8 Things I Wish I'd Known About Perimenopause Before My Last PeriodFeb 27, 2023
I celebrated something momentous recently. It was an event that doesn’t get nearly enough appreciation…It was my menoversary! What’s a menoversary? It means that it’s been one year since my last period, which also marks my entry into post-menopause where I will statistically spend at least ⅓ of my life! While supporting women through all stages of menopause is my work and passion, being able to share my own journey was really meaningful. It wasn’t always pretty, but it did come with some surprising gifts!
What many women don’t know about menopause is that it’s not something that can be diagnosed with a blood, urine, or saliva test. It’s a clinical diagnosis-meaning that it’s determined by a person’s symptoms, age, and medical history, not by a test or number.
As I was one of the “lucky” 20% of women who start perimenopause in my late thirties, I am happy to say I have made it to the other side. And it’s actually pretty fantastic over here. But there’s also a lot I wish I knew before it all started. Perimenopause can last up to a decade, so join me for this episode and let’s make sure you don’t suffer alone and put your life on pause for the next ten years!
What you’ll learn in this episode:
- The earliest signs that I was entering perimenopause
- Why you can’t afford to ignore the symptoms of perimenopause
- Why hormone therapy wasn’t the best match for me-but it might be for you!
- How I’ve learned to use food to manage the worst symptoms like hot flashes and night sweats
- How I’ve been able to trade brain fog for renewed confidence and creativity all month long!
Episode #45 Breast Cancer and Nutrition Myth Busting
Episode #48: Straight Talk About Menopause
Hi and welcome to the Midlife Feast- the podcast for women who are hungry for more in this season of life. I'm your host, Dr. Jenn Salib Huber. Come to my table. Listen and learn from me, trusted guests, experts in women's health and interviews with women just like you. Each episode brings to the table juicy conversations designed to help you feast on midlife. Hey there, welcome to this week's episode of the midlife feast. This is a fun one for me. So this is mid-February and on Friday, so five days ago, on the 10th of February, I hit a milestone. I hit my one year from my last menstrual period day, which means that I am now officially past menopause.
So menopause Of course, being that day that marks 12 months since my last period and everything leading up to it was perimenopause. And now everything after it is post-menopause. So I shared that on social media on Instagram and was completely overwhelmed in the best possible way. With how many of you reached out to me with questions with your own stories. And so I thought that I would kind of turn a little bit of what I was talking about into a podcast episode, maybe two. But we're gonna start with this on.
Because I work in this space, because it's, you know, it's my job, and I love it. I'm really immersed in all things midlife and I have been kind of taking notes about my own personal experience, journaling parts of it, you know, kind of writing things down over the years. And that's why I was able to kind of pull together this list of eight things that I wish I had known about perimenopause before it started. And that's what I want to share with you.
Today, I want to share a little bit about my story, which I've shared in different parts, different episodes, different posts, you know, and even on other people's podcasts, but I thought it would be maybe helpful to put it into one episode. As you can hear my voice, I'm still getting over this cold. So apologies for that. But let's dive into it. Because I do love talking about this because I think that this is really practical, tangible information, that if you're in your 30s, or 40s, or even 50s and are wondering, what is going on, what do I need to do?
Why don't I know more about this, this episode should help fill in some of those blanks. So I'm turning 46 In about two months. And my perimenopause journey started in my mid 30s. And that is probably the number one thing that I wish I had known. So I was 37, when it really started to become obvious that something was changing. My kids were seven and five. So I had three kids under the age of eight, I guess, life was very busy. I was running a full time practice and a full time clinic. And yeah, there was a lot going on. But all of a sudden, I started to notice that my sleep had become very different. I could fall asleep relatively easily. But I would wake up at two or three in the morning. Not with a hot flash, not because of anything that I could pinpoint. But I would often just wake up and be wide awake. Sometimes there was some anxiety there. But more often than not, I would just wake up and I'd be awake for hours. For years.
The first question my husband would ask me in the morning is How did you sleep? Because the sleep report, as I used to call it really kind of dictated everyone's day. But also, you know, he could tell that I was just having a really hard time with this. I was also noticing that my mood swings and especially the PMS that I had always experienced, but was really experiencing was getting a lot worse. Instead of two or three days of being maybe kind of a bit cranky, but tired bit bloated. It was not lasting sometimes, you know, pretty much the entire second half of my cycle, a solid seven days. And there was usually a day or two in there where I really felt like something was going to break. And that was probably going to be me. It's the only way I could describe it.
There were days when I you know would just collapse out of feeling so overwhelmed and being unable to cope and feeling like everything was just kind of coming down on me. And then I'd start my period and everything was better again. And that pattern became really clear. And you know, I think in hindsight, it probably would have crossed Last into that diagnostic threshold for PMDD, or premenstrual dysphoric disorder, but at the time, it just felt like really, really bad PMS. And like so many others, I had started to notice that my body was changing.
I have shared that, you know, I've had a pretty, a pretty long history with disordered eating through my teens, 20s and 30s. And the things that were quote unquote, working, definitely stopped working. And as I shared in the Keto episode from summer of 2022, that was kind of my proverbial straw, that was my last kick at the can. And it was really what kind of spurred me into trying something different because I could not do another diet. And yet, my body was changing in ways that I did not understand.
So all of these things started happening around 37. And, you know, I was reaching out to everyone in my circle of care, my family doctor, my naturopathic doctor, my counselor, anybody that I could reach out to and say, this is happening, and it's scaring me. And I don't know why it's happening. And I need help. And I tried all the usual things.
And finally, it was around 38, that it kind of started to come together because I was starting to experience the cycle change as the cycle changes, especially the shortening of my cycles. Sometimes I was having two cycles in a 30 day period. But my very regular 2627 day cycle, which had been normal for me, was now 2324, maybe 25 days. And I had started to notice that I was getting hot flashes and night sweats in the two or three days leading up to the start of my period. All of those things combined with my sleep changes, my mood swings, and also these heavy periods. I forgot to mention, you know, what I call Crime Scene periods were happening. You know, we're kind of the dots that finally connected to say, Oh, okay. This is probably perimenopause. And then when I got some information from my mom about our family history, and that both my mom and my grandmother were menopausal by their mid 40s, it kind of became clear to me that, yeah, this is probably what's happening.
And just knowing that didn't necessarily change anything, but it sure as heck made it a lot easier for me to understand that I wasn't broken. There wasn't something wrong with me. I wasn't doing the wrong things. I just wasn't treating those symptoms as hormonal symptoms. I was, you know, looking at them as depression, anxiety, insomnia, you know, men, arranger, heavy periods. I wasn't seeing it all, as, you know, a symptom of this one change in my hormonal soup that was happening. And, understandably, most people aren't looking at perimenopause in their mid 30s.
Most people barely even look at it at 40. Even though 20% of women will meet the criteria for perimenopause, which is a clinical diagnosis, there's no blood test. There's no urine test. There's no saliva test that can tell you that you're in perimenopause. It's a clinical diagnosis, meaning that we take age and symptoms and history. And, you know, if there's enough of them happening at the same time, then we can assume that this is what's happening. And, you know, 20% of us will meet it at 40, which means that there is, you know, probably one in 10, at least, who are starting this in their 30s. So, know that it can happen in your 30s. But it probably won't. Most people go through perimenopause in their 40s, much, much more common. And just know, though, that it can happen.
So that's kind of the one thing that I want people to know. And if you're someone who is in menopause before 40, meaning that you've stopped having a period altogether, that's premature, and that is, you know, affects a much, much, much smaller percentage of the population. And it's definitely something that you should you know, be talking to your doctor and your healthcare team about to make sure that you can continue to be your healthiest through the next season of life. The second thing is that my worst symptoms would happen before I ever missed a period. So I assumed that things would get really crazy when I started skipping periods, I think because that's the narrative we've been told. That's the narrative we've come to expect. But honestly, when I started missing periods, that meant that I was in a lower hormonal state. My estrogen levels had kind of dropped down Don't again. And that was actually better for me. And I'm gonna explain why. Because, you know, yes, the favorite, you know, the thing that I love about estrogen is yes, you'll miss her when she's gone.
And while that may be true, because estrogen does do some pretty awesome things for us and progesterone, there's something about the highs and lows of estrogen and progesterone and perimenopause that do not feel good. And they are really at the root of a lot of the symptoms that most people that I talked to, you are most bothered by mood swings, sleep changes, body changes, period changes. And for many people, and I was one of them, they got better when I started skipping periods. And as I shared the other day, you know, the last six months for me have honestly been the best six months of the last decade. Because yes, my hormones are all pretty low right now. But that actually makes me feel better. So just know that, you know, if you haven't missed a period, yet, you should still be watching and looking for the symptoms that are interfering with your life.
You shouldn't wait for them to be over that you can and should look for help in minimizing the impact of those on your life because perimenopause can last 10 years, you do not want to be suffering through a decade of your life. And which takes us to number three, it will get better. Oh my goodness, it gets so much better. And I know that when you're in the throes of waking up every night and feeling like you haven't slept in a billion years, and maybe your hot flashes are driving you crazy. And you're afraid to leave the house when you're having your period because it's so heavy and you think, oh, Ken, is this ever gonna get better? It will, it will it will, I promise.
The thing about menopause is that once when you're in perimenopause, you're on this roller coaster, and everything is up and down and sideways and backwards, you don't know what to expect, no two cycles are the same. No two months are the same. You feel like every day, you can kind of feel a little bit scared about what is today gonna bring because yesterday was crazy enough. And then maybe you have a totally normal cycle and you think everything is fixed, or it's all in your head. And it can really make you feel out of control. When everything is reliably and predictably low, which is what happens in menopause, everything is a little bit more stable. So it may not be perfect, but it's better. And I'll take this over five years ago, any day. So the other thing about it for me in and this kind of ties into some of my personal story is that I had, you know, quite severe endometriosis for, really, pretty much. As soon as I started having periods, I think I had my first laparoscopy at 17 and had five or six others I lost count over the next kind of 20 years. My last one being I think at 39.
So when I stopped having enough estrogen to you know, move a cycle every month, that meant that my endometriosis pain got a lot better. And it also meant that I wasn't dealing with the chronic iron deficiency that I had been struggling with for, again, most of my reproductive life. So those two things alone made my life a whole lot better. And I hear that from so many people who, you know, are so worried about what's going to happen when I lose my estrogen and progesterone, forgetting that there actually might be some slight benefits to that. So I'm not saying it's perfect, but that definitely for me, was a highlight that I wanted to share with you that there was so much about the last six months, that I was so thankful for that at least once a week I would say, this is better, this is so much better than it was even a year ago.
And so the fourth thing is around hormone therapy, which can be a really contentious topic. And so I'm going to come out right from the get go and say, I love HRT or MHT, whatever you want to call it. For other people. I love that it's a choice that more people are able to make safely and confidently and with the help of their health care team and I love when I hear of others who feel like it has changed their life in the best possible way. That wasn't the case for me. And Amanda Thebe and I actually talked about our experience, which was really eerily similar on episode a few back and I really wanted to just kind of tell people that it's okay. If you try hormone therapy and all the different ways that you can and it doesn't work. It doesn't mean there's anything wrong with you. It could mean that like me, you're hormone sensitive. And the way that I should have known that I think in hindsight is that during my pregnancies, I felt Very hormonal the whole time.
It was, you know, my mental health was not at its best when I was pregnant and postpartum was maybe even, you know, certainly wasn't worse. But being pregnant was definitely a challenge for me. And my mental health. And also, I was never able to tolerate the birth control pill. So anytime that I tried it, within a few months, I had to stop because I felt awful. It would make me nauseous, it would, you know, it made my PMS worse, which was one of the reasons why I tried it in my early 20s. And so in hindsight, there were lots of hints that I was, would fall into that category, someone who is hormone sensitive. And I hear from so many people, when they're trying different combinations of hormones, that they feel like there's something wrong with them. Am I doing it wrong? Why am I feeling worse? Why? When am I going to start to feel better? Everyone tells me just to keep waiting. And while there's some truth to that, absolutely, because there often are dosage adjustments that need to be made. Just know that if it's not for you, that's okay, too. So I just wanted to share that part of my story. Which really kind of led me though to the next point, which was that food can be used to help manage some of the symptoms that you're experiencing.
And most specifically, I talk about phyto estrogens that come from soy and flax as one of the things that has continued to help me manage my hot flashes and night sweats. In particular, that, for me is the most tangible improvement in my midlife symptoms that I was able to achieve by regularly including soy, tofu, edamame, a flax beans and lentils. And I always like people to know that it's an option. It doesn't compare to hormone therapy, though. So don't think that one don't think you have to choose one or the other. You can absolutely do both because there are other benefits to including these phyto estrogen rich foods. But just know that I'm not saying that one is better. I'm not saying that you should choose plant based phyto estrogens over HRT that is not at all what this conversation is about. But there are a lot of people who can't or don't want to take hormone therapy for reasons similar to mine, or maybe they have contraindications or other reasons why they can't. And this is an option. So there are some options that I like people to know about.
And the thing about phyto estrogens is that there really is no downside to them. I've shared on different points in different podcast episodes and tons on social media that phyto estrogens are safe. Soy is safe. It does not cause breast cancer. It does not make breast cancer worse. There's an episode with Tamara Rothenburg, who's that breast cancer nutritionist who really we go into this in detail. So if you have specific questions about breast cancer and phyto estrogens, go back and watch that episode. But I like people to know that it's an option because it has been a game changer for me. The other thing which kind of ties into you know, this is number six is that restrictive diets, trying harder doing more would not be the answer to my body changes.
And this is one that I wanted to talk about because there's so much conversation and chatter and talk about intermittent fasting and keto and low carb and how women quote unquote need to do this, in order to change the course of the body changes that you may be experiencing in midlife. And let's just back up a little bit and talk about why those body changes are happening. One, we have a pre programmed change to our hormone soup that will make where our body stores fat or adipose tissue change. This is the redistribution of assets that I've talked about so many times that where you go from a quote, pear shape, to more of an apple shape.
And so even if the scale isn't changing what you see in the mirror and how your clothes fit probably are and restricting counting calories, omitting food groups, making life all about trying to manage that midlife change isn't going to help. And since we know that there are side effects to restriction, there are mental and emotional side effects but they're also physical side effects that our body tends to fight that restriction. It doesn't like to be underfed and undernourished. So not only may it have some impact on your metabolic rate in your metabolism, it's going to make you more interested in food. Because the part of our brain that regulates appetite and hunger is also involved in making sure that we survive. So if we're chronically under fed undernourished, we're probably going to actually want food more often and think about food more often. And for people like me who were chronic dieters, professional dieters, and hit this midlife roadblock, it, it felt it felt urgent, I get that I fit. You know, I remember feeling that panic of Oh, my God, what is happening? All of the things that used to quote work are not working anymore. And I feel like I'm living in a body that I don't even recognize, you know, really felt like I had been abducted by aliens.
But when I understood why my body was changing, when I understood that the best way to support my health, and my mental and physical health, through midlife, was not to jump on this really restrictive bandwagon. Well, I did, I tried the keto diet, and then when that failed spectacularly in every possible way, then I realized that okay, I actually need to understand what's happening and learn to work with my body in midlife, I can't and don't want to spend the rest of my life chasing a number on the scale. I can't and don't want to spend the rest of my life feeling broken. And I want to be able to eat peacefully, I want to just trust that I know what my body wants and needs, that I can trust my hunger and fullness. And then I can have this relationship with food that will help me to feel good in my body, which bleeds into helping me feel better about my body.
So that is something that I want you to hear. If you're in that place of feeling this urgent need to do something, press pause, press pause, and try and understand why it's happening. And try and work with someone to develop a plan that's based on this, what I call these four pillars of, of intuitive nutrition, understanding, so what is happening, self compassion, that it's not just happening to you, it's happening to all of us in midlife, you're not doing something wrong, and that you can't hate yourself into a body that you love.
Attunement, which is the third pillar. So how can I learn to listen? How can I develop more awareness of what my body is telling me of what it wants, what it needs? And how can I respond in a way that feels like it is attuned to that? And this goes beyond hunger and fullness. It's also you know, what do I need in terms of self care so that I can take better care of myself? Not just how can I change my body? And then the last pillar is gentle nutrition. So how can I bring it back to nourishing my body, not just with nutrition, but with food, and that in that big picture of what do I need and want to feel good and to support my health, not just achieve a caloric deficit or not always be about changing what my body looks like. So that's number six.
Number seven, which I'm sure you've heard me say, and I've heard so many others say, it's not all bad. As I mentioned a few minutes ago, I felt so much better once I hit this milestone and was as I was approaching it, I was even tempting fate by pretty much telling the world that I was, you know, within weeks or months of my last period, because I knew I had felt this internal shift that this was different. This was good. And with that really came renewed creativity. You know, I have have so many ideas for ways that I want to work with people that I you know, don't have time almost because I have this creative spark.
Whereas five years ago when I was in the throes of perimenopause, I was just surviving. I was you know, just trying to get through the days I had no mental physical emotional space for anything creative. And I have loved how that has come back. I also love this crystal clear clarity about what I want and don't want and it has made it so much easier to say no to things that don't feel good. It has made it so much easier to say yes to what I want to do. And I'm no longer feeling stuck in that should zone that I think so many of have us spend a lot of our life in. And the absolute best part is I have zero tolerance for bullshit. And that is something that I think almost everyone starts to feel at this age. I don't think it's necessarily tied to hormones. But I think that that hormonal shift, maybe made it a little bit easier. So I want you to know that it's not all bad. I want you to know that yes.
Even though there are downsides to menopause, you know, would it be nice to have estrogen and progesterone around for a little bit longer to protect our heart and our bones? Sure. Do I love that my knees creak a little bit more? No, I don't love that. Do I love all of the physical changes? No, I don't love those either. But because I have a body neutral approach. My body image isn't driving my self image. And so I'm able to lean into the positives without dwelling on the negatives. And I think that that is a really key way to be able to just navigate this Asian stage with grace, because it's happening, we can't deny aging, we can't turn back the clock. I don't like the term anti aging, because that makes it seem like aging is a bad thing. And it's not there are changes that maybe aren't so awesome. But it's not a bad thing, because there are lots of upsides to it.
And my last thing, which I hope you can hold on to if you're in the stage where you think, I don't believe anything that she just said, because every day sucks, or I hate this. And I really wish I could turn back the clock because 10 years ago, I did feel better, I was happier, it was easier. I want you to know that it's possible to thrive. But it may not be possible to thrive if you're continuing to do the same things that you've always done. Meaning if your plan for thriving involves restriction, counting calories, thinking about food all the time, trying to manage the calorie and calorie out equation. hinging how you feel in your body based on how you feel about your body or your clothing size, or what the scale is saying. That is going to be hard for you to thrive in. It is going to be hard to feel like you have your feet firmly planted on the ground. If you're always making those decisions around fear, because that really is what is I think driving a lot of the the negative experiences of menopause, it's fear, fear of the unknown fear of losing control fear of what's next. But thriving means having the flexibility to roll with the punches. It means having the resiliency to kind of bounce back when maybe something isn't going as planned.
So if you have a few weeks or months where you're having some really bothersome symptoms, knowing that that's not derailing you that that is something to manage to deal with, you don't have to wait it out, you shouldn't wait it out. But that you know, when you're surrounded by information that is empowering, but also is effective, so you know it's going to work, then thriving feels a lot easier. It doesn't feel like this pie in the sky goal that you can only achieve when things are perfect, because as we all know, usually by this time in our lives, perfect isn't something we can ever really achieve.
So I I hope that you know, kind of this expanded version of eight things that I wish I had known, has given maybe a little bit of insight into some of the things that you're experiencing, but also some insight into what you can do, what you should do, and what you can look forward to as you cross the line of your mental Versary as I call it, and, you know, move into this season of life that so many of us love and wouldn't change for anything. So thanks for tuning in to this week's episode. And stay tuned. I'm pretty sure there's gonna be a part two about you know, some of the ways that I think women can lean into this thriving piece because it is I think, at the end of the day, we want to feel good like I don't need to be a superwoman I don't need to feel like I'm Wonder Woman, but I don't want to feel broken.
And I'd love to chat a little bit more about that with you as well. But for now, have a great day. Thanks for tuning in. And see you soon. Thanks for tuning in to this week's episode of the midlife feast. For more non diet health hormone and general midlife support. Click the link in the show notes till Learn how you can work and learn from me and if you enjoyed this episode and found it helpful please consider leaving a review or subscribing because it helps other women just like you find us and feel supported in midlife
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