Change is difficult for most people, but change can also be exciting.  Most women as they approach their forties feel stable and take pride in having successfully made it through their preteen years, teen years, and childbearing years and begin looking forward to aging gracefully.   Many have successful careers; many have teenage children or children that are already grown. Most women are married or have had at least one, or a few successful long-term relationships.  Their world seems somewhat established and predictable and then along comes these wild capricious hormones that can suddenly turn your world upside-down!  You can feel like a teen-ager again, taking things too seriously, randomly breaking out with pimples, and feeling as if you are on an emotional roller-coaster.   Your menstrual cycle can become erratic and unpredictable coming more frequently or lasting longer, with more cramping and raging emotions.  I remember longtime client of mine walking into my office in tears.  She was a school teacher, with a good marriage, had proudly married off two of her children, and was coping well with her remaining two teenage daughters.  Her life was organized and ran smoothly and going then suddenly, out of the blue, she was sure she was having an emotional break-down.  She was moody, getting her period every couple weeks, was impatient, easily agitated, having random panic attacks and began experiencing migraines!  She questioned what was happening to her and was afraid she was on the road to a nervous breakdown.  Being responsible she made an appointment her family doctor who said she was just ‘stressed and over-worked,’ so offered her tranquillizers to help her sleep more deeply at night.  He also referred her to a neurologist for her headaches.  The neurologist stated that she was just ‘stressed-out,’ handed her strong medication for her headaches and referred her to a psychiatrist.  The psychiatrist said she had unresolved anger problems and gave her a prescription for a psychotropic medication and also referred her to a gynecologist.  The gynecologist handed her a prescription for birth control pills to regulate her cycle and suggested a family therapist.   She was devastated and didn’t know where to turn.

She walked into my office and put the four different prescriptions on my desk and beckoned my opinion.  She was not a person who regularly took medication so to begin taking four medications all at once was daunting for her.  I looked into her eyes and asked her if any of her doctors spoke to her about perimenopause?   She peered at me through tearful eyes asking, ”Peri-what?” With a look of terror in her eyes she questioned, “Is it curable? Can I be a normal wife, teacher and mother again?”  “Yes,” I said as a look of relief and joy filled her eyes.  “Let me explain what is going on….”

Perimenopause is the normal stage in a woman’s life that precedes menopause.  It usually lasts somewhere between a few months to ten years, with the average time frame of about four years.  Perimenopause is the time when the woman’s body is transitioning from a period of fertility to a time of infertility.  The Mayo clinic defines perimenopause as, “the menopausal transition, it is the interval in which a woman’s body makes a natural shift from a more-or-less regular cycles of ovulation and menstruation toward permanent infertility, or menopause.  Woman start perimenopause at different ages.  In your 40’s, or even as early as your 30’s, you may start noticing the signs.  Your periods may become irregular—longer, shorter, heavier or lighter, sometimes more and sometimes less than 28 days a part.  You may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness.  As you go through the menopausal transition, your body’s production of estrogen and progesterone fluctuates. These hormonal fluctuations are at the root of the changes your body goes through during perimenopause. Perimenopause lasts up until menopause which is the point when the ovaries stop releasing eggs.”

Most women will experience one or all of the below symptoms during perimenopause.

  • Hot flashes
  • Breast tenderness
  • Worsening of premenstrual syndrome
  • Decreased libido
  • Fatigue
  • Irregular periods
  • Vaginal dryness
  • Urine leakage when coughing or sneezing
  • Urinary urgency
  • Mood swings
  • Difficulty sleeping

Herbalists do not look at perimenopause, or menopause for that matter as a negative time, it is a powerful time for woman as they journey toward becoming a ‘wise-woman.’  In days of old, the ‘older-women’ in the clan were known as the ‘wise-women’ and those elders were revered and honored.  The ‘wise-women’ were the decision makers and the younger women summoned their guidance.  Susun Weed, the herbalist, teaches that during a woman’s childbearing years her energy, is centered around their pelvic area and their power is being pulled down and out of their bodies, firstly with their monthly menstrual cycles, then with childbirth.  When women begin to leave their childbearing years and enter their next stage of life their energy is no longer centered in their pelvic are, rather, being transferred and lifted toward her brain helping her develop into her wise woman stage, hence, hot flashes.  Susun Weed believes that older women become deeper thinkers and become more intuitive and brain scanning is now confirming her beliefs. Christiane Northrup a gynecologist and researcher theorizes that the female brain gets an intuitive boost by the hormone changes that take place at menopause.  Northrup suggests that the LH and FSH hormones, which are only high during ovulation in younger women, remain high for postmenopausal women.  There is some evidence that these two neuropeptides stimulate whatever brain function is responsible for intuition, making postmenopausal women more consistently intuitive.    Their body may be slowing down but their brain (with a proper diet, exercise and sleep) can become sharper and more intuitive.  According to Dr. Brazeltine a neuropsychiatrist, “women’s intuition is likely more biological than mystical”. It is a time that the body and soul is preparing for the second phase in a woman’s life.

If our goal during our perimenopausal period is to mold ourselves to become the wise-centered-balanced woman how do we get there?  How can we gracefully exit out the other side to this place of being “wise?”

The way we become ‘wise-women’ is to tune into how we are really feeling and not worry about what people around us will feel.  Say what you feel (just try and say it as nicely as you can).  Take up new hobbies (even if you feel you do not have the ‘time’), be adventurous, see new places, try new foods, go to art galleries, buy a new perfume, take classes at your local college, and wear a new color dress.  But watch out, you can I still become pregnant during perimenopause!  So, if a baby is not in your plans for your middle years, you will need to continue birth control until you have gone at least 12 months in a row without having your period.

Daily suggestions to keep you stable emotionally and physically are:

  • Drink more water
  • Try to get to sleep earlier (often women wake up very early and find it difficult to go back to sleep)
  • Eat lots of fruits and vegetables
  • Meditate
  • Take deep breaths throughout the day

The following herbs have been used for centuries to help ease woman’s symptoms and help women adjust to their new lives.  The herbs can be used one to four times a day and are best used in tincture form (herbs soaked in grain alcohol.  The usual dose is 25-40 drops three times daily diluted in water or juice.  You can use the herbs singly or a few herbs mixed together.  It is best to work with a herbalist who can analyze your specific symptoms and make a blend that will best fit your personal needs. When you find the herb or herb combination that works for you your symptoms will be less severe and manageable. Companies such as Herbalist and Alchemist, Herbpharm, and Gaia have pre-made herbal combinations that are very well produced herbals.  Or you can try the single herbs yourself and create your own combination.

  • Sage-used to help relieve nervous tension.
  • Black Cohosh is helpful alleviating many symptoms including hot flashes, and is specific for hormonal depression.
  •  Motherwort-is used for emotion swings such as moodiness and sadness.
  • Skullcap-is used for nervous tension and anxiety.
  • Chaste berry– Is an over-all toner for the hormonal system; this herb is excellent for restoring and regulating hormonal balance.
  • Red Clover– hot flashes, osteoporosis, and improves cardio-vascular health.
  • Cramp bark/black haw mixture-used for cramping and PMS symptoms.

So enjoy this time of change and experiment with the herbs listed above.  You will find that a combination of these herbs will help assist your body in handling and enjoying this time of change in your life.