Vim & Vigor - Summer 2021 - 12

12

What Is

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Crying for
No Reason?

During perimenopause, minor
mood changes can lead to
heightened anxiety, worry and
depression, and managing a
family through a pandemic only
adds to the stress.
A provider can help you enjoy
the transition to what UVA
midlife health expert JoAnn
Pinkerton, MD, describes as the
" day you find your postmenopausal zest and realize all of
the advantages of being older
and wiser. "
Dr. Pinkerton says to talk to
your provider if you notice signs
of perimenopausal depression:
Fatigue, particularly before
or during your period
Irritability (often cyclical)
Emotional flatness
Crying for no reason or
tearfulness
Difficulty remembering,
multitasking or decreased
concentration
Trouble falling or staying
asleep

Your Estrogen
May Vary

What's causing all of these fluctuations? In a word, it's estrogen. More
technically, it's the change in estrogen
production that occurs in a woman's
40s and 50s. So much more is understood about this hormonal shift today.
In years past, many women were told
their symptoms were all in their heads.
There's a hint of truth to that, but
not in a dismissive way. Allmen
explains: " The brain and ovaries
work as a team. It's a relationship
that began in your teenage years, "
when the brain first began telling
the ovaries to produce estrogen in
adolescence. That's the first hormonal roller coaster we call puberty.
That ride evens out as the cycle
of ovulation and menstruation
continues through a woman's peak
reproductive years. By the late
30s, estrogen production begins to
decline. The ovaries cannot recruit
follicles to ovulate eggs as they once
did, so a woman may not ovulate or
have regular periods every month.
Added to this is the fact that both the
number and the quality of a woman's
eggs have declined.

PHOTO BY JOHN KUCZALA AND GETTY IMAGES

o understand what perimenopause is, it's helpful to
understand what it isn't.
" Perimenopausal women are not
menopausal, " Allmen says. " Peri "
means " around, " so perimenopause
is literally around or near the time
of menopause.
One thing very much sets it
apart. " During perimenopause,
you're still ovulating eggs, " Allmen
says. " Therefore, you can still get
pregnant, so you better not toss out
your contraception just yet. "
By definition, perimenopause
begins with irregular menstrual
cycles triggered by declining ovarian function. Perimenopause ends
a year after a woman's last period,
and that is when menopause technically begins.
" Perimenopause just slides
right into menopause. It's a continuum, " says Stephanie Faubion,
MD, medical director of the North
American Menopause Society
and author of Mayo Clinic The
Menopause Solution.
Although perimenopausal
women still have periods, many
perimenopause symptoms mimic
those of menopause. Women
can experience just a few or
many symptoms, which range in
severity. They include irregular
or erratic menstrual cycles, heavy
menstrual flow, night sweats,
hot flashes, vaginal dryness and
painful sex, sleep problems,
mood disturbances or irritability,

difficulty concentrating or " brain
fog, " anxiety, joint pain, and hair
thinning or hair loss.
If you're experiencing these
disruptive symptoms, the good
news is you're not going crazy.
" We now understand that the
symptoms women were always
complaining about are truly
related to hormonal change, "
Faubion says. " We have
more evidence now to
validate what women have
been experiencing all along. "

SUMMER 2021 VIM & VIGOR

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4/28/21 10:28 AM
Vim & Vigor - Summer 2021

Table of Contents for the Digital Edition of Vim & Vigor - Summer 2021
