The prefix “peri” means “around”. “Meno” has to do with menses. Pause is obvious. So by definition, perimenopause means around menopause or around the time periods stop. Now, maybe we should also get this word menopause straight. Women talk about going through menopause. Well, you don’t exactly go through it; you go into it—and stay there for the rest of your life. Menopause is the time of life when your periods have stopped. The term postmenopausal is sort of a misnomer because you don’t really ever leave menopause once you are there. Menopause happens because the ovaries’ egg supply dwindles to nothing and the majority of estrogen production ceases. Once you hit this point, you obviously stay there until you die. So what’s perimenopause? This is the time of life as you approach menopause. It is a time of hormonal fits and spurts. Basically it is like when your car’s gas tank is running out of gas. Your car starts to lose power and cough until it just quits. Now you know how one car’s gas gauge seems to sit on empty forever, and you can eek out many more miles, maybe stopping and starting? And another car’s gauge reaches empty, and that’s it—you’re done, and the car stops? Women are like that too. Some women hang out on the perimenopause rollercoaster for a decade with all kinds of annoying hormonal and emotional ups and downs. Other women hit 52, miss a period, and they’re done. Most women are somewhere in between. So what’s to be done about all of this? Well, first you should know that it is normal. Yes, let me repeat that loudly—NORMAL. Society at large and the medical establishment in particular might have you believe that this is not the case. Often patients are told that this time of life is something to dread and basically the beginning of the end. Well, I refuse to see it this way. Life is a progression of transitions from birth to death. This is one of them. That doesn’t mean it’s all kittens and daisies. Change is difficult, and it can be really hard for some women. There are things to be done to smooth the transition if needed. But the first order of business is to understand that this is supposed to happen and is normal. In my mind, a lot of our feelings about all of this find their origin in our fear of aging. Our society doesn’t look kindly upon the aging process. I desperately wish this was not the case, especially as I am fifty now, but I probably won’t change our societal/cultural perceptions. We can, however, change our individual perceptions.
So take a deep breath. Yes, you are getting older. It is the natural way of things. I’m planning to do it as gracefully as possible.
Dr. Heather's musings about medicine, mindfulness and life.
Heather Krantz, M.D.
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