A woman’s 40s and 50s can be particularly difficult decades. If she’s a mother, her kids might be in their teen years, and she must cope with their hormone fluctuations along with the enormous challenge of raising wholesome, healthy children in a world that makes that task increasingly difficult. Or, if she had children later in life, she is spending a great deal of energy on nurturing toddlers or managing carpools, play dates, homework, and all the needs of youngsters. Added to this, her own parents are likely aging and need her assistance, too. If she has a career, she is also constantly juggling work responsibilities with all of her duties at home, thus, having little time to nurture herself.
Combined with all the unique and exhausting pressures of the mid-life decades, women have an additional challenge: their hormones are changing drastically, often causing physical and mental upheaval that makes day-to-day life difficult or even unbearable.
Every woman who lives long enough will go through perimenopause and menopause. While these are natural parts of a woman’s life cycle, they are rarely discussed and often misunderstood. While many middle-aged women today can vaguely remember their mothers talking about hot flashes, they did not learn much about the other symptoms of perimenopause, or how to alleviate them. For instance, many don’t realize that the changes to a woman’s body during perimenopause can cause anxiety and depression. And some women didn’t even realize that a phase called “perimenopause” even existed!
What is perimenopause?
According to the Cleveland Clinic, “Perimenopause is the transitional period before menopause. During perimenopause, levels of estrogen, a key female hormone, start to decrease. You may begin having menopause-like symptoms, such as hot flashes or irregular periods. Perimenopause can last for years. When you go a full 12 months without a period, menopause has begun.”1
Though there are various possible physical ramifications of perimenopause, this article is going to focus on the mental ones.
In an article for the American College of Obstetricians and Gynecologists, Dr. Nazanin E. Silver writes, “The hormone changes that affect your periods during perimenopause can affect your emotions, too. Also, physical menopausal symptoms can lead to stress and fatigue, intensifying emotions. About 4 in 10 women have mood symptoms during perimenopause that are similar to PMS, or premenstrual syndrome. You might feel irritable, have low energy, feel tearful and moody, or have a hard time concentrating. Unlike PMS, these symptoms may come at times unrelated to your menstrual cycle. Symptoms may occur for years with no pattern. This type of mood change is known as perimenopausal mood instability.”2
Depression and Anxiety
“Most studies agree that the risk of depression increases during the menopause transition,” says Dr. Silver. “Symptoms of depression include crying a lot, feeling hopeless or worthless, feeling numb, and losing interest in your normal activities. There are few studies about anxiety and perimenopause, but some women report symptoms of anxiety during this time. Anxiety involves constant worrying that gets in the way of your day-to-day life. You may feel muscle tension, sweating, or nausea. Both depression and anxiety can make it hard to concentrate, sleep, and take care of yourself.”3
Makes Parenting Harder
Perimenopause symptoms may make a woman feel exhausted, irritable, sad, and quick to anger. She might feel impatient and annoyed with her family frequently and unable to control her powerful emotions. Young children will probably be confused about their mother’s change in mood and lack of energy, focus, and patience. Teens, who are going through their own hormonal upheaval, are likely to clash with their mother who is fighting her own internal battle.
A mother’s mental well-being affects her whole family. When she is struggling, it is likely to trickle down to her children, affecting how they feel about their home, their life, and themselves. That is why it is so important for women who are experiencing mood instability to seek treatment, for their own sake and for their family’s.
Women who are experiencing any of the challenges associated with perimenopause should talk with their healthcare provider. It is a good idea to write down all the symptoms you experience with as much detail as possible and bring your notes to your doctor’s visit. There are treatments for anxiety, depression, and other mental health problems that arise during perimenopause. You and your physician can discuss which are best for you, but some options include:
- Talk therapy
- Hormone replacement therapy (HRT)
- Changes to diet and exercise
- Holistic medicine, natural remedies, and adaptogens
Be prepared to search diligently for a doctor who will take you seriously and treat your symptoms effectively. There are very few physicians who specialize in perimenopause or menopause, and many doctors don’t know much at all about this topic. According to an article in AARP The Magazine, “Most medical schools and residency programs don’t teach aspiring physicians about menopause. Indeed, a recent survey reveals that just 20 percent of ob-gyn residency programs provide any kind of menopause training. Mostly, the courses are elective. And nearly 80 percent of medical residents admit that they feel ‘barely comfortable’ discussing or treating menopause.”4
The article goes on to say, “ . . . research indicates that just a small minority of menopausal women are receiving the medical care they deserve. A Yale University review of insurance claims from more than 500,000 women in various stages of menopause states that while 60 percent of women with significant menopausal symptoms seek medical attention, nearly three-quarters of them are left untreated.”5
Although it might seem like just one more item to add to your ever-growing to-do list, seeking treatment for debilitating perimenopause symptoms is worth the effort. Since it might last for several months or even years, perimenopause is nothing to sweep under the rug. Even though it is a natural part of life, it is not something women just have to endure. Their mental and physical health is important. They carry a heavy load in their 40s and 50s and deserve a body and mind that feel healthy, resilient, and capable.
Laura El Alam is a freelance writer and editor and the author of the book Made From the Same Dough, as well as over 100 published articles. A wife and mother of five, Laura lives with her family in Massachusetts. You can visit her online at www.seaglasswritingandediting.com.