Perimenopausal / menopausal women: what do you wish you knew before it all started?

[ChicaWowWow]

I'm approaching that age bracket, and sometimes wonder if I can prepare mentally and physically for any aspects of (peri)menopause. Sounds woo-woo but I kind of want to listen to my body and do my best to respond to its new needs rather than try and ignore it or freak out and pretend it's not happening.

What do you wish you knew before it all started for you? Any tips?

The perimenopause often starts in your early 40s and you gradually lose oestrogen which causes the atrophy.

Later you may have what we used to call symptoms of the menopause like hot flushes, palpitations etc. These are now recognised as perimenopausal symptoms too. The menopause is literally the moment you haven't had a natural period for a year.

Many women may experience soreness or hot flushes and think they're not old enough for the menopause, so delay getting support.

Getting vaginal pessaries before getting oral HRT or patches, can stave off atrophy. They also work locally, so the risks for women who have had breast cancer or a family history of BC, are much lower.

Often sex begins to feel sore before other symptoms emerge and pessaries should be started as soon as it gets uncomfortable. Some women don't associate vaginal soreness with perimenopause and seek different treatment when pessaries can sort it out relatively quickly.

Have plenty of Gaviscon in the house. The first time I’ve ever had indigestion at the beginning of perimenopause and it kept me up all night. Expect stiff joints, random aches and pains. Try and cut your working hours down.

Yes but if sex isn't uncomfortable ?

Then ask for pessaries when you start having other symptoms. My menopause specialist said most women will get atrophy at some point and pessaries will prevent the atrophy.

I get that some systemic oestrogen not stop atrophy ? I am new to this and it is something of minefield.

That HRT is not the answer for everyone. It just made me put on weight which I have never lost and did nothing for my symptoms.

HRT may help, but in many women's experience localised vaginal oestrogen is more effective for atrophy.

Also if atrophy is the only symptoms it means you don't have to take other forms of HRT.

I have spent three years trying to get my HRT and pessaries right and it's difficult. I was sitting at a lovely talk earlier and my watch was telling me my pulse was over 105 - menopausal palpitations, which i haven't had for ages.

If you can find a great menopause doctor or nurse, you've beaten half of the battle.

TBH you can buy vaginal oestrogen OTC. My last period was February, I have only relatively mild symptoms ( hot flashes mainly at night) but have decided to take it for the cardioprotection and bone/ muscle health. Haven't noticed any gential symptoms- libido is still good, is vaginal oestrogen beneficial in this situation ?

I wish I had known how to prepare for it , it feels like it happened over night and for the 1st 18months kicked my arse.
Thankfully I think I have a handle on it now and touch wood all of my symptoms have either stopped or are very mild and rarely rear their ugly head .

What’s best for atrophy, cream or pessaries?

There was nothing I wished I'd known, because it was very straightforward. But based on another thread here, I'd say don't assume that everything will be awful. Catastrophising won't help, and there is a lot of misinformation out there.

Here’s what I wish I had done sooner. Cut out alcohol. It does you absolutely no favours; makes symptoms worse, wrecks your sleep and piles on the pounds. Weight gain is not inevitable, but you will notice it if you don’t take care of what you’re eating. Preserve your muscle mass and bone density like your life depends on it (because it does). Whatever your age, start lifting weights now. The sooner the better. Cardio is important but is not all you should do. If you need to take HRT then do so. It’s not something everyone can or needs to take, but it is an option for those that do.

One, how your parts will shrivel and disappear. No one warns you about that. Two, what a battle it can be to get HRT. I have loads of symptoms but until I "fail" a blood test my GPs won't give me HRT, even local for atrophy. They keep saying it's "just" lichen but I don't think it is.

Further to that I think they take it less seriously if you're single. Basically, you don't need a functioning vagina anymore so why worry? But if you have a partner who's getting sad face then that needs to be sorted.

Someone said on here you can get local oestrogen over the counter

DM and my aunt (her sister) nothing at all. Aunt didn’t break any bones, very active until age 86. DM has broken bones, but always has.
Gym instructor told me to weight train, I was 26 -33 at the time. I keep active with gardening etc but I need to get on the weights- felt great when I did them. Time is an issue due to DM .

That your periods don’t just stop, they go on and on (53 and 3/4 and still going strong).
How hard it would be to get a doctor to take me seriously. one young female GP said to me, ‘you can’t be young forever, I see women a lot worse of than you’.
And like most people have said, the wide range of symptoms.

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Being a healthy weight can help but do you find that you need to eat very little, and exercise a lot, to maintain a healthy weight?

I do the 16:8, an strict with my diet, jog 7kms 4 times a week, and I am still a stone over my ideal weight. I think to maintain even a size 16 figure takes lots of effort.

Do you lift weights? Jogging is great for cardiovascular health, but it won’t build/preserve muscle mass. In my experience, that’s what makes the difference for reducing body fat, alongside a fairly strict diet prioritising protein.

Localised oestrogen will only help the vaginal symptoms afaik, you need topical (so a patch, gel or spray) for the whole body benefits. And if you have a womb you ll need progesterone when taking oestrogen to prevent thinking of the womb lining, and obviously utrogeston (body identical oral progesterone) comes with its own benefits like calming anxiety and sorting insomnia etc

Please can someone post the brand name? I have no idea what to ask for.

https://www.womens-health-concern.org/help-and-advice/factsheets/

this is a useful website

This

I think I’d say cast your mind back to puberty and how everything got shaken up. almost as if you were turning into a different species - it’s a bit like that. So take the opportunity to get to know yourself again, take care of yourself however you need to, and enjoy healthy hobbies and activities that bring you a sense of purpose and wellbeing. I think for me it’s been important to refer to it openly and matter-of-factly in conversation too, including in the workplace, though that might not be possible or appropriate for all women.

Sorry for not coming back for so long! Life with young kids plus a loss in the family - it's been a lot. I want to cry all the time, I'm often angry, enraged rather, exhausted all the time... I don't know where my head's at most of the time.

I don't think I'll have the capacity to reply individually to all of you, but I immensely appreciate all of your answers. I feel like I could listen/talk/read non stop about the myriad of experiences women have around this stage in life. What you all shared is so personal, very rarely talked about in person (or in public) and it must at times feel scary, lonely, ... (I don't have the words yet, I think).

Anyways, I don't know where I'm going with this, I'm just rambling. Thank you all for answering, and if you feel like it, please keep sharing. I read it all 😇