Poor sleep, brain fog, change in libido, change in weight and, yes, hot flashes.
Women experiencing these symptoms starting in their 30s may assume that they’re dealing with different issues, but Dr. Karen Tang said they can all be part of what’s called perimenopause — that’s the transition to menopause, when women stop having periods altogether.
Tang, a board-certified gynecologist and the author of “It’s Not Hysteria,” a book on women’s health, said women with a laundry list of those complaints may bring them to a doctor, only to be dismissed.
“The reason my book is called ‘It’s Not Hysteria’ because a lot of times women’s health issues get painted with this brush of like, oh, if a woman’s complaining about a lot of stuff, it’s got to be anxiety or it’s got to be that she’s just overanalyzing stuff,” Tang said.
The fact that so many women deal with perimenopause symptoms while not knowing that those symptoms are all part of a single process has led to calls for education on the issue.
There’s even a bill being considered in Maine to require that state’s Department of Health and Human Services develop educational materials on the topic.
“Hearing about the symptoms of perimenopause and recognizing that is a lot of what you’re experiencing, I think, you know, like a little light bulb sometimes goes off,” Tang said.
The transition to menopause can begin a full 10 years before a woman stops having periods, Tang said.
While hot flashes — the sometimes overwhelming sensation of feeling overheated and breaking into a sweat — are a frequent complaint of women in perimenopause, Tang said brain fog is the most troublesome symptom that patients see her about.
“You feel like you can’t focus, you’re searching for words, you just don’t feel as sharp, or you’re having trouble at work or just kind of juggling tasks,” she said.
Poor sleep is also a common symptom, and one that can make that sensation of brain fog worse, Tang added.
It can also exacerbate other symptoms: “You can feel like anxious, or more depressed. That can be worse obviously if you’re not sleeping very well.”
Tang said perimenopause symptoms vary widely among individual women, and some demographic groups report certain symptoms that others don’t. One example is musculoskeletal pain. “Asian women for example, are more likely to have the musculoskeletal pains rather than hot flashes and things,” said Tang. “Like, you can have joint aches and pains, lower back pain.”
Treatment can include hormone replacement therapy, Tang said. And the types of hormone replacement therapy employed now are quite different from those used decades ago.
“Vaginal estrogen and transdermal estrogen, like in estrogen patches, are very, very different in terms of their risk profile compared to the oral HRT that was given” to women in the past.
In any case, Tang said women should consult their doctors to explore ways to address their concerns.
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