From 10 Ways Perimenopause Is Destroying My Life – The Mid.
1. My Period Is Trying to Kill Me
For years, I enjoyed a regular and uneventful menstrual cycle. Now, I never know when I’m going to get my period. It could be in the next six weeks causing a panicked pregnancy scare, or it could decide to come every two weeks (and always when I’m not expecting it at all, and wearing white pants). How long it will last is also a mystery. Once, I had my period for two days, and another time it lasted a full 12. Cramps, heavy bleeding—I’ve got all that in perimenopause. Last month, I passed something that resembled a London broil. It was as if my entire uterus was trying to escape through my vagina. I don’t like this. I want the boring periods I experienced in my 20s back.
2. I Can’t Sleep
Every day I tell myself that this will be the night that I will go to bed at a decent hour and get a full night’s sleep, but it never happens. My sleep patterns now resemble a newborn’s. I’m up every two hours. I’m hungry, I have to pee, I’m bored. I’ll toss and turn for hours each night, praying that my mind will shut off and let me go to sleep, but nope. Naturally, because of this, I’m exhausted all day long and have to drink a ton of coffee to stay awake. To further torture me, in the past year, my body has decided it doesn’t want to metabolize caffeine like it once used to. I’ve morphed into a hybrid of Lady Macbeth and Cornholio. If you ever see me furiously Irish step-dancing through the aisles of Walmart, I swear it’s not meth. I just had a cup of coffee, because I was tired, because I can’t sleep at night, because of perimenopause. Save me, please.
3. Unexplained Weight Gain
No, I’m not pregnant. I’m just cruelly bloated. They make mom jeans for women like me. Once a sworn enemy, elastic is now my greatest ally. I swear, I haven’t changed my diet at all. If anything, I eat healthier now than ever, but my metabolism is nonexistent these days. I used to be able to rip through nachos, Twix bars and Slurpees, and remain a size four, but now a single Cheeto will force me into a higher dress size.
4. My Body Is Growing Weird Hairs
I hate my teenage self who used to wonder why older ladies always had wiry hair on their chins. Now I know. It’s because those hairs can randomly sprout three inches in about two seconds. And also because we are so old that we can’t even see black whiskers shooting out of our faces. Yes, I’ve accepted it, I’m either turning into Witch Hazel from Looney Tunes, or a walrus.
And when I cough, laugh, or jump up and down. I’m an old house—quaint and charming on the outside, but my plumbing system is a leaky nightmare.
PMS is apparently having its last hurrah with me and is determined to go out with a bang. Irritable doesn’t begin to describe it. Little things set me off: going to IKEA, wanting tortilla chips but being out of them, if my daughter whines because, God forbid, I gave her the wrong plate at lunch, and when my clock ticks too loudly in the middle of the night. It’s awful. Whenever I see a woman on the news who’s had a road rage incident, I sigh knowingly and say that I bet she’s in perimenopause. Sometimes I have fantasies of getting a job at an amusement park haunted house just so I can chase people around with a chainsaw, because most of the time, that’s what I feel like doing anyway. I may as well get paid for it, right?
7. My Skin Is Freaking Me Out
I’m so dry and wrinkly that I think my vagina has cobwebs. I recently read somewhere that during perimenopause “breast tissue may reduce.” Great. That thing sputtering around the room? Not a deflating balloon. That’s my left boob. The skin on my arms and chest is so crepe-y that you could make streamers out of me. Yay! I love looking like a beige party decoration. I found an age spot on my hand the other day, and I also heard that you can get age spots on your nether regions, which is fabulous because I always wanted my crotch to look like a Chinese crested puppy. Said no woman ever.
8. I Can’t Remember Anything
What was I saying? You know that feeling when you’re trying to remember something, and it’s right on the tip of your tongue? That’s me 24/7 these days. They call this brain fog, and I feel like I’ve reached my brain’s natural storage capacity and now it’s malfunctioning from overload. I need an external hard drive for my mind. The number of times in a day when I find myself standing in the middle of a room and have no idea how I got there or what I’m supposed to be doing is staggering. Every time I open an app on my phone, I forget what I meant to look up, log or check. I’ve officially turned into the guy from Memento and am going to have to start writing notes on my skin to piece together my life.
9. Everything Makes Me Cry
Last week, I cried because I saw a high school marching band coming down the street playing Stevie Wonder. I cried at a puppet show, from watching children ride a carousel and over the grand finale of a fireworks display. Forget Idina Menzel. Before she even opens her mouth to sing, I’m weeping uncontrollably.
10. I’m Hot—NO, I’m Freezing
My internal temperature gauge has gone haywire. I wear cardigans in the summer, and bathing suits in the snow. Nothing makes sense anymore.
But that’s the nature of perimenopause—everything is different, it’s confusing, and most women don’t know what to expect. Now that I know I’m not insane, that this stuff is pretty normal, and that I’m not dying from a terrible illness that causes insomnia, vaginal dryness and ugly boobs, I can usually laugh off my symptoms. When I’m not hysterically sobbing, that is. Perimenopause is a sucky part of life, like puberty was, and when it’s over, the very second my last period ends, I’m throwing a huge party. Or, more than likely, just going to bed.
What is Polycystic Ovarian Syndrome (PCOS)?
PCOS is a health problem that can affect a womanís menstrual cycle, fertility, hormones, insulin production, heart, blood vessels, and appearance. Women with PCOS have these characteristics:
- high levels of male hormones, also called androgens
- an irregular or no menstrual cycle
- may or may not have many small cysts in their ovaries. Cysts are fluid-filled sacs.
PCOS is the most common hormonal reproductive problem in women of childbearing age.
How many women have Polycystic Ovarian Syndrome (PCOS)?
An estimated five to 10 percent of women of childbearing age have PCOS.
What causes Polycystic Ovarian Syndrome (PCOS)?
No one knows the exact cause of PCOS. Women with PCOS frequently have a mother or sister with PCOS. But there is not yet enough evidence to say there is a genetic link to this disorder. Many women with PCOS have a weight problem. So researchers are looking at the relationship between PCOS and the body’s ability to make insulin. Insulin is a hormone that regulates the change of sugar, starches, and other food into energy for the body’s use or for storage. Since some women with PCOS make too much insulin, it’s possible that the ovaries react by making too many male hormones, called androgens. This can lead to acne, excessive hair growth, weight gain, and ovulation problems.
Why do women with Polycystic Ovarian Syndrome (PCOS) have trouble with their menstrual cycle?
The ovaries are two small organs, one on each side of a woman’s uterus. A woman’s ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These sacs are also called cysts. Each month about 20 eggs start to mature, but usually only one becomes dominant. As the one egg grows, the follicle accumulates fluid in it. When that egg matures, the follicle breaks open to release the egg so it can travel through the fallopian tube for fertilization. When the single egg leaves the follicle, ovulation takes place.
In women with PCOS, the ovary doesn’t make all of the hormones it needs for any of the eggs to fully mature. They may start to grow and accumulate fluid. But no one egg becomes large enough. Instead, some may remain as cysts. Since no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a womanís menstrual cycle is irregular or absent. Also, the cysts produce male hormones, which continue to prevent ovulation.
What are the symptoms of Polycystic Ovarian Syndrome (PCOS)?
These are some of the symptoms of PCOS:
- infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
- infertility or inability to get pregnant because of not ovulating
- increased growth of hair on the face, chest, stomach, back, thumbs, or toes
- acne, oily skin, or dandruff
- pelvic pain
- weight gain or obesity, usually carrying extra weight around the waist
- type 2 diabetes
- high cholesterol
- high blood pressure
- male-pattern baldness or thinning hair
- patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
- skin tags, or tiny excess flaps of skin in the armpits or neck area
- sleep apnea – excessive snoring and breathing stops at times while asleep
What tests are used to diagnose Polycystic Ovarian Syndrome (PCOS)?
There is no single test to diagnose PCOS. Your doctor will take a medical history, perform a physical examópossibly including an ultrasound, check your hormone levels, and measure glucose, or sugar levels, in the blood. If you are producing too many male hormones, the doctor will make sure itís from PCOS. At the physical exam the doctor will want to evaluate the areas of increased hair growth, so try to allow the natural hair growth for a few days before the visit. During a pelvic exam, the ovaries may be enlarged or swollen by the increased number of small cysts. This can be seen more easily by vaginal ultrasound, or screening, to examine the ovaries for cysts and the endometrium. The endometrium is the lining of the uterus. The uterine lining may become thicker if there has not been a regular period.
How is Polycystic Ovarian Syndrome (PCOS) treated?
Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatments are based on the symptoms each patient is having and whether she wants to conceive or needs contraception. Below are descriptions of treatments used for PCOS.
Birth control pills. For women who donít want to become pregnant, birth control pills can regulate menstrual cycles, reduce male hormone levels, and help to clear acne. However, the birth control pill does not cure PCOS. The menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone, like Provera, to regulate the menstrual cycle and prevent endometrial problems. But progesterone alone does not help reduce acne and hair growth.
Diabetes Medications. The medicine, Metformin, also called Glucophage, which is used to treat type 2 diabetes, also helps with PCOS symptoms. Metformin affects the way insulin regulates glucose and decreases the testosterone production. Abnormal hair growth will slow down and ovulation may return after a few months of use. These medications will not cause a person to become diabetic.
Fertility Medications. The main fertility problem for women with PCOS is the lack of ovulation. Even so, her husbandís sperm count should be checked and her tubes checked to make sure they are open before fertility medications are used. Clomiphene (pills) and Gonadotropins (shots) can be used to stimulate the ovary to ovulate. PCOS patients are at increased risk for multiple births when using these medications. In vitro Fertilization (IVF) is sometimes recommended to control the chance of having triplets or more. Metformin can be taken with fertility medications and helps to make PCOS women ovulate on lower doses of medication.
Medicine for increased hair growth or extra male hormones. If a woman is not trying to get pregnant there are some other medicines that may reduce hair growth. Spironolactone is a blood pressure medicine that has been shown to decrease the male hormoneís effect on hair. Propecia, a medicine taken by men for hair loss, is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair. A woman with PCOS can also take hormonal treatment to keep new hair from growing.
Surgery. Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation. The doctor makes a very small incision above or below the navel, and inserts a small instrument that acts like a telescope into the abdomen. This is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these effects may only last a few months. This treatment doesn’t help with increased hair growth and loss of scalp hair.
A healthy weight. Maintaining a healthy weight is another way women can help manage PCOS. Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy weight, which will help the body lower glucose levels, use insulin more efficiently, and may help restore a normal period. Even loss of 10% of her body weight can help make a woman’s cycle more regular.
How does Polycystic Ovarian Syndrome (PCOS) affect a woman while pregnant?
There appears to be a higher rate of miscarriage, gestational diabetes, pregnancy-induced high blood pressure, and premature delivery in women with PCOS. Researchers are studying how the medicine, metformin, prevents or reduces the chances of having these problems while pregnant, in addition to looking at how the drug lowers male hormone levels and limits weight gain in women who are obese when they get pregnant.
No one yet knows if metformin is safe for pregnant women. Because the drug crosses the placenta, doctors are concerned that the baby could be affected by the drug. Research is ongoing.
Does Polycystic Ovarian Syndrome (PCOS) put women at risk for other conditions?
Women with PCOS can be at an increased risk for developing several other conditions. Irregular menstrual periods and the absence of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Without progesterone, which causes the endometrium to shed each month as a menstrual period, the endometrium becomes thick, which can cause heavy bleeding or irregular bleeding. Eventually, this can lead to endometrial hyperplasia or cancer. Women with PCOS are also at higher risk for diabetes, high cholesterol, high blood pressure, and heart disease. Getting the symptoms under control at an earlier age may help to reduce this risk.
Does Polycystic Ovarian Syndrome (PCOS) change at menopause?
Researchers are looking at how male hormone levels change as women with PCOS grow older. They think that as women reach menopause, ovarian function changes and the menstrual cycle may become more normal. But even with falling male hormone levels, excessive hair growth continues, and male pattern baldness or thinning hair gets worse after menopause.
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