Perimenopause—the time before menopause hits—is still only sporadically talked about, yet brings many challenges to us uterus-havers that can range from the mildly uncomfortable to the seriously exhausting. When people think of classical menopausal symptoms such as hot flashes, mood swings, and changed menstrual cycles, they usually imagine women 50+ and usually only for a short amount of time before the final period cycle runs its course.
The truth of the matter, however, is that menopause—that period when your menstrual cycle starts slowing down and eventually disappears—is only one (comparably short) stage in the hormonal changes we go through before our very last period. Before menopause, there is perimenopause, basically “the time span before menopause,” with menopause itself being “the time span before your final period.”
Perimenopause can last years, sometimes up to a decade, and the symptoms range from mild to severe. The gradual drop in estrogen during those perimenopausal years can affect your body and mind in rather unexpected ways, and for me, many of them were a bit of a shock due to being totally unprepared for their weirdness.
Perimenopause can last years, sometimes up to a decade before menopause starts, and the symptoms range from mild to severe.
Now, everyone is different, and both perimenopause and actual menopause will be a unique experience for each of you—very much dependent on a mix of lifestyle, genetics, and even cultural differences. However, given that I am currently still very much in the midst of this awkward and—let me be very real here—often embarrassing phase of life, I felt it could be helpful for other uterus-having people in their mid- to late 30s to share some of the lesser talked about symptoms and unexpected challenges of perimenopause.
1. Symptoms Can Start as Early as Your 30s
Is it just my imagination or does most of the information out there about perimenopause make it appear as if this is mainly a phenomenon that will hit you in your late 40s? Articles about perimenopause usually show older women with grey hair and serene smiles, which led me to always assume that I’d be “safe” for at least a decade more, when in fact I’ve had symptoms now for almost five years, if not longer.
It actually took me a long time to figure out that the sudden sweat attacks in my mid-30s were hot flashes, and even my gynecologist shrugged away tentative questions about the potential of my hormones changing towards menopause. “Too early” is basically what he barked at me—the last time I saw this particularly unhelpful doctor.
I think it doesn’t help that so many of us are kind of freaked out about addressing “the elephant in the room,” and a large portion of my female acquaintances tend to stress that, oh no, they do not have any hormonal changes whatsoever even at 40, wait what do you mean you have strange heat flashes, how very quaint. This, I think, links back to my first point about smiling women with grey hair being associated with “the change”—the idea that menopause happens when you are, gasp, old! In truth, we are usually still both quite young and very much still fertile when we experience our first signs of the changes to come.
We are usually still both quite young and very much fertile when we experience our first signs of the changes to come.
2. Your Hair Will Change
As someone who prides herself on having thick but still very manageable and compliant hair, this was a big shock. I honestly don’t think enough people mention how hair can be affected by aging and hormonal changes. Not only did I start seeing grey hairs as early as my very early 30s (I blame the stress of writing a PhD thesis for this), my hair is also beginning to look more and more coarse, making it difficult to create those lovely sleek waves I used to love so much. I’ve also noticed my hair becoming drier overall, and it definitely needs a lot more maintenance care than in my 20s.
I am still working on adjusting to the changes in my hair. Sure, I can dye over my greys, but they still feel and look different from the non-greys, mostly because they have a strange wiry texture and tend to go frizzy faster. Using a rich hair treatment every week helps, as does using extra gentle shampoos and soothing scalp serums. I’ve also started exfoliating my scalp regularly and it seems to support my hair in growing stronger, thus causing less breakage.
3. Your Skin Will Get Out of Control
There is plenty of menopausal and post-menopausal skin care advice out there, and most of it is focused on anti-aging or dealing with persistently drier skin as we age. None of this advice is helpful to me, however, since my combo skin just basically went back to being a moody teenager, meaning it tends to break out like crazy right before and—what a novel and fun surprise—right after my period. I am also getting more blackheads than I’ve had in decades, and my nose is embarrassingly oily. Since I am also dealing with the first signs of aging, I am very much not enjoying the supremely odd experience of having blemishes grow on top of my first wrinkles.
Asian beauty products have helped so much here, given that most of their textures are wonderfully light while still feeling moisturizing. I am also a strong proponent of beneficial skin care actives in my routine: Both vitamin C and chemical peels with AHAs and PHA—my current acid fave—have become regulars in my routine. Retinol is still something I’m quite new to, but I can see myself experimenting with it more and more as I try to balance anti-aging needs with this weird “skin adolescence 2.0” I am going through right now.
4. Hot Flashes. That’s It, Just … Hot Flashes
I feel hot flashes should be renamed to something far more sinister-sounding, maybe “hot sweaty gross embarrassment peaks”? To me, the sensation of a hot flash isn’t even the most debilitating thing about them—the shame over being a sweaty mess is far worse. It may be because I am a plus-sized woman and already feel quite self-conscious about my body in public spaces, but having sweat run down my face when everyone else around me seems a dewy, sweat-free picture of serenity is truly the worst for me.
Having sweat run down my face when everyone else around me seems a dewy, sweat-free picture of serenity is truly the worst for me.
I‘ve actually developed a whole range of coping techniques— no, yoga and meditation haven’t helped one bit, but regular exercise does seem to support my body in “sweating it out” in a safe setting where this is not only allowed but kind of expected. When out in public, I also tend to carry a cooling face mist with me, a cute hand-painted fan that makes me feel like an elegant lady from the 1920s, and I always make sure I can peel off extra layers of clothing in case I fully combust.
And, if you can afford it, investing in one of those amazing luxury pillar fans that look like something from the space age is the best treat you can give yourself for the flashy hot years to come!
5. Expect Changes in How You Experience Your Monthly Cycle
Again, this is something I didn’t anticipate, and as someone who already suffers from depression and anxiety, I wish I had been forewarned how intense mood swings and energy level fluctuations can get during the monthly cycle. I have always suffered from debilitating fatigue right before my period, but now this also happens right around ovulation. And ever heard of mittelschmerz? Until my mid-30s, I did not know this was a thing, but now I get a fun day or two of intense stabbing pain when I ovulate (“mittelschmerz” is a German word meaning “middle pain,” the pain right in the middle of your cycle).
I also feel more bloated and just generally more unwell during my period, and just notice a gradual increase in the severity of my PMS symptoms. This, apparently, is actually quite common during perimenopause due to the gradual loss of estrogen and imbalances in progesterone levels.
Things that have helped me are:
- switching to more moderate exercise right before my period,
- eating foods rich in omega-3s and magnesium-rich fruits and veggies,
- tracking my cycle with an app so that I know the reason for any erratic emotions or energy levels,
- and above all, being more gentle and forgiving with myself on days when fatigue and depression hit.
In truth, I feel that perimenopause is a chance for us to re-evaluate a lot of things that we kind of take for granted when we are younger, and to learn to adjust to the realities of growing old(er): abundant energy levels simply aren’t that easily achievable anymore, and learning to be kinder to ourselves is really the key in accepting the changes to come. I am definitely starting to up my self-care game lately and feel less guilty about taking some time out to just rest and nurture my body. It does so many amazing things and goes through such crazy highs and lows, and I am in awe of its resilience more than ever before.