Ready or Not Here It Comes – Which of These Peri-Menopause Symptoms Do You Have? "It started with an itch." I literally laughed out loud when I saw this chapter title in Suzanne Somers' recent book I'm Too Young for This (Harmony Books, 2013) on perimenopause. Perimenopause is the time before menopause when a woman's body starts changing. I laughed at the title because my whole perimenopausal journey started with an itchy left arm when I was 43. It was an itch like none other. I would lay awake at night because I couldn't fall asleep or stay asleep. I scratched my left upper arm until it bled and I had to wear long sleeves. I tried every available cream, and I even tried Benadryl - but nothing stopped the itching. Around this time I gained more than 20 pounds, all around my middle, making most of my clothes not fit. It became harder to work out without wetting my pants, especially before my period. I developed severe diarrhea often related to eating, but couldn't figure out which foods were causing it. I had a racing heart at night and felt so anxious as I tossed and turned, and broke out in cold sweats, that I thought I might have a heart attack. Intimacy with my husband, which I have always enjoyed, became a bit of a gamble. If he smelled like garlic or the phone rang during sex, the mood was ruined and there was no getting it back for me. Sometimes it took so long for me to finally orgasm I would just call it quits, which left me feeling grumpy. And worst of all were the crazy mood swings. One Thanksgiving, I hadn't bought enough potatoes for a large family dinner at our house. I told everyone to be considerate in the amount they took so there would be some for all. One guest sighed: "Too bad, they are my favorite part." I started crying and couldn't stop. There we sat through a holiday meal with 25 family members and me bawling at the head of the table. Needless to say, some of these folks haven't been back yet! I quite honestly thought I was having a nervous breakdown. I went to see different doctors. All my tests came back "fine." I was told I wasn't premenopausal as I was still having regular periods. I was given sleeping pills, anti-depressants, and prescriptions for my heart - all the standard medications that many of the 40 to 50 year old women in America take on a regular basis. The only helpful advice I got was from my hypnotherapist who told me after several years of suffering with these symptoms: "You are starting the change. Go find some supplements". On my way home from her office I stopped at the health food store and stood like a lost puppy in the aisle reading labels and trying to figure out what the heck to take. Here I was, a PhD in Reproductive Physiology, with no idea how to improve my health and quality of life. Finally, I chose an herbal supplement with a pretty picture of palm trees on it and a daily multi-vitamin for "older" women. The products, which cost $200 per month, helped me a little bit, but I really had no idea how to change up this supplement regimen to improve the effectiveness. I look back at the SEVEN years I went through perimenopause as one of the hardest times of my life. But now I know that everything about my experience was 100% normal. I also know that if I had understood that I wasn't having 10 different health problems, but that all my different symptoms were part of the changes in hormone levels in my body, I would have felt more confident to try different supplements and lifestyle changes, to see which worked best for me. I also realized that many of the times when I went to see the doctor, I would forget certain symptoms (such as the itching), or I would feel embarrassed to discuss what was going on (as a sexual intimacy expert and sexual lubricant inventor, I felt awkward saying I was having vaginal dryness issues). What my 43 to 50 year old self needed was a sheet where I could record my physical and emotional symptoms. Given that I pretty much had ALL of the symptoms associated with menopause, if I could have checked off my symptoms, I wouldn't have needed a doctor to tell me I was perimenopausal, I would have KNOWN. I also could have used this symptom sheet to identify supplements and lifestyle changes that helped me find relief from various symptoms. And I could have shown this sheet to my doctor and asked for a referral to a physician who specialized in the aging female. Based on guidelines from international medical menopause societies and the lens of my own experience, I recently crafted a Daily Menopause Symptom Tracker. This daily tracker can be used to indicate trends in your overall health associated with menopause, and how your quality of life is being impacted. Completing this daily charting helps you monitor how changes in diet, exercise, supplementation, medication or stress may impact your menopausal symptoms. Use this tracker to discuss your body's changes with your healthcare provider (preferably a healthcare provider that specialized in menopause), and to find out what lifestyle changes provide you with the best health! Menopause should be entered with a plan…not the guesswork I used! Feeling Better During the Change When it comes to finding relief from perimenopausal symptoms, there are several approaches women can take. The important thing to remember is that you definitely don't have to just lay there and take it! You can make positive changes in how you feel. And by knowing what works, you can try different approaches with confidence. Unlike my aimless wander in the supplement aisle a decade ago, there is now some good data from clinical studies on the supplements that are beneficial for improving symptoms. The truth is that there are are very few herbs or vitamins that have been shown in Level 1 clinical studies to help with menopause changes. Level 1 is the highest possible level of medical evidence. The reason there is a lack of Level 1 evidence for supplements is that it is hard to find numerous clinical trials that looked at supplements at the same dose from the same source. So even though there isn't current Level 1 evidence that supplements help (your doctor may say "there is no evidence" they help), actually there is "insufficient evidence" to know the true effect of supplements. But there are good Level 2 studies (the next best thing) showing that botanical and vitamin/mineral supplements offer many women relief from perimenopausal symptoms. If you are one of the ones that is helped by these products…Hallelujah! To make sure you are staying with supplement options that offer a chance of benefit, while limiting the risks of impure or contaminated products (with who knows what in them), be sure to stick to reputable brands that measure their actual ingredients and make their products in the USA. I was recently asked to review Fairhaven's new product BalanceBlend (Made in the USA). I was impressed that this product contains effective herbs, as well as vitamins and minerals for a one-product solution. It is also extremely cost effective at <$30/month. Trying BalanceBlend for a month is a simple way to see if some of your worst menopause symptoms can be alleviated by a daily supplement. The table below lists just a few of the ingredients in BalanceBlend that have been shown in quality clinical studies to help decrease the symptoms of menopause. Ingredients that Help Decrease Menopause Symptoms Hops Decrease hot flash frequency and severity Black Cohosh Decrease hot flash frequency and severity, allows easier time falling asleep and less waking Wild Yam May protect against some forms of cancer and osteoporosis Licorice Works with Cohosh to decrease numerous menopausal symptoms Maca Decreases blood pressure, decreases depression, increases sexual function Ginko Increases sexual desire Chasteberry Improves anxiety and moodness, decreases food cravings Zinc Improves memory and mood Vitamin D Improves immunity Vitamin B Improves mood Do supplements work? In studies, 28-46% of women felt relief of symptoms from supplements (in some studies this number was as high as 70%). If you are like me, I knew I needed to lose weight and exercise, but I felt too crummy and time stressed to work out. But I could take my supplements. So start here! Even 20% of ObGyns feel that botanical supplements alone help their menopausal patients. Other lifestyle changes that have been shown to help combat perimenopausal symptoms are exercise and yoga. Don't be afraid to try yoga even if you are a klutz like me. Really no one in the class is worried about you, they are all focusing on not falling over! Exercise does help, with 57-72% of women reporting relief of symptoms from exercise. And an equal 54% of docs say exercise helps their patients. So after a few weeks of taking BalanceBlend, when you feel a little better, start walking 30 minutes 3 times a week (at the very least). Hormone replacement therapy with a doctor's prescription can be a lifesaver during this time. One of the best books on hormone replacement is Suzanne Somers' book I'm Too Young for This. My book Slippery When Wet also has more information on why menopause happens and the newest data on the overall safety of hormone replacement for women. Going through menopause is a natural part of being a woman. Understanding that you aren't crazy and you aren't falling a part can help each of us approach this time with more knowledge and a greater sense of direction. You want to feel better! Know what symptoms you have. Try approaches to improve your health and quality of life. If one approach doesn't work, try another. You have many exciting times ahead. As for me and my house, we are having more fun in our intimacy than ever, I rarely cry anymore (wahoo) and everyone is coming for Christmas this year! I will buy a LOT of potatoes!! Disclaimer: Please note that the information in this website is an educational resource. All decisions about any treatment you need must be made in consultation with your doctor or your healthcare provider who has examined you. Nothing in this post is meant to be used to diagnose or treat any person.
