Perimenopause, the transition of time that leads us into menopause, is a phase many of us don't fully anticipate until the symptoms start to disrupt daily life. But hormone expert Dr. Sara Szal Gottfried, the New York Times bestselling author of The Hormone Cure, says the signs can begin as early as your mid-thirties - and some of them might take us by surprise.
From weight gain and mood swings, here's what she wants women to look out for...
Unexpected perimenopause symptoms
1. Cycle changes in perimenopause
One of the first, and less surprising signs of perimenopause is changes in your menstrual cycle explains Dr. Gottfried. "If you were an every-28-day person, [your cycle might shorten to] every 25, sometimes even every 21 days," she explains. "Sometimes your period can also change in quality, so not just frequency, but it can get heavier or lighter."
2. Mood changes in perimenopause
Beyond changes to your cycle, Dr. Gottfried highlights that there are "100 plus" symptoms that particularly arise between the ages of 35 and 40 and notes irritability, mood swings, and weight changes as the most common.
"Some people notice that initially, they may have night sweats the day or two before their period comes - that's how it often starts. They may not ever have hot flashes. And then there's mood swings, meaning people have more anxiety and that's related to the changes in estrogen and estrogen receptors, [which leads to] more depression."
3. Perimenopausal weight gain
But it's what you discover when you step on your scales that can take most of us by surprise, says Dr. Gottfried.
"Typically, by 40, you are gaining about five pounds of fat and losing five pounds of muscle every decade," she explains. "You become more insulin resistant, and unless you're specifically addressing it, you're going to notice, even if your weight doesn't change, that you've got less muscle mass and more fat. So every decade you've got that five-pound situation happening."
READ: I tried to lose weight for 20 years - here's what finally helped me at 44
Navigating these emotional and physical shifts of perimenopause can feel overwhelming, but as well as introducing strength and weight training to your exercise routine, Dr. Gottfried emphasizes the importance of self-care and mindfulness.
© GettyWhen asked for her top tips for women beginning their perimenopause journey, Dr. Gottfried advises starting with lifestyle changes such as weight training and meditation to help with symptoms such as weight gain and depression. Advocating for your own health journey with education and awareness is key, she says, too.
"Lifestyle medicine is number one," she says. "I think the other thing is awareness. There's a way that our culture forces us to go on autopilot, and it can feel like all these things are happening to you. The more that you can create mindfulness and awareness, whether that's with meditation or the way you're exercising or dance, some sort of embodied practice, I think that's critical as a way of tracking what's happening."
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