A healthy diet, like the Mediterranean diet is a nonhormonal way to treat perimenopause symptoms, says Andrea Messina, M.D. iStock/alvarez
Local women raise awareness about perimenopause.
Most of us are familiar with the general outlines of menopause, clinically defined as the period after menstruation has stopped for one year. But what about perimenopause? The less-understood “little sister” of menopause can start five to 10 years before menopause itself and comes with its own range of symptoms. To mark World Perimenopause Awareness Month, we spoke with Edina’s Andrea Messina, M.D., MSCP, a Park Nicollet gynecologist who is a certified perimenopause and menopause practitioner through the North American Menopause Society.
Andrea Messina, M.D., MSCP specializes in perimenopause and menopause. Photo: Andrea Messina
Edina Magazine: Can you define perimenopause?
Andrea Messina: Perimenopause is the time … where women start experiencing changes in menstrual cycles and can start experiencing some of the symptoms we usually associate with menopause … We usually see it start for women in their 40s or early 50s, but I’ve had patients in their late 30s.
What are some common symptoms?
AM: Night sweats, brain fog, irritability, mood swings, heart palpitations, headaches, vaginal dryness, joint pain, hair thinning … and that’s just to name some of them. It’s extremely variable, and the symptoms can fluctuate. There’s so much transition in this time. Weight gain and an increase in belly fat is almost universally frustrating for women, too.
What treatments are available for perimenopause symptoms?
AM: One of the more common treatments is hormonal contraception—birth control pills, rings or patches, or a progesterone IUD. We also talk about hormone replacement therapy. There’s also nonhormonal options. We talk about a healthy diet—like the Mediterranean diet—and making sure you’re getting cardiovascular exercise and, especially, strength training. Get those habits going during perimenopause because it’s going to get more difficult once you enter menopause. That’s why it’s helpful to seek out a menopause provider.
Why do you think there’s still a stigma around talking about perimenopause and menopause, and how can we bring the conversation into the mainstream?
AM: Perimenopause presents in so many different ways; it can be hard for a primary care provider who’s only seeing someone for 20 minutes to address this. There’s more information on social media, so more patients are coming in more educated. I encourage these patients to get these things started.
Sharing Her Journey
Janie Shaw, a longtime Edina resident, started noticing some odd symptoms when she was 41—fatigue, hot flashes and a general sense that something was “off.” Doctors ran a gamut of tests, for everything from Lyme disease to early-onset Alzheimer’s disease. But nothing showed up. “I was having 10 to 12 hot flashes per hour, every hour,” Shaw says. “And I had extreme brain fog. I would be driving in my car in Edina and wouldn’t know how to get home.”
After four or five years of struggling, Shaw finally insisted on getting her hormones tested though her providers were skeptical. It turned out she had an extreme estrogen deficiency: “Less than zero,” she says. She started on an estrogen patch plus progesterone. “Literally within 24 hours, I was a totally different person,” she says. Though her physical symptoms improved, Shaw says she’s still recovering—now 10 years later—from the long-term effects of her untreated symptoms. “It felt like I lost years of my life,” she says.
Shaw, 52, shares her story to help other women know they’re not alone when they start experiencing the often scary symptoms of perimenopause. “The more we talk about it and ask our medical professionals to know more and do more, the better off we’ll be,” she says.
Visit menopause.org for helpful resources about perimenopause and tips for finding a certified menopause practitioner.
