a treatment, the practitioner will needle specific acupuncture points to help reset the body to find equal balance by boosting Qi, nourishing yin and yang and calming spirit.” according to Sue Yang, a second year resident at Bastyr Center for Natural Health.

Most commonly, acupuncture treatments are recommended once a week for six to eight weeks, and then the practitioner will reassess the condition. Depending on each individual, if the symptoms are mild, acupuncture alone can be very effective to alleviate the symptoms. For those individuals who experience moderate to severe symptoms, Chinese herbs can be incorporated as part of the treatment plan in conjunction with acupuncture to help work on a deeper internal level.

Lifestyle factors have an impact on the intensity of menopausal symptoms. Excessive stress in your life may increase the probability of more severe symptoms. Diet is important, too. Not eating right and staying well hydrated will likely aggravate symptoms. Also, getting adequate sleep is important. Even if perimenopause is years away, getting a head start on managing your stress, eating right and getting enough sleep will make a difference later when you do begin perimenopause.

It’s important to note that the onset of perimenopause doesn't mean you can't get pregnant. Women who do not want to get pregnant should use a form of birth control for one full year after their final period.

Naturopathic treatment options for perimenopause

This outline is designed to guide you and your health care professional in choosing the best strategy for managing your menopausal symptoms, starting from the least invasive level of intervention (level 1) to the highest (level 5). Your decision will be based on the severity of your symptoms, as well as your risk for conditions such as heart disease, breast cancer and osteoporosis. It is important that you seek guidance from a health care professional knowledgeable about the risks and benefits of all these options, and only move to the next level if you’re not getting relief.

LEVEL 1
Diet — Increase soy, avoid spicy and hot foods, minimize alcohol and caffeine
Exercise — 30 minutes, 5 times/week
Behavioral — Stop smoking, layer clothes, manage stress, increase sleep
Mental/emotional — Explore and reframe experience of menopause

LEVEL 2
Therapeutic nutrition, e.g. vitamin E

LEVEL 3
Botanical medicine, e.g. black cohosh or a mix of herbs including black cohosh, licorice root, red clover, alfalfa, dong quai

LEVEL 4
Plant-based, bio-identical hormone therapy, e.g. bi-estrogen plus micronized progesterone

LEVEL 5
Conventional hormone therapy , e.g. Estradiol (Plant-based), or conjugated equine estrogen (Animal based) plus Medroxyprogesterone acetate (Synthetic) or Micronized progesterone (Plant-based)

If you think you may be experiencing perimenopause or menopause, you may want to consider meeting with a knowledgeable natural health care provider at Bastyr Center for Natural Health.

Writer: Bastyr Staff Writer
Contributor: Jane Guiltinan, ND; Sue Yang, LAc
Date: 2004

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