Navigating the Stormy Weather of Menopause
Part I: Irregular Periods
At 43 years old, Cheryl Miller couldn’t help but ask, “What’s wrong with me? Am I going crazy?” as she faced mounting physical changes that proved something strange was happening to her.
The only way the stay-at-home mother of three knew how to cope with her mysterious symptoms was to pencil in the words “hell week” across her calendar on that dreaded week before her menstrual cycle. Like clockwork, she would be hit by crazy, insane mood swings, heart palpitations and vertigo, and deep, debilitating bouts of depression.
Then the storm cleared as abruptly as it had arrived, “and I’d feel normal again,” she says. “It was just insane.”
Like so many women in the prime of their lives, Cheryl was too busy with life’s responsibilities to pay attention to perimenopause’s first signals.
“Here I was, right in the middle of the age range when women start going through perimenopause, and yet I didn’t put two and two together at first,” she recalls. “I had no idea of what to expect.”
Perimenopause literally means the time “around” menopause and is a term used to describe the beginning of the estrogen decline leading to menopause. However, many women use the term “perimenopause” to describe the time when they first begin to notice menopausal symptoms.
With the help of Heather Pugmire, MD, an obstetrician-gynecologist (OB/GYN) at the Bingham Memorial Women’s Center, it’s time to decode the signals of perimenopause—that transitional phase before periods end for good. During our five-part series, she’ll help women understand the signs, symptoms and what to look for, along with exploring practical strategies for weathering a variety of perimenopausal storms.
Signal: Your menstrual cycle’s droughts—and floods.
Storm advisory: Cheryl had very regular periods until age 41, when a “phantom period” mid-cycle turned her life upside down.
The disruption in her normal menstrual cycle led to an unexpected pregnancy, and after the birth of her third child, she started having heavy menstrual cycles to the point that she couldn’t leave her bedroom. “I would go through a whole package of pads in two hours,” Cheryl says. “It was just awful. And then my next cycle would literally be spots. It went back and forth like that for a number of months.”
How to weather it: Dr. Pugmire explains that a change in a woman’s menstrual cycle is one of the first clues they’re in perimenopause. In the beginning, periods may come a week early or a week late.
“The more common that pattern becomes, the greater the likelihood that a woman is entering perimenopause,” Dr. Pugmire says. “The peculiar thing is a characteristic of perimenopause is to have irregular bleeding. But irregular bleeding can also be a sign of problems such as endometrial cancer or hyperplasia. So breakthrough bleeding throughout the month or cycles that have gotten noticeably heavier or longer could be normal but are definitely things to check out with your gynecologist or physician.”Dr. Pugmire says that a woman may choose to stabilize her erratic periods. Some women choose a hormonal option like birth control pills (if she doesn’t smoke, have high blood pressure, or a history of blood clots) or progestin—the synthetic form of the hormone progesterone. Other women do better with a surgical option to destroy or remove the cells that are causing the bleeding. There are several options available and you should talk with your gynecologist to find the one that works best with your lifestyle and symptoms.
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