Many women end up in my office with the same story, they are between the ages of 35 and 55, and the story goes something like this: "I just don't feel right, I know something is wrong, I went to my GYN but she said everything was fine, then my hair was falling out so I went to the dermatologist but he said everything was fine, then I thought my thyroid was not working right and so I went to the endocrinologist but she said I was healthy. Everyone says that I am fine, but I know in my heart that something is wrong." Some tears usually follow this.
How about these symptoms?
Edgy, irritable and exhausted, heart palpitations, difficulty recalling familiar words, loss of sex drive, mood swings, anxiety, word-recall problems, fuzzy thinking, migraines, joint and muscle pain, dry skin, thinning hair, weight gain and digestive problems.
All of these symptoms can be due to fluctuating levels of the hormones estrogen and progesterone that start as many as 10 years before menopause.
When women of this age group go to their doctor with complaints like these; one of two things happen:
- They are told that they are fine, totally healthy.
- They are prescribed: sleeping pills, tranquilizers, anti-depressants or anti-anxiety medications and birth control pills.
Many women walk away feeling insulted and shocked that their doctor told them that stress was making them depressed.
After seeing hundreds and maybe thousands of women like this my advice is: If doctors dismiss symptoms as "all in your head" or "aging", persist until you find a doctor who can help you. Trust yourself and how you feel.
"But doctor, I have a good life, I have no reason to be depressed."
Yes, I know, now go tell that to your declining hormone levels.
This life phase, called peri-menopause or menopausal transition, begins when a woman's monthly period first becomes erratic, and it's increasingly recognized as the time when symptoms can be most severe.
During peri-menopause, estrogen receptors throughout the brain are affected by changing levels of the hormone-including regions that regulate sleep, temperature control, blood pressure and heart rate. Estrogen also affects the action of serotonin and norepinephrine, the neurotransmitters that are important in regulating mood. This is why low-grade depression is common in peri-menopause. A few studies have shown that estrogen replacement is as effective as antidepressant medication in treating depression. Estrogen decline also affects memory and as many as two-thirds of women in peri-menopause experience some type of cognitive problem.
Note from Dr. P
To repeat: If doctors dismiss symptoms as "all in your head" or "aging", persist until you find a doctor who can help you. Trust yourself and how you feel.
What to do: Not all doctors think to attribute insomnia, mood changes and memory problems to hormonal shifts. Some gynecologists who realize that hormone shifts are underway prescribe birth control pills. Prescribing birth control to women over 45 to control peri-menopause symptoms is missing the boat. Women experiencing symptoms of peri-menopause should undergo a comprehensive exam to measure blood pressure, cholesterol and bone density, as well as thyroid and other specific hormone levels. They need to be educated as to what is happening, how to use diet and lifestyle to maintain balance, and to use supplementation to restore hormone levels to ease the transition.