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PODCAST - What is Perimenopause ANYWAY?

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In this episode, Victoria discusses perimenopause and its signs and symptoms. Perimenopause is the phase leading up to menopause, characterized by irregular menstrual cycles and declining ovarian function. The duration of perimenopause varies from woman to woman, ranging from a few months to a decade. The most common symptom of perimenopause is hot flashes, which can be triggered by various factors. Other symptoms include vaginal dryness, heavy bleeding, sleep disturbances, mood swings, and memory problems. Victoria also explores complementary therapies for managing perimenopause, such as nutrition, exercise, stress management, and hormone therapy


Victoria (00:01.937)

Hey everyone, welcome back to another episode of Victoria L. Women's Holistic Health Strategies. Now, this is actually being recorded in real time. So I'm here this Monday morning recording it and I'm putting it out right away. Not normally what I do, but I've had a lot of questions coming forward in our group on Facebook, as well as through private message and all that kind of stuff about women wanting to know like, what actually is perimenopause? What signs can we expect?

what should we be on the lookout for? So I thought today, instead of just doing what I had planned, I would switch things up and we're gonna record this one about what is perimetopause actually? Like what is that? What the fuck? So if you're ready, let's go. Buckle up. We're gonna dive deep. We are getting sciency. We are using like professional terminology here. I have done research.

through major medical studies and all that kind of stuff. So I am gonna try and make it more fun in the long run, but just be aware that we are gonna use some science and we are gonna use some big terminologies, right? So you may have been asking yourself, like, what are the actual signs of perimetopause? You're in your 40s, you wake up in the night, you are sweating buckets, your periods are erratic, and they're often...

becoming really heavy, right? Chances are you're going through perimetopause. Many women experience an array of symptoms as their hormones shift and change during the months or sometimes years leading up to that day of metopause. So we've talked about this before. Perimetopause is the whole phase leading up to the day of metopause. Metopause is the day when your period has not arrived for exactly a year.

and you are now period free and you are menopause. That is menopause day, right? So menopause is that natural end of your menstruation and menopause is a point in time where, you know, where your peri -menopause has come to an end. But peri -menopause, peri, Greek for around or near.

Victoria (02:21.489)

plus metaphors, right? Break the word down, that's exactly what it means, is an extended transitional state. So over the years of your body changing and releasing your monthly period. It's also sometimes referred to, sometimes you'll hear people refer to it as the metapausal transition. Although technically the transition ends, like I said, 12 months.

earlier than perimetopause. So you know there's different stages of your reproductive aging that's a whole other podcast we will go into another time. But what is perimetopause? That's what we're here to talk about today. So perimetopause has been defined on different levels but experts generally agree that it begins with the beginning of your irregular menstrual cycles.

courtesy of your declining ovarian function, right? So here's the thing. I know a lot of women that have never really had regular menstrual cycles, right? If you're anything like me, where you've had been diagnosed with things like endometriosis and PCOS, what actually is an irregular menstrual cycle? I have no idea. I didn't have any clue until I started doing my seed cycling.

Like I talked about after perimetoposal really hit me hard, but four months in, I all of a sudden started having regular cycles the first time in my entire life after really dialing in my nutrition and adding the seeds and the movement that coincided with what my body needed, right? But here's the thing. If you've been having regular cycles, you can pretty much know exactly where you are. And then all of a sudden they become irregular.

that's usually courtesy of your declining ovarian function, right? And ends a year after the last menstrual period. So that is when you are officially in menopause, okay? When you have a full year of no period. So perimenopause varies greatly from women to women. We are not all the same. We don't all go through it the same.

Victoria (04:37.233)

and the average duration is somewhere between, can be like as short as three years, can be as long as 10 years. Although, you know, for some women it can also just be a couple months. And for other women, like I said, it can be a full decade. Some women feel completely taken down by the hot flashes and wiped out by heavy periods. Many have no symptoms whatsoever.

So some of y 'all just cruise through this and have no idea and then all of a sudden your periods are gone, right? That's not fair. I'm joking. I'm happy for you. Periods may end more or less abruptly for some, like I said, some may just all of a sudden be like, oh, I'm not getting it anymore. While others may, you know, others of us, we have erratic menstruation, it goes all over the place, it becomes really irregular. We have all these other symptoms and it can be a really tough couple of years.

So fortunately, as knowledge about our reproductive aging has grown exponentially over the last couple of years especially, so many have the options for treating some of these distressing features. Like there's no, we don't have to feel so alone. We are talking about it. I love that we are talking about it more and more. We are using social media to get out there.

and to really express what it is that is going on with us and to share, you know, what is working for us, right? And there's so many different things that can potentially help. So I love that we are doing this because perimetopause is really defined by estrogen, what's going on with the estrogen in your body. The physical changes of perimetopause are rooted in these hormonal alterations.

particularly the variations in the levels of circulating estrogen. So the estrogen that is within your body moving around doing its thing, right? During our peak reproductive years, the amount of estrogen and circulation rises and falls very, very predictably.

Victoria (06:49.745)

throughout the menstrual cycle. Like I said, if you are fortunate enough to have a regular menstrual cycle or have a mostly regular menstrual cycle, you have been very fortunate to have this normal up and down of estrogen as it moves through your body. So estrogen levels are largely controlled by the two hormones in your body. So the follicle stimulating hormone or often referred to as FSH.

I always say fish, but it's not fish. It's FSH and the luteinizing hormone, right? So, or LH. FSH stimulates the follicles and those are, you know, the follicles are those, the fluid filled sacs in the ovaries that contain the eggs. So they are the ones where the eggs are inside. So FSH stimulates these to start to produce estrogen, right? When estrogen reaches a certain level,

The brain signals the pituitary to turn off the FSH and produce a surge of the luteinizing hormones. You notice these hormones sound a lot like the different cycles, right? The different parts of your cycle. And there's a reason because that is what's happening, right? This in turn, once the LH is turned on, this in turn stimulates the ovary to release the egg from its follicle. Yes, we are going back to like grade nine. So thank you.

So we are then releasing the achromas follicle, we're moving into ovulation, right? The leftover follicle produces the progesterone in addition to the estrogen and prepares your body for a potential pregnancy. As these hormone levels arise, the levels of FSH and LH start to drop down. If the pregnancy doesn't occur,

the progesterone falls and then that's when we move into our menstruation, right? And then the cycle just keeps going and going and going and that's what happens. So when you're having hot flashes during perimenopause, most women don't expect to have hot flashes until the menopause phase. So a lot of us were like, what is happening? Why are we having these?

Victoria (09:15.697)

things happening right now. So it can be a big surprise when they show up early, you know, during this perimetopause transition. So hot flashes, sometimes called hot flashes and given the science, so the science name behind these are vasomotor symptoms. That's what they are. The sciencey people call them and the most common reported, they are by far the most commonly reported symptom of perimetopause.

for like 99 % of women that I talked to, that is what triggered them to be like, oh shit, I'm moving into this next phase of life. There are also a regular feature of sudden menopause, you know, maybe due to surgery or treatment or sometimes certain medications can trigger menopause in women. Things like chemotherapy is a huge one. I do work with some people who are,

who are going through some chemotherapy and the hot flashes are insane for them, right? Hot flashes tend to come on rapidly. We know this all of a sudden we are sweating and it's gross and can last from one to five minutes. I've been fortunate. Usually mine come on super strong and then dissipate. But they range in severity from this fleeting sense of warmth. Like all of a sudden you're just like, oh, I'm a little warm here.

to feeling consumed by fire from the inside out. I have literally, when everything started to hit me, that is one of the major things that I experienced. I would wake up feeling like my body was on fire. It was intense. I have never experienced anything like that in my life. And major hot flashes can induce that facial.

that redness, the flushing that goes all the way up the body, sweating, chills, sometimes even if they're really bad confusion, so they can actually give you a sense of like brain fog or not really sure what's happening, right? Having one of these at an inconvenient time, sometimes, you know, maybe you're in the middle of a speech or you're doing an interview or, you know, it's like you're having a romantic time with your partner and then all of a sudden you're like, holy Jesus.

Victoria (11:37.297)

this is too much can be, it can be quite disconcerting, you know, it's not fun. So hot flashes, the frequency, how they come on, what happens, it's such a wide variety between women. And some women have a few over the course of the week, others experience like 10 or more in one day. A lot of us have them at night, you know, waking up, the sheets are like sticking to us and it's just like.

right? The worst feeling if you have them at night, you wake up sweaty. It's so gross. Most women have hot flashes around the time of menopause, but the studies are starting to show that other cultures, this experience is not universal. So this is a really interesting tidbit, okay? So in North America, they've studied what hot flashes are and why they're happening and what's going on. So in North America,

the women that they've studied show that these hot flashes happen around menopause, okay? But then they've also studied these other cultures that suggest that this is not normal for women all across the world. Like, so for example, Japan, Korea, South Asia, women report having very few hot flashes.

in Mexico, women appear to not have any at all, right? So these differences may reflect on cultural variations in perception, but I feel reading these studies that a large factor is the lifestyle factors. So things like the diet, much cleaner diets amongst these women.

much better health in general before heading into perimetapause and metapause and much less occurrence of all the other factors that come along with metapause. So it's an interesting study. I highly recommend that you, if this is something that you're kind of geeked out on like I am, it's a really great thing to look into to see, you know, why are different cultures not experiencing what we are experiencing here in North America.

Victoria (13:54.001)

Stress is a major major influence. I've talked about this before stress is a major influence on your hormones Your cortisol levels affect your hormone your hormone period hormones huge So in these other cultures, they find the women don't have the same level of cortisol and stress that we have here. So Although the you know physiology of hot flashes they have been studying this for decades like

for over 30 years, the studies I could find go back on. No one is absolutely certain as to why they occur or how they occur or what exactly is happening when they're doing this. They have found that estrogen is involved and if it weren't for estrogen, many of these symptoms, like more for dealing with the estrogen levels in your body.

many of these symptoms do not become alleviated or relieved at all when you refuse to deal with what's going on with the estrogen, right? So although it's a major part of it, it really isn't the whole story. For example, researchers have found no difference in estrogen levels in women who have had hot flash symptoms and those who don't. So a better understanding of the cause of hot flash and perimenopause,

really, I feel could open to new ways of looking at things that are not just taking hormone treatments. Hormone therapy sometimes can quell your hot flashes, but it is not risk free. There are risks involved. So we need to really start to learn the other factors that are going on in our bodies. And that's why...

you know, for me, a major part of it was nutrition and movement and taking care of myself and learning how to manage the stress because there's so much going on behind the scenes in this phase of life. So by our late 30s, we actually also stopped to stop or slow the progesterone production as well. The number and quality of our follicles is diminishing. We know like,

Victoria (16:15.185)

we've heard people say like the clock is ticking, running out of eggs, right? And that's what's happening is your body has released a lot of them. So the quality of the follicles is diminishing. This causes a decline in estrogen, causes fewer ovulations. And so as a result by our 40s, our cycle length and menstrual flow may vary from period to period.

and it can also become very irregular because if we don't have the number of eggs that we used to have then our body is not producing as much period symptoms, right? So estrogen may drop or spike higher than normal depending on what's going on in your body and over time the FSH levels rise in a vain attempt to produce

more estrogen, right? Like to keep prodding those follicles to be like, let's make an egg, let's get going here. So that's why they are rising in response to this. So although the high FSH can be a sign that, you know, your perimenopause has begun. So this is another good reason why I always tell people, get in with your doctor, ask them for a hormone panel, figure out what's going on there, get the blood work done, right?

And it's important to do that, but although, you know, we can get these numbers, a single FSH reading isn't a reliable indicator because day -to -day hormone levels are going to fluctuate dramatically. So it is something that you want to kind of get on top of and look at what's going on in your body over time. So what are the symptoms other than hot flashes? Because those seem to be the thing that everyone kind of knows about.

So it can be difficult to distinguish the hormonally based symptoms of perimetopause for more general changes due to aging or common midlife events. So there's a lot of things that are going on that can affect how your perimetopause hits you. So such as the stress of children leaving the home, changes in relationships, careers, there's stress around illness in parents, there's death, all those things.

Victoria (18:36.465)

Given the range of women's experiences, and honestly, I've talked to so many, we are not all the same, but we are all in the boat together kind of feeling, right? So there's so many experiences that happen in this midlife phase that it's unlikely that symptoms depend fully on just hormone fluctuations, right? Hot flashes and night sweats, as an example, an estimated.

35 to 50 % of perimenopause women suffer sudden waves of body heat with sweating and flashing that lasts between five to 10 minutes, often at night, as well as during the day. They typically begin in the scalp, face, neck, chest area and can differ dramatically among women who have them. So...

They are totally, we're all different, right? The way that they come on, how they feel. Some women feel only slightly warm. Others, like I've said before, others end up like drenched and not availing the greatest. So hot flashes can continue for maybe a year or two, even into menopause state and after. And then up to 10 % of women say they persist for years beyond that, right? So that's another thing to keep in mind.

but what is the root cause of these? What is happening? How can you support your body in this time with, you know, the, maybe the minerals that it needs or the vitamins that it needs to help make sure that you're not suffering with these for that long. I can say that, um, about six months into changing everything, following the 28 day strategy, I have knock on wood, had very few hot flashes, none.

to the extent of that one that I, or the ones that I was having before I started this journey, you know, where I commented where like drenched, not feeling the greatest, right? So that is a major symptom that comes on. And then this is the one that a lot of my, so I'm 43. And so my people that I've talked to that are a little bit older than me have really,

Victoria (20:56.273)

of giving me a big caution warning sign about this one. So the next one, the next symptom that I want to talk about is the vaginal dryness. During late perimetopause, those falling estrogen levels can cause the tissue to become thin and dry. And this can actually become worsen as you head into post -metapause and

It can lead to things like itching, irritation, and it can also be a source of pain not only during intimacy, but can be also contributing to that feeling of decreased libido, just not feeling it, just not being your normal sexual self in midlife. So that is a big thing that a lot of my...

my friends that are a little bit older than me have come to me and talked to me about and been open with and said like, stay, stay aware this is coming. You're not abnormal or alone and there's nothing wrong with you. This is just a normal thing that can happen with the change in your hormones, right? And then the next thing that happens,

And I feel like a lot of us have experienced this is the bleeding problem. So with less progesterone to regulate the growth of the endometrium, which is the uterus lining, the lining may become thicker before it is shed. So that can result in really heavy periods. It can also result in fibroids, which are benign tumors that happen in the uterine wall and

endometriosis which is the migration of the endometrial tissue into the pelvic structures. It's extremely painful, causes a lot of clotting and deep bleeding issues, but this is all fueled by estrogen. If you've had the problems like this before,

Victoria (23:04.657)

and now you're heading into perimenopause and it's getting even worse, this is something to be aware of. You want to really look at what's happening and look at what's going on. Again, hormone testing, finding out what's going on. And then a lot of people report sleep disturbances, right? You're having a hard time falling asleep. About 40 % of perimenopausal women have sleep problems. So that's like almost half of us.

That's a lot of us. And some studies have shown a relationship between like the night sweps, the disrupted sleep. And then there's other studies out there that are showing that they have no correlation whatsoever. So the problem here is that the hormones are very complex, right? So we can't just blame the hormones. There's a lot of things going on in the body and

there's more than just a hormone oscillation happening. So sleep cycles change as well as we age and insomnia is quite common. Um, and as we age in, in both men and women, so that one's a tough one. I have found that making sure that your sleep routine is really on point. Learning when your body can actually shut down and turn off and go to sleep is also really important.

So for me, if I'm not in bed and quiet by 10 o 'clock, I have the worst night's sleep, right? But that was all trial and error, trying to work through things. The other thing, can we talk about the mood swings a little bit? Oh my goodness, and the rage. Estimates put the number of women who experience mood swings during menopause between 10 to 20%. Now, I feel like either,

some of y 'all don't know that your mood swings are happening and you think you're lovely all the time or

Victoria (25:10.513)

or somebody just straight up lied because they don't want to admit that they're having mid -swings. So, I'm sorry, but it's a fact. We all, I've actually had conversations with women that are like, I don't have mid -swings as they're being grumpy. Like you're having one right now. So let's not lie about that. We all go through that.

Some studies have linked estrogen to things like depression during the menstrual transition, but there actually is no proof that depression in midlife women reflects the declining hormone levels. They are trying really hard to link these things together, but it's hard to find the proof that links them together. In fact, women actually have a lower rate of depression after age 45 than before. Now,

I don't know if that's because we get to that no more, no more fucks in our fuck bucket at 45 because I'm getting there and that's how I feel. And we're just like, no need to be sad about it. I'm not sure. But hormone related, um, menopause related hormone changes are also unlikely to make, um, you anxious or irritable chronically. Okay. This means like,

If it's just hormones, if you're chronically anxious or chronically irritated, there's probably other things going on other than just your hormones. And that is why dealing with stress factors and learning how to calm your body is extremely important in this phase. So although the unpredictability of perimenopause can be extremely stressful, I know that it definitely is.

and can provoke some episodes of irritability or anxiousness, it really shouldn't be chronic at that time from the hormones. So that is something to look for, like your situations, what's going on around you. Also, some women may be more vulnerable than others to hormone -related mood changes.

Victoria (27:22.065)

The best predictors of mood symptoms at midlife are things like stress, like I've talked about before, stress, overall health, history of depression, what's going on with your body physically before these symptoms hit, right? Other problems that many women complain about are short -term memory problems. How many of y 'all walk into a room, completely forget why you're there? Like, hello.

That is definitely a thing. And there's also this phase, a lot of the, when the hormones are all over the place, difficulty concentrating. It's like ADHD on steroids. Sometimes it is really, really over the top. And although estrogen and progesterone are players in maintaining brain function, there's too little information at this time to separate the effects of aging and the physio -social factors.

from these related hormone changes. So like I was talking about before, your environment around you is just as important as your environment inside of you when it comes to these kinds of things. If your brain is stressed out 24 seven and you're hitting perimenopause and your hormones are dipping and you're losing your memory, look at what is going around. If you are asking your brain to remember every single little thing and to function,

non -stop 24 -7, never resting. Of course you're going to forget why you walked in that room. Right? So here we are. We've gone through these symptoms. We've talked about them. But what are we supposed to do about them? This is the big thing, right? So there are several different things that have been studied for managing perimetopause, for managing the stuff that's going on midlife. So like,

We call them complementary therapies, things like nutrition, exercise, stress management, movement, all those kinds of things. They are very, very, very well researched and are showing great promise with what is going on with the body. Right. So when it comes to your hot flashes, the first rule when you're trying to manage the symptoms of hot flashes is to avoid possible triggers.

Victoria (29:45.745)

So which may include warm temperatures, hot beverages, spicy foods, many people's triggers are different. So just I know for myself, if I eat junk food, it triggers. If I eat, if I have like things that have chemical, chemical preservatives or dyes that my body does not like those. So that will trigger me to go through a flash to not feel the best. So knowing your triggers.

being aware, right? Comes back to being aware of what's going on in your body. It's why we track our cycles. We get in tune with our bodies. One of the best things you can do when you're going out, dress in layers so that you can take off clothes as needed, you know, and making sure that you are not panicking when they happen. There's actually really good evidence that shows that when you pace your respiration, you take those deep breaths,

that they can actually alleviate the hot flash or slow it down so it doesn't get as bad. They're showing that doing things that help with estrogen production like the seed cycling is an extremely effective treatment for hot flashes. So unless you've had a hysterectomy, you'll likely need to take something to help with

with the hot flashes. So there's lots of things out there you can speak with your practitioners, your medical practitioners about what is out there for you. I talk about this in the group all the time about how to use our food and our nutrition to help with this, right? So, um,

There's also, we also want to talk about the hormone irregularities that happen, right? So when, when you go to your doctor, I'm curious, what did they say to you when you said, you know, my periods are all over the place. Um, I need something, right? Or I'm getting heavy periods, heavy bleeding. Most, most of the time, the first thing they do is give you oral contraception, right? They tell you to take that. And although, you know, for many women that, that has been a game changer and.

Victoria (32:07.633)

has really helped. Some people, this is not the best thing. For me, it was not the best thing. It put me in a bad situation. It made me not feel the greatest when I came off of it. It actually really was detrimental for me. So that is part of my story. But again, talking to your health care practitioners is really important. If your hot flashes are getting really severe and

you know, you can't take hormonal therapy or there's, you know, things that are happening, then again, reach out to a practitioner that you trust to help you. So I know lots of, lots of amazing naturopathic doctors that help with this. They talk about different things that can help like herbs and tinctures and, you know, things that are less likely to give you severe side effects and have

been shown to be really useful. So, obviously with your regular periods, it's really hard at this phase or the heavy bleeding to kind of track what's going on in your cycle, but doing the best you can and then feeding your cycle or moving your body in a way that will help to regulate the period or stabilize your body.

There are lots of things that you can do there as well. Again, a lot of people talk about oral contraception for all this kind of stuff and it's completely up to you. I will never make anyone's decision for their body, but I just ask you to do your research and to find if there's other ways to help, right? So when it comes to the vaginal dryness, the best thing just...

get some lube right make sure you have because honestly there's yeah you don't want to be in pain that's just not great don't do that to yourself don't like it's okay to admit it and to say this is what's happening and just to feel better so when we talk about perimetopause there's a lot of different things that come up there's a lot of changes that are happening in the body.

Victoria (34:28.721)

And like I said, for many of us, the hot flashes are the biggest indicator of holy shit or the weight gain, right? The we didn't talk about it today, but we have talked about it before. The the menopause belly it's called and the hormone belly. And it is a huge, huge indicator that the hormones are off and that there's something going on. My number one advice to all of you out there. Take inventory of your stress. What is going on with your stress?

How are you managing? How are you coping? Get real and get honest with that first and foremost and address that first and foremost. So that is all for today guys. That was a lot longer episode than I planned on it being, but I really wanted to share with you that there is a lot of information. Finally, we are doing the studies. We are pulling the information.

And I wanted to help you understand a little bit deeper what's going on with your body. I hope you didn't find this dry and boring. I love the sciency stuff, but I know that a lot of people get like, wah, wah, wah brain around it. So that's all for today. If this has helped you, I would encourage you to leave a comment, like, and share. Please pass this on to your friends, your fellow women that are.

potentially going through the same stuff. Let's educate, let's talk, let's open conversation. And until next week, see you later.

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