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Coping With Perimenopause
I knew menopause would come sooner or later, but at 40 years old and having just had baby, it didn’t cross my mind that the symptoms I was experiencing could be perimenopause.
I should have had a clue really, since my mother and grandmother both started perimenopause at a younger than average age and suffered (really suffered!) years of heavy but wildly irregular periods before finally coming out the other side.
Perimenopause (sometimes called menopause transition) is the period leading up to the end of menstruation when the ovaries gradually release fewer eggs. As time goes on the drop in estrogen accelerates and symptoms of menopause may start.
Back to my story. I had a newborn baby and beginning a few months after his birth was experiencing very irregular periods, which ranged from a few spots to trouser-soaking bloodbaths. (Sorry. Probably TMI!)
I was wearing tampons and pads and carried them with me constantly, never knowing when I might get that tell-tale cramp or what I might find when I got to the bathroom!
Since my teens I had always been on a 21-day cycle with almost identical periods month on month, lasting three to five days. But in my 40s I found myself experiencing gaps between periods varying from one week to three months, with bleeding lasting from an hour to 10 days.
We had been considering having one last child, but found trying to chart ovulation just about impossible. I bought ovulation sticks and had some unexpectedly strong results over and over again at times I wouldn’t have expected to ovulate – I later found out high levels of FSH (follicle stimulating hormone) is common as you near menopause.
Somehow despite the issues I found myself pregnant, only to start bleeding at 11 weeks. A scan showed no heartbeat. We vowed to try again, only for my periods to be even more unreliable after the miscarriage was finally over.
I went to my doctor, who after testing gently broke it to me that I had probably been in perimenopause for a while. Our final pregnancy was a fluke and I was unlikely to be able to either get pregnant or sustain a pregnancy due to my fluctuating hormones.
I am already a mother several times over, so know I am very lucky to have the children I birthed successfully, but I was filled with grief for the loss of my fertility.
If you are experiencing bleeding after menopause here is what you need to know in terms of possible causes, treatment options and when to see your doctor.
Grief – it sounds extreme, but I truly mourned the end of that stage of my life. Like the stages of grief when you lose a loved one I went through denial, determined to carry on trying to conceive. I became sad and angry when I realized I would never become pregnant again and then as years passed and my periods stopped altogether I accepted it, and started to enjoy the freedom that being baby-free brought.
Interestingly, my husband also grieved. He refused to accept the fact that perimenopause and my subsequent menopause meant we could not have another baby and in fact only last week voiced his desire for another child despite the fact I have not had a period for 18 months and he knows it is impossible.
I think the worst thing was being in my early 40s meant I had friends who were still getting pregnant and it made me feel old, and like I had nothing in common with them. One of my best friends who got pregnant at the same time as I did with our last unsuccessful pregnancy went on to have her baby and even now, four years later I find it incredibly difficult to interact with her little boy, and our friendship has suffered.
I was less bothered about the other symptoms of perimenopause, simply changing my skincare regime to deal with my new drier skin type and buying new underwear to make the most of my slightly altered figure.
I had more trouble coping with problems I encountered with my intimate life. I suffered a prolapse – apparently this can be common as estrogen declines. This made sex firstly uncomfortable, and then downright painful.
Luckily I plucked up courage to mention it to my (female) doctor and she prescribed topical estrogen in the form of a tiny pessary applied trans-vaginally. My husband and I are very thankful for this simple solution, which hasn’t fully solved the problem but has at least helped. I gather oral HRT can also help.
As the years of perimenopause gave way to menopause I became more accustomed to my new stage of life and in fact embraced it. I have stopped dying my hair and love my new lighter blonde hair with its “glitter highlights,” and very much appreciate not being burdened with a stroller and diaber bag.
I spent time rethinking my wardrobe and makeup so I can still tap into trends without looking ridiculous or resigning myself to the boutiques targeting the more mature lady. I have upped my exercise levels to make sure middle-aged spread doesn’t take over, and I keep a very close eye on portion sizes too.
I found it really helped to remind myself that perimenopause and menopause is not an illness or condition but a new stage of life to be explored with excitement. There are lots of websites, chat rooms and forums offering strategies on coping with perimenopause and a friendly ear when you feel down.
Take a tip from one who has trodden the path – don’t worry in secret, don’t hide your concerns. Be brave and speak to your peers or your health care provider. They will reassure you that you are not alone and possibly even solve issues you are having on your own journey.