Waking up drenched in sweat, having irregular periods and forgetting your friend’s name mid-conversation — sound familiar? For many millennials, these aren’t just signs of a hectic life, but the early symptoms of perimenopause.
Perimenopause, the transition leading up to menopause, can start as early as the late 30s and last up to 10 years. Yet many people remain unaware they’re experiencing the symptoms, often attributing them to stress, a busy lifestyle or simply aging.
Millennials, born between 1981 and 1996, may not think they’re old enough for menopause symptoms, but many are already at an age where early signs of perimenopause can appear.
“I call it ‘millenialpause,’” said Dr. Judith Joseph, a medical doctor and board-certified psychiatrist based in New York City, speaking to Global News ahead of World Menopause Day taking place on Friday.
Joseph, who is a millennial herself, explained this generation has much more information at their fingertips about perimenopause and menopause than those before them, leading to help destigmatize the topic and fostering open conversations.
“We are the age of information, so we want to learn about things. We don’t trust people to rescue us,” she said. “That’s why I think we’re set up for a better outcome than earlier generations because we just have so much information and we have a culture of curiosity.”
Although she believes millennials will be more open to discussing the symptoms and impacts of perimenopause, Joseph still sees it as a largely underdiagnosed stage of life.
Menopause is officially diagnosed after a person has gone a full year without a period, usually occurring around the average age of 51, according to the Menopause Foundation of Canada. Yet, the journey to that milestone — referred to as perimenopause — brings unexpected emotional and physical challenges that many people may not anticipate.
During this phase, estrogen levels begin to drop, ovulation begins to wind down and menstrual periods become irregular, the Menopause Foundation of Canada stated.
And it’s different than the hormonal changes people feel during their periods, Joseph said.
“You’re going to experience hormonal fluctuations of estrogen and progesterone that are way more intense and way more wide and unpredictable compared to, let’s say, your menstrual period,” she explained.
“It’s different because leading up to that point where you have your final period and you’re no longer ovulating, those fluctuations are much more intense and they can lead to the symptoms of perimenopause.”
Perimenopause symptoms to watch for
Tracy Gomes, 54, had always experienced irregular and heavy periods. In her 40s, when the bleeding worsened, the Toronto resident consulted her doctor, who told her she had amenia caused by iron deficiency from excessive blood loss.
But she and her doctor did not know what was causing the heavy blood loss.
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“I thought it was fibroids and that’s what I was going back and forth to my doctor about. So I had ultrasounds and all of these tests to see what it was, and I also saw an oncologist for a while,” she told Global News.
However, the heavy periods persisted. It wasn’t until Gomes reached her 50s and entered menopause that she realized her previous symptoms, including the heavy bleeding, had been clear signs of perimenopause.
“I went to the Menopause Foundation of Canada website and they had a page on symptoms of menopause and symptoms of perimenopause,” she said, adding that once she read that heavy periods were a symptom she realized that’s what she was experiencing.
She was happy she finally found her answer but still upset that her doctor and all the specialists were never able to identify the underlying cause of her symptoms earlier.
This is not uncommon, Joseph explained, as many doctors may be unfamiliar with perimenopause and often attribute the symptoms to other conditions, such as burnout, depression or autoimmune diseases.
“When I was in medical school, I didn’t know…. I thought about menopause as happening when you’re 50. No one told us about perimenopause. This is a relatively new thing for so many health-care professionals,” she said.
Symptoms of perimenopause can vary but often include:
- Irregular periods, such as changes in menstrual cycle length, frequency or flow.
- Hot flashes and night sweats.
- Urinating more frequently.
- Joint and muscle aches.
- Mental health symptoms, such as depression, anxiety or sleep problems.
- Brain fog and forgetfulness.
- Weight gain or slowed metabolism, especially around the abdomen.
- Vaginal dryness.
- Change in sexual desire.
It’s important to keep track of these symptoms and discuss them with your health-care provider, Joseph advised, to avoid being misdiagnosed and placed on unnecessary medication.
Reasons for perimenopause
Several factors can cause some women to show signs of perimenopause earlier than others, Joseph explained.
These factors may include genetics, lifestyle choices such as smoking, diet and exercise, as well as certain medical conditions or treatments, like autoimmune diseases.
Race and ethnicity can also play a role.
“Depending on race and background and genetics, Black women and Indigenous women tend to go through perimenopause and menopause earlier, longer and with more severe symptoms,” Joseph said.
Healthy eating, getting enough sleep, regular exercise — such as strength training, limiting alcohol and avoiding smoking are crucial not only for preventing perimenopausal symptoms but also for relieving discomfort, Joseph said.
“Now I really limit alcohol, I’m eating tons of protein and in terms of working out, I’m lifting weights,” she said.
“When you’re eating foods that are not processed or sugary, that decreases inflammation in your body. And decreasing inflammation helps with joint pain, it helps with brain fog, it helps with sleep. These lifestyle hacks are really important.”
She also mentioned that other, more natural, effective methods for managing symptoms include meditation and cognitive behavioural therapy.
There are also hormonal specialists to consult with about whether medication could be a good fit for you, Joseph said.
This includes hormone therapy using estrogen or estrogen and progestins to level out hormones and selective estrogen receptor modulators (SERMs), according to Johns Hopkins Medicine.
“It depends because when you see a hormone specialist, they may say hormone replacement therapy or birth control pills,” Joseph said, adding that because of all the different treatment options, it’s important to have someone know you and understand your unique biochemistry so they can provide the best treatment.
