Peri-Menopause- AKA “The Abyss”

It seems to me, the lifespan of a woman can be divided into several distinct time frames: There is:

The Age of Reproduction — approximately age 16 to 42

The Age of Menopause — approximately age 52 until forever

….and then there is that time period in between the two — about age 43 to 52, which can be referred to as the Age of Peri-Menopause. I lovingly refer to it as THE ABYSS. Why? Because an abyss is an endless hole — a deep and seemingly on-going chasm. An abyss also describes the “regions of hell, conceived of as a bottomless pit”. In my experience, as an ObGyn for the last 20+ years, this is exactly the way women in this age group describe what it feels like to be perched on the edge and almost falling in.

When a woman is in The Age of Reproduction, it is fairly easy to understand the role of the gynecologist — it is often as simple as a choice between two opposite plans — Either “Help me have a baby”, or “Help me to NOT have a baby”……to boil it down to the simplest elements— fertility vs contraception.

When a woman is in The Age of Menopause, it is also often fairly simple to come up with a plan, which will almost always include “Treat my menopausal symptoms”, and “Keep me healthy throughout my older years”.

BUT — when women are in the Age of Peri-Menopause, it is almost always a complicated mix of seemingly random symptoms and processes that are in need of attention. I have heard the following: “I think I’m going crazy”. “My hormones are all out of whack”. “I cannot get out of bed”. “I have suddenly gained 15 pounds”. “I have constant fuzzy brain”. “ I’m in a bad mood all the time”. “I don’t know what’s happening to me!” THIS is the gynecologist’s complicated dilemma — — and the one where I have had to come up with a true plan of action to help women who find themselves “falling” into this hole.

This truly is a time period where women are unlucky enough to have many of the well-known menopausal symptoms (hot flashes, insomnia, vaginal dryness, leaky bladder, low energy) and at the very same time (sometimes on the same day!) the shock of having periods that remind them of their teenage years — — heavy, irregular, painful, clotty and just plain annoying. It seems the pendulum swings up and back, one day causing…