Perimenopause … What is going on with me right now.

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THE BAD NEWS FIRST:

You’re not crazy. It’s perimenopause. The good news: You’re not crazy. It’s perimenopause. The brain fog (see this NYT article), the irritability, the depression, the fatigue, the sudden allergies, the skin conditions, the hair loss, the weight gain, the mood swings… it’s not you, it’s HER. Little Miss Peri. And you know what? I can’t stand her.

Simply acknowledging that makes things feel a little better doesn’t it?!

Ok…More good news: We aren’t alone. It seems everyone has been talking about menopause lately (Tabitha Brown, Halle Berry) and if you look at their comment sections, SO MANY WOMEN are relieved to know that we really ARE in this together!

I too, have been sharing about my perimenopausal journey (See my instagram highlights– I saved some of it there). Rob said to me recently, “You’ve changed. Since about ten years ago, you’ve been different.” A light bulb went off. Because I had JUST read a post by Dr. Mary Claire that said perimenopausal symptoms can start as early as 10 years before menopause. Like… as early as 35 years old. Whew! That explained everything.

HOW I KNEW I WAS IN PERIMENOPAUSE

After reading books (see recommendations later) and watching doctors’ posts. You are probably in perimenopause if you’re 35+ and start to feel and see certain changes. Everyone is different but things like: PMS type mood swings that don’t stop when menstrual cycle starts, lethargy, major irritability, hot flashes, depression, anxiety, sleep issues, joint and muscle issues, libido issues, skin changes and more… a doctor can tell you if it’s something else or perimenopause. But if you’re 35+ and wondering, you are probably in it! To help, HERE’S a quiz. And another is HERE.

WHY I AM SHARING HERE

When I started sharing about my issues, every single time, my DM’s exploded.

“Me too!”

“The ADD is wild!”

“I haven’t been myself, either!”

“I have been so depressed and now I think I know why.”

“The night sweats are unbearable.”

“I am irrationally angry at everything and everyone, too!”

So, I decided to keep sharing. I wrote this post so people can reference what I share in one place. Also, it is difficult to manage wildly different reactions on such a sensitive topic (menopause and my body) in dms. I will also share some books to read, and accounts to follow. And finally, I will share some online resources to find doctors who specialize in menopause near you.

WHAT THIS POST IS NOT:

PLEASE NOTE: What I am NOT doing is giving medical advice or advising anyone on how to treat their perimenopausal symptoms. Since I am not a doctor, I am not qualified to give advice. I am just a 48 year old who wanted some help. I DO, however, want to share my journey for solidarity, and because YOU asked. I am writing this blog post because my DM’s are flooded with women who are desperate and feeling gaslit and alone. I hope this helps. This is just a glimpse so PLEASE find a doctor and process that works for you, and remain under their guidance.

This post is not an endorsement for the practice I went to, so if you’re one of the women who has been chastising me in the DM’s, please stop. I am just a 48 year old woman out here doing my best and trying to find relief so I can be myself again.

Research on menopause is seriously lacking, and medical school dedicates just a sliver of time to menopause. This piece in the New York Times is utterly shocking: Dr. Stephanie S. Faubion, medical director for the North American Menopause Society stated:

“When we surveyed residency programs, across internal medicine, family medicine and gynecology residents, they had maybe one or two total hours of education about menopause. About 20 percent said they’d had no menopause education, and only about 7 percent said they felt prepared to treat menopausal women.”

So I think it’s safe to say that as of now, there is not a single doctor who knows everything. Or a single book with all of the answers. Or a single HRT treatment that is one size fits all, or a single diet or fitness plan or supplement routine that will help everyone, or a single philosophy or value that fits every woman’s lifestyle and needs. So, we should remain open minded and non judgmental in regards to menopause and the treatments women choose for themselves.

To reiterate, this post is not an endorsement of any kind to do what I am doing- it’s simply a place for me to share my personal journey and resources from different kinds of doctors (both conventional and naturopathic) so people have a starting point.

WHERE TO FIND HELP

To cut to the chase, if you are looking for a provider who specializes in menopause, you can use this search tool HERE. or HERE or HERE OR if you cannot find a doctor near you, you can get an appointment online with a doctor and obtain a prescription for Bio-identical HRT (Hormone Replacement Therapy) HERE.

WHAT I AM DOING CURRENTLY

Some of my friends use body identical hormone therapy. Some use supplements. Some use bio-identical hormone therapy.  I am listening to my doctors and practitioners and friends and making the best informed decisions that I feel comfortable with. What I list here may change because every person is different and I need to see what is working for me.

On the recommendation of several local women that I know personally, I went to Happy Hormone Cottage. It started with a consultation over zoom. These are done individually or in a group. I did the group -it was less expensive and it was actually nice to hear each woman talk about her experience. We were all more or less going through the same thing! We weren’t alone.

Next I purchased a DUTCH test from them. This was not to diagnose (I already know I am perimenopausal), but to see where my testosterone, estrogen and progesterone levels were, as well as see how my cortisol levels were doing (NOTE: a doctor can also determine some of these things through a full blood panel. A DUTCH test is not the only way, nor is it necessary in order for someone to get a prescription for hormone replacement therapy from their doctor.)

They mailed me the DUTCH test along with a pre addressed envelope, which goes to the lab. I took urine samples on little pieces of paper provided in the test kit, at different times of day/night. I labeled and let them dry for 24 hours, put them in their little package and sent them off.

A couple of weeks later, HHC had my results and I set up a zoom call with an RN to go over what it all meant. I loved how she asked me about my experience before jumping into results. I felt seen as she nodded and validated everything I was saying. She shared my results on the screen (and emailed me the pdf). We covered my testosterone levels and estrogen levels, which were in the normal range. But when we got to my progesterone, it was just hovering above nothing! “This is why you have been feeling this way.”

Next, she pointed out where my cortisol levels were extremely low, which at first surprised me (I am so stressed!) but it all made sense when she showed where they were at different times of the day. Then it was clear why I could barely keep my eyes open at 2 pm!

At the end, she told me what she would be prescribing. I got an Rx for Progesterone (BHRT) 10% (100mg/ML) Cream. HHC has their own compounding lab and they use bio-identical hormones and plant based ingredients. I want to state here that millions of women take hormones from different sources (for example, body identical micronized tablet or bio identical plant based cream) and that is OK! There is no hierarchy of hormones. Someone in DM’s said that there is no credible evidence that bio-identical is better than placebo. OK. Do what your doctor says to do and what works to give you relief and peace of mind. For me, I didn’t want peanut oil, soy lecithin and FD&C red dye No. 40 in my pills because I also avoid it in my daily foods. If that’s of no concern, go for it because it clearly works for millions of women! (and yes I see the irony in me doing botox lol)

Next, she gave me a suggestion for a supplement (Adrenal Support) that they sell at HHC, but she said the ingredients are pretty common and can be found in supplements that you can find online or on amazon. I am taking it once in the morning with food and once in the afternoon.

I WANT TO NOTE HERE that I’ve heard of women being pressured by these types of practices to buy a bunch of supplements (kind of playing on our desperation to sell to us) so I went in with my eyes wide open in case they tried to “upsell me” in addition to prescribing HRT. For me that wasn’t the case but just in case I wanted to put it out there. You can always hear what they have to say and then get whatever supplements you want online from wherever- the most important thing for me was getting some HRT)

I started last night- I will keep you posted!

***UPDATE: 8 days in and oh my goodness I feel like a new woman and want to cry! I wasn’t sure if I was imagining things so I posted this TIKTOK update to ask how fast Progesterone works and just look at the comments! Hundreds of women nodding in agreement!****

FOOD

Right now, I am focusing on eating how I normally do- read my post on why I started eating paleo here. After almost 10 years eating this way 80 percent of the time, I am remaining gluten and dairy free, and continuing to limit ultra processed sugars/foods because I like how I feel when I eat this way. But one area that I am working on, from listening to Dr. Mary Claire, is to make sure I am getting 130 grams of protein a day. I am not counting macros or calories. I don’t diet or eat to lose weight, I eat for FEELING my very best. I simply want to make sure I feel energized and strong throughout the day by trying to eat the most nutritious foods I have access to, and getting that protein in.

EXERCISE

I am walking every day and doing pilates a few days a week (it doesn’t have to be long- I do a lot of 15 or 20 minute classes on the peloton app). I am incorporating some weights to build more muscle mass for longevity and energy. I used to run (I finished my 9th half marathon last year) but found that I was getting super bloated and my clothes weren’t fitting. Getting older, I also realized that my joints were feeling the impact a lot more. I read up on the benefits of walking and it seems to have helped me a lot. I may run from time to time but for now I am not doing any more half marathons.

SUPPLEMENTS

What I am already taking:

I already take a TON of supplements. Here is a blog post where I share my supplement routine. These have saved me but for this stage of life I needed to address my depleted progesterone specifically, and the BHRT will hopefully fill that need.

Adrenal Support:

HHC recommended this one for my low cortisol and fatigue but they said I could find similar online. I searched and found this this and this – they don’t contain bovine but that can be found separately here or here.

BOOKS

HORMONE REPAIR MANUAL

Several years ago, I read Dr. Lara Briden’s book, the Period Repair Manual (for those under 40) and I purchased the Hormone Repair Manual (for those over 40) a couple years ago. These were game changers for me, and I am positive I would have been more desperate if I hadn’t followed some of the protocol in these books over the last several years. They helped me to find supplements and keep my hormonal ducks in a row for the stage I was in. As I entered more deeply into perimenopause, I wanted to see what else I could do. For the longest time I believed that HRT was not for me, since my mother died of cancer and we were told that it was one of the causes of her relapse and ultimately, her death. New studies are showing that is faulty research. There is much to be explored, but Hormone Repair Manual is a great starting place.

PERIOD REPAIR MANUAL

THE NEW MENOPAUSE

THE GALVESTON DIET

THE MENOPAUSE BRAIN (i just preordered this- available March 13)

PEOPLE TO FOLLOW

Dr. Mary Claire, Menopause Specialist

Dr. Lisa Mosconi, Neuroscientist

Dr. Wendy Goodall

Dr. Lara Briden

JUST THE BEGINNING

I am hopeful because the last several years have been really hard. I sincerely know in my heart that at 48, this is just the beginning! I will keep you updated on my progress!

Thank you for stopping by, and be sure to follow me on instagram, TikTok and LTK so you never miss a thing!