One of the greatest frustrations of midlife is that women don’t know what is normal and what isn’t regarding their body. The most common perimenopause questions voice this frustration. When it’s challenging to find quality information or (worse) medical professionals don’t take women seriously, it’s easy to flounder.

But that doesn’t mean you should give up! As a perimenopause women’s health coach, helping women get the answers they need to feel their best is what I do. Readers of Well Balanced Women know that was is presented in this blog is high-quality, scientifically-backed information. It is presented as unbiased as possible so that women can be informed to make the best decisions for themselves.

Note that not all women experience noticeable changes during perimenopause. It is not necessarily a horrible phase! Approximately 20% of women move through perimenopause with no significant lifestyle disruption. If you want to be one of those women, keep reading!

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Perimenopause Question #1: What is the difference between perimenopause and menopause?

In short, perimenopause is the time period when a woman’s fertility hormones begin to decline. It may last for up to 10 years! Menopause is a single moment in time that marks one year after a woman’s final menstrual period.

So, why does the media talk about “going through menopause”? Honestly, I don’t know.

While it may just be a matter of semantics, I believe that using the right words matters. When we call things what they are, we treat them–and by extension ourselves– with deserved seriousness.

Learn more about the difference between perimenopause and menopause (and why it matters!). The more of us who use the language appropriately elevates the conversation for all of the women coming after us.

Perimenopause Question #2: How do I know when I’m in perimenopause?

Unless you have experienced medical menopause due to hysterectomy, oopherectomy, or other intervention, perimenopause begins for most women after they turn 40. The average age for menopause in the United States is 51.

Perimenopause is a period of up to a decade before menopause. So if you are 41 or older, you are likely in perimenopause.

If you’ve ever asked yourself Am I in Perimenopause?— you very likely are! 

Perimenopause Question #3: Is there anything I can do about my hair loss/weight gain/sluggish energy/feeling of overwhelm?

Okay, so this is actually four different questions.

Hair loss, weight gain, sluggish energy, and feeling of overwhelm are all common issues reported by women in perimenopause. In fact, it is often one of these symptoms– or a combination thereof– that start women down the path of thinking about midlife hormonal changes.

The good news is YES there are things that can be done to reverse these unpleasant symptoms. With careful assessment of lifestyle choices and self-care practices, many women are able to improve their condition without prescription medication.

If you’re suffering from midlife weight gain, it’s likely due to your metabolism slowing down. This is a function of aging more than actual perimenopause. There are real, hormonal reasons for a shift in where you gain weight, though. So if you’re noticing specific weight gain in the abdomen, that is more likely due to hormonal imbalance.

And sluggish energy levels or increased anxiety can both be due to a high stress lifestyle. Rethinking self-care and how important it is to release yourself from unattainable expectations helps.

The most common physical perimenopause symptom is hot flashes. Even researchers don’t understand why women get them for sure. There are, however, natural ways to cool off from hot flashes when the heat rises.

Perimenopause Question #4: What is the best form of exercise for women in perimenopause and menopause?

Good question! Women often report frustration with exercise in their 40s because their old routines don’t seem to be working any more. It can be so frustrating!

The truth is, with the hormonal changes of perimenopause, women need to change up the types of exercise they do. By shifting away from long, slow, steady-state cardio to interval training, you start working *with* your body rather than against it. Increasing the intensity of your workouts is like fighting fire with fire— you reset your body’s thermostat and metabolism.

Don’t be afraid to hop off the cardio machines and pick up the weights. Women over 40 need muscle for several reasons. Not only will pumping iron build up your lean muscle mass and rev your metabolism, but it has heart and bone health benefits, too.

But not all workouts have to be mega-intense. Many instances of hormonal imbalance in perimenopause are rooted in over-anxious, constantly busy lives. Mind-body exercise like yoga offers meaningful health benefits to perimenopausal women.

Like most things, finding your body’s balance between intense, heart-rate-raising exercise and more gentle, intentional movement will best serve you in your 40s and beyond.

Also make sure to check out 5 Fitness Myths Women Over 40 Should Dump — see if you have some ways of thinking about exercise that are actually working against you. The more you know, the better you can work with your body!

Perimenopause Question #5: Why should I be concerned about my bone health or heart health?

Again, this is a two-parter. Common media covers bone health as an “old lady” issue. We can all picture the little old lady with the hunchback shuffling over her walker. No one wants to be that lady!

Bone health is a significant factor in your overall quality of life. Ensuring that you are exercising in ways that promote better bone health is essential in perimenopause. By protecting your skeleton, you’re setting yourself up for a more active, more engaged lifestyle.

As far as heart health is concerned, heart disease is the number one killer of post-menopausal women. With the loss of estrogen and its heart-protective benefits, post-menopausal women are at a real and severe risk for heart disease.

The good news is that, other than age, many of the most statistically significant contributing factors to heart disease are lifestyle choices. By monitoring your weight and balancing your blood sugar, you help your heart work at its best. Managing your stress in perimenopause is also critical for heart health.

Don’t underestimate the importance of paying attention to your bone health and heart health! Your life quite literally depends on it!

Perimenopause Question #6: What foods should I eat or avoid if I’m experiencing unpleasant symptoms of hormone imbalance?

Now we’re talking! This is the type of lifestyle change that can have real, meaningful positive effect on your life.

First of all, focusing on balancing your blood sugar will stabilize your energy. When you have more stable energy, you are better able to make quality, health-oriented decisions.

The good news is that there are natural ways to lower your blood sugar, none of which require you to eat weird expensive foods. Just by trying a few of these tweaks, many people find their mood and energy levels boosted and stabilized.

Dietary changes for perimenopause include increasing the attention not just of *what* you eat but when and how it makes you feel. By turning yourself into a bit of a science experiment, you get near-immediate feedback about what foods may or may not agree with your body. Use this information to guide your meal planning.

Perimenopause Question #7: Do I really need to be concerned about how much I sleep?

Yes. Without a doubt.

That seems like an unfair answer, though, doesn’t it?! I mean, women in perimenopause often indicate that sleeping is a challenge. Some women find it hard to wind down at night due to anxiety. Other women struggle with middle-of-the-night insomnia. And still others are awakened by night sweats. Any way you look at it, perimenopause insomnia is awful.

If you have a hard time settling to sleep at night, try using a short, simple bedtime routine. Giving your body a series of actions that signal an invitation to sleep is a powerful transitional tool.

Regardless of the sleep issues you are experiencing, there are solutions! Try reading through these 3 Common Sleep Problems and get some tips about how you can get a better night’s sleep.

Perimenopause Question #8: What’s the deal with Hormone Replacement Therapy? How do I know if it’s right for me?

Great question!

Hormone replacement therapy (HRT) is neither all good nor all bad. It is the right choice for many women. Yet for other women, it merely provides a new normal, not necessarily better than before.

How can you know whether HRT is right for you? Always start with testing! Know exactly what your hormone levels are and how those levels relate to each other. Having a full blood panel drawn by a health care provider who is experienced with women in perimenopause is essential. If you don’t have a health care provider you trust, ask friends for references.

That said, just because your best friend is having great results with a supplement  or HRT protocol doesn’t mean you will. Bodies are highly individualized!!

Regarding HRT, women should make an informed decision, and know that whatever you choose can be altered, changed, or ceased at any time.

Perimenopause Question #9: How can I learn to better advocate for my health?

Isn’t it odd that women’s health education about perimenopause is so poor?! One would think that given the number of women who experience perimenopause, it would be a well-understood topic.

Furthermore, many women in perimenopause have daughters who are adolescents. And these mamas are doing a rocking job empowering their daughters with education about their bodies. All the while, the mamas are walking around confused about what is happening in their bodies.

Not anymore!

Learning about the physiology of perimenopause is the first step to becoming a strong self-advocate. We can’t intelligently ask about something we don’t fully understand. Arming yourself with education will allow you to ask good questions and know when you’re getting answers that make sense to you.

Perimenopause Question #10: Will I always feel this way?

You don’t have to!

While you may feel overwhelmed and confused about perimenopause now, know that there are resources to help you. And just by asking questions, you’re on your way to moving through perimenopause with less stress and greater ease.

The Well Balanced Women blog is for educational purposes only and is not medical advice. Please discuss your health issues with a licensed medical practitioner.