Confusion with menopause and whether we’re "at that stage yet" or not is because of a relatively new term that's been introduced in the past decade into our current culture's vocabulary of female health and that’s “perimenopause”. While the term can be traced back to a 1931 book, Obstetrics: Gynecology by Joseph Bolivar De Lee and Jacob Pearl Greenhill, it's a new bit of lingo. In fact, as I write this and then spell check, my auto-corrector recognizes "menopause" but not "perimenopause".
The lack of recognition of this word isn’t limited to my spell-checker. Many women I speak to today, whose periods are a thing of the past, have no idea what this newfangled word “perimenopause” is. They've never heard of it! When I’ve mentioned it in conversation they look at me like I'm from the wimpy, whiney, younger generation that has to make a big deal about everything they experience.
I admit that they might have point. The tail end of the Baby Boomers (born between 1946 and 1964) and the generations that follow are known for setting the bar high when it comes to having demands and wanting choice. And now, that choice has extended to lifting the lid on a lot of the so- called “normal” ways of doing things. We're now looking closer at the stories we’ve been told. We’re asking questions and naming names. While perimenopause was always there, somehow accepting, understanding and seeing it as a tangible stage of life never quite took off for the generations that came before us. Label or no label though, when I clarify the difference between perimenopause and menopause for my older and wiser women friends, they recognize right away what I’m talking about. Some even admit having a name to put to what they went through might've been helpful. It would’ve been really frustrating to not be able to give a name to a host of stuff that was going on.
So here’s the thing:
Perimenopause is the lead up to menopause. It’s responsible for the upheaval and classic symptoms that most of us have attributed to menopause. This process, which can take years, is when our hormones start making themselves known, often manifesting by way of symptoms that accompany our periods. As progesterone, estrogen and other hormone levels begin to fluctuate, they set off a chain of events that begin stimulating several aspects of our nervous system. My belief is that this hormonal reaction stirs things up and calls our attention to nearly every key area of our life from the way we feel about our bodies to the demands on our time. It can even make us face up to our unresolved hopes and dreams or highlight the health of our closest relationships and more. It’s almost like these hormones go on a massive fishing expedition to inspect what’s going on and to search for where things aren’t up to scratch. And as often happens in life, it’s the things that aren’t working that stand out the most.
So let’s get down to the very basics. When you’re reading this book, I kind of tandem between the two words. When I say "going through menopause", that might not necessarily mean periods have ceased. I may be talking the old school label of what we now know perimenopause to be. When I say “perimenopause” I’m talking about the lead up to the time when periods officially stop which is menopause. Basically, I’m probably gonna interchange the two words just to keep a complicated scenario semi-simple.
Confused yet?
I hope not too much.
The most important thing to understand about both of these life events is that they can be considered massive wake up calls to address all aspects of your being from your health and family life to your vocation, your spirituality, your core values and beliefs. Really taking charge during perimenopause is the equivalent of developing a business plan for the rest of your life. Right now, this is a time to take a look at what you’ve got and then, work out what you’re going to need to thrive in the years ahead.
There’s no doubt in my mind that this is a radical time. Women who take on the challenge of this opportunity are absolutely pioneers because this is stuff no one ever told us how to do. Who knew it was even possible to look forward to the years ahead in a dynamic way?
One way to look at what we’re going through right now is to go backwards a bit. To me, going through perimenopause has big similarities to pregnancy. And this similarity is all about cultural shift.
Whether you’ve had a child or not, if you think back over the years, there was a time when pregnancy did not have the social cachet it has today. Actors couldn’t even say the word on television. A woman either got “knocked up” or had a “bun in the oven” or some long beaked bird was responsible for bringing a human baby into the world and dropping it into a lowly cabbage patch. Being pregnant was something that “happened” not something that was owned.
But somewhere along the way, and this happened recently, the way the world thought of pregnant women changed. Now, the words “mummy” and “yummy” are used in the same breath. This is a whole other story than when I had my kids! I remember when I was pregnant for the first time, over 25 years ago. It was a license to be a frump. I used to schlep around in shapeless giant t-shirts and unattractive mother-to- be overalls (I gotta say, I was comfortable!). But now, that attitude of seeing pregnancy as a nine month hall pass to let yourself go is a social no- no. Pregnancy is now touted as empowering. Sexy.
And rightly so. Times and attitudes have changed dramatically and that’s a good thing.
And so this cultural shift of perception, of something that once needed to be kept under wraps but now is out and proud, reminds me very much of where we’re at with midlife.
A lot of us connect perimenopause and menopause with everything that sucks. We've been told since we were young girls how our bodies will just plain turn on us. We’ve been brought up to believe that the path beyond 40 is a loaded minefield, a sagging booby trap full of extreme lowlights like being ravaged by hormones from hell, losing our looks, being invisible, being redundant in the workplace, never having sex and on and on and on.
With a laundry list of scary and downright unattractive expectations, it’s no wonder we don’t want to know about this thing and hope it just goes away.
To be totally honest, there’s no doubt that this stage of life presents a variety of symptoms and scenarios that are confronting. But let’s be realistic here. Don't all stages of our human life have their unique quirks? For example:
Did you teethe as a toddler or have acne as a teenager?
Did you hide or love your newly grown breasts as a pre teen?
Did you want to tear the roof off the house during periods from hell?
Did you do the “Freshman 15”? That’s the slang term for gaining weight when you first left home. Maybe you had an eating disorder as you tried to put some kind of control into your life.
And how about managing monthly periods as an adult or going through pregnancy? There’s a few quirks there to say the least…
Now, imagine that during every physically quirky life stage you found yourself in you made a choice. You decided how you approached each stage and how you took care of yourself. You chose to either learn about the processes you were going through OR you chose to soldier on without looking too close. Or, you ignored them all together and kept on moving. Which category do you slot into?
And let’s go one level deeper.
We all know that our human experience reaches far beyond flesh and bone. Beyond the physical, we’ve also gone through stages of learning how to make our way in the world. That means that we’ve developed patterns for how we make choices, a lot of times courtesy of the way we’ve been brought up. We most likely do what we learned, either consciously