Perimenopause is freaking complex, yes? Because it is such an individual journey, it is dfficult to fit a definitive diagnosis into the yes or no diagnostic criteria that we like as clinicians.
Let’s take anxiety for instance. It’s an extraordinarily common symptom that women report increased levels of anxiety during perimenopause. However, as it’s difficult to measure objectively, it’s not often included in a medical history workup. If it is mentioned, it is as an aside, and dealt with via way of an antidepressant prescription.
The issue is – why is there such a marked increase in anxiety levels during perimenopause, and why is it it happening in your particular case?
Is it because our beautiful peri woman is estrogen dominant and anovulatory, thus no longer producing progesterone in order to calm her mind?
Is it because our amazing peri woman has been under chronic stress for the last 20 years, has adrenal fatigue, and can no longer keep up with the demands for cortisol and has to steal the building blocks of progesterone to make enough of the stress hormone? (look up pregnenolone steal – it’s bonkers and probably impacting so many of the women that you know.)
Is our determined peri woman struggling with digestive issues, including constipation, bloating and poor digestion, thus recycling her estrogen marked for elimination, leading to an imbalance of estrogen to progesterone?
Is our majestic peri woman starting her day with coffee because she’s so damn fatigued, but needing alcohol in the evening to wind down because she’s so wired and can’t cope?
Holy moly, I can keep going. We haven’t even touched the surface of the impact of gut health on serotonin and vitamin and mineral deficiencies.
But what about, Is our vulnerable and desperate peri woman suffering from anxiety due to a deficiency in antidepressants?
I don’t think so.
Yet symptoms such as gut health, diet, lifestyle, stress, activity levels, loneliness, rage, motivation and libido are rarely discussed when looking to ease the symptoms of perimenopause.
This is why it’s important to find a health care provider who looks at the whole picture. I take at least an hour during my initial consultations because it’s so important to get the full details of what is going on in order to accurately diagnose the root cause.
However, it is generally not one root case – we are complex creatures!
For those of you that have asked – a few common but subtle symptoms of hormonal imbalance that can lead to a difficult perimenopause are
– thinning hair or brittle nails
– indecisiveness and a sense of doom associated with any decision
– difficulty in finding the words to express oneself, decreased ability to communicate
– not wanting to be touched (by anyone, romantic or otherwise)
– waning ambition, or just can’t seem to care anymore. It all feels too much.
– changes in digestion, or inability to tolerate foods that you used to be able to.
See how these symptoms are not measurable but have such an impact on quality of life? And they can be directly linked to hormone balance. You are more than your blood test results, and they often won’t even scratch the surface of where to actually begin.
