Perimenopause: what helped you?
September 23, 2013 6:29 AM   Subscribe

Older women of mefi, what have you used to help with perimenopausal symptoms, both prescription and alternative? What worked and what didn't? I'm having horrendous hot flashes, periods from hell, mood swings that . . um. . . oh, and mental fuzziness. Yes, I'm going to make a doctor's appointment but I'd like to have some possibilities in mind to talk over with her when I get there.

I am 50 now and have been having various perimenopausal symptoms for 10 years. That's right, TEN YEARS. Or that was what my doctor (same doctor I'm going to see) told me 10 years ago, but that was apparently just the warm up stage. Mostly, I've been able to cope with the symptoms, although the fibroid induced hemorrhaging blood every month is an issue, but over the last couple of months they have really, and I mean really, ramped up and I can't stand it. Last week I think I had a severe hot flash every 20 minutes or so; my last period went on for 25 days and so on and so on. I finally, after three years without, have health insurance again, so I want to do something about all this. I am wary of HRT given the heart risks and the fact that birth control pills gave me migraines - although I quit smoking last November after almost 30 years and I haven't had a migraine in almost as long. I am also kind of unclear on what, exactly, HRT entails? A birth control pill? So any clarity or recommendations on that would be appreciated.

I'd love to find an alternative solution but I still don't have money. Thus, when I went last night to the health food store and stood there staring at the $30 bottles of special menopause vitamins and $18 tubes of wild yam cream, I decided to ask metafilter before parting with half a days wages. So, here I am. HALP!

Special bonus question! After menopause, do you still need to go to the gynecologist every year? Or should you just switch to a regular GP?
posted by mygothlaundry to Health & Fitness (13 answers total) 23 users marked this as a favorite
You ALWAYS need to go to your GYN. You can still develop cancers or VIN (I had that one last year.)

I had a hysterectomy at 42, and I went on HRT right after. I have a tablet compounded for me of estradiol, testosterone and progesterone. It's BRILLIANT. The jury is out on HRT, all I know is that it works for me.

Also, "natural" stuff is exactly the same as chemical stuff. Oral contraceptives were extracted from yams, may as well get the things that are tested by the FDA and approved by your GYN.

I don't have any symptoms of menopause at all. I have friends who are miserable and I say, WHY?
posted by Ruthless Bunny at 6:33 AM on September 23, 2013

While I'm in a much milder state, I'm pretty damn sure I've started perimenopause because my schedule is starting to go really weird, and I'm pretty sure I've started getting hot flashes. But my hormone levels test normal. So I've had to do the natural thing because my doctor and I are leery of prescription anything in that case.

The hack with hot flashes seemed to be lowering your core body temperature when you feel one coming on - I read something somewhere that said that could trigger them is if your core body temperature fluctuates up a couple degrees. Your internal thermostat is basically on the fritz now, so rather than turning things down if your core temperature goes up, it turns it UP at first instead. Then realizes "wait, shit, that isn't right" and starts turning it back down again. So, if you have some ice water or something cold when you feel one might be looming, that can nip it in the bud. That actually seemed to help a lot (or, at least, I used it as an excuse to eat more ice cream this summer and may have just been too happy to care because whee ice cream).

As for the mental fuzziness, I found that just getting more sleep helped (and it may have been the problem all along anyway).
posted by EmpressCallipygos at 6:40 AM on September 23, 2013 [1 favorite]

Why did doc say perimenopause? If you have explained your concerns, doc should be scheduling blood work timed to your cycle.

Over the last ten years, have you discussed this with the doc? Cramps and mood swings and sore boobs and mental fuzziness are one thing, but frequent , long-term heavy bleeding is another. Was the doc aware this was more than periods being closer together?

FWIW, my current gyno, who enjoys horror stories, has told me that a decade of "the Change" is not unheard of.

I hope your doc is able to get a line on where you are and provide meds if needed. If you don't feel good about this conversation, take your cycle history to another gyni and get a second opinion.
posted by Lesser Shrew at 6:44 AM on September 23, 2013

I started getting perimenopausal in my late 30s (yeah, I know) and my doctor put me on birth control pills; Loestrin 24. No more perimenopausal symptoms, and bonus, no more periods. I had heavy flow, every 28 days on the nose, 5-7 days of hell with cramps so bad I'd pass out; 20 years of that was more than enough.

I'm also on thyroid medication, and both these things happened about simultaneously, so it's hard to say what exactly did it. The thyroid controls or is a factor in so much of our body function, if you haven't looked into that you might want to consider getting a check up and a regular run of blood work to see if your thyroid levels are off.
posted by jennaratrix at 7:02 AM on September 23, 2013 [1 favorite]

My periods started going whacky in my early 40s. My cycles were as short as 22-24 days, and I'd bleed for 9-12 days of each cycle, with terrible flooding (nothing like a sudden hemorrhage that goes right through your clothes and onto your friend's couch cushion!). I could fill a Diva cup in under 20 minutes. Birth control pills didn't help me, and I reacted very badly to the hormones. A Mirena IUD made me suicidally depressed and had to be removed in under a week.

So then, I had an endometrial ablation, which is the destruction of the uterine lining by heat, freezing, or radio waves. I can't even remember which my ob did. Women who've had an ablation may still have spotting if some parts of the lining aren't completely destroyed; I have one day of pink-on-the-toilet-paper spotting most cycles. Not bleeding anymore is wonderful, though it's weird to still have hormonal cycles without bleeding, and it can be hard to keep track of my cycles, although it is also important as I have PMS, breast swelling and tenderness, changes in sexual sensitivity, mood swings, and menstrual headaches. I have not fully solved the keeping-track-of-cycles problem and it seems like I sometimes attribute symptoms to my cycles but am wrong about it.

I also developed terrible mood swings with my cycles at about this same time. My irritability and anger were so out of control pre-menstrually that I became sincerely concerned that I should not be left alone with my young children at that point in my cycle. This problem was solved with Effexor, thank goodness.

Over-the-counter remedies and special teas did nothing for me. Going full-on medical and letting myself be talked into drastic measures made my life worth living again; in fact, this past year has been the best of my life.

I'll be turning 48 in a couple of weeks, for what that's worth.

Good luck. Dealing with the bleeding and mood swings was horrible for me. I hope you find your solution.
posted by not that girl at 7:16 AM on September 23, 2013

I live in Japan and my gyno always goes for the Chinese herbs, first.

I had my first perimenopausal symptoms nearly a decade ago (at 37) but she said it is not uncommon for women who have not had the menstrual break that comes with bearing children to begin early, especially if they have estrogen-production issues in their family (check and check.) She had me on a dong quai mixture and it really helped me with the hot flashes, headaches, and also stabilized my cycle for the first 7 years. Only once did I have a never-ending period which forced me to stop the herbs and do one 2 week cycle of Premarin (ugh) but I went back to the herbs for another 2 years after that. In February I had to start taking some pretty intense painkillers and my ortho specialist wanted me to take a break from the herbs to make sure there would be no interactions. I'm trying to make some big surgical decisions right now and the multiple daily hot flashes are not helping. (I'm in the middle of one as I type this...)

I would love to simply go back on the dong quai, but even my gyno said it was good to have a several month break to make sure it wasn't building up in my liver. Perhaps it is something you could try for a few months just to see if it alleviates your symptoms?
posted by squasha at 7:44 AM on September 23, 2013

What seemed to help for me was exercise. I started biking 15+ miles a day at least five days a week in my mid forties. I mostly was searching for an endorphin rush needed post-divorce and general life with teenagers, but I think it really helped keep my body in tune. Boring, but true.
posted by readery at 7:45 AM on September 23, 2013 [2 favorites]

Your menopause is lasting so long, I'd speak with your doctor about why. Could be something underlying that is making it even harder, like undiagnosed endometriosis? Your fibroids will be a contributing factor, no doubt.

I had a hysterectomy because of the bundle of undiagnosed issues I had. Medication was/is not a great option for me for a host of reasons.

What has helped me most, oddly enough, has been diet. The days I eat loads of dairy, I'm a hot mess. On the days I don't, I am okay. No one else I know has observed this kind of thing. Staying away from really spicy foods helps too.

Hot flashes are caused by vasodilation (right?) so I was also told to stay away from caffeine as much as possible.

I also find acupuncture also helps a lot for when you can afford it.

The Hyland's brand menopause homeopathy has also been helpful (on days when all I want is pizza and ice cream).
posted by mamabear at 8:15 AM on September 23, 2013 [2 favorites]

I went back on the pill because of the horrific menstrual cycles of perimeopause. I am very pleased that the heavy bleeding and constant 24/7/365 cramping are gone. I still have hot flashes, but I also love caffeinated tea.
posted by Malla at 9:45 AM on September 23, 2013

Perimenopause began for me at age 35 and lasted until age 59, when I guess you could say I went full menopause. I took black cohosh and evening primrose oil every day and still do. Hot flashes are mostly gone now but every once in a while, whoo, hello power surge! If you are trying to avoid HRT as I did, be sure to look into Astroglide or some similar product - it really helps with sexy times! Calcium supplements and exercise, including weightlifting, will become necessary if you want to slow down bone density loss. Good luck!
posted by Lynsey at 9:48 AM on September 23, 2013

"You ALWAYS need to go to your GYN."

No, this is untrue. Even childbearing-age women can get well-woman care (birth control, cancer screening) from a GP. You don't need a gynecologist unless you have a complicated problem your GP can't handle. The current recommendation for pap testing is every three years (no NOT annually) until age 65.

I would see a GYN or midwife for symptoms like this, though, especially since it sounds like you already have one. HRT contains a lower dose of estrogen than combination birth control pills. You could also try progestin-only pills to reduce or eliminate bleeding but they probably won't help with hot flashes.
posted by Violet Hour at 10:37 AM on September 23, 2013

Have you considered going to a new improved doctor, someone who will give you better answers?

Two things that helped me: lots of exercise and lots of citrus fruit. I found myself craving oranges, lemons, and limes, don't know why.
posted by mareli at 11:53 AM on September 23, 2013

Perimenopause can indeed last over ten years...ask me how I know ;-)

One of my friends did well by having a pharmacist formulate natural hormones (I think they are bioidentical).

As for me, my symptoms are relatively milder so I am gutting through. The good news at least is that at some point your periods won't be gushy anymore. Mine went from "stuck pig" to lighter and less frequent-at this point Aunt Flo hasn't paid a call for three months so I have my fingers crossed.

Do your best to get enough sleep. Your sleep patterns do change and the fatigue exacerbates all our symptoms. Exercise is also very helpful. I have heard good things about the wild yam formulations but haven't taken them. I did try the progesterone cream for awhile a few years ago but I didn't think it helped me any. YMMV.

One other thing. Are you charting your cycles? I use an app on my android and it has been invaluable. If you haven't yet, I recommend you do so. My app lets me leave notes on specific days, and having all the information recorded is quite useful especially when it's doctor visit time.
posted by St. Alia of the Bunnies at 3:52 PM on September 23, 2013

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