Written by Clinton Ashford, MD, FACOG
Are you waking up at 3 a.m. and can't go back to sleep? Do you feel more anxious, irritable, or tired than your life's situations really call for? Have your periods become heavier or less predictable? If so, you're not alone, and you're not imagining it. Read on to find out what may be going on and what can be done about it.
What's Really Happening in Your Late 30s and 40s
Beginning around age 35 to 40, the ovaries gradually produce less of three key hormones: Estrogen, Progesterone, and Testosterone. This transition is called Perimenopause, and it can begin years before any obvious change in your periods. For some women the changes are sudden, and for others they creep in so slowly that it's hard to put a finger on what's different.
Each of these three hormones plays its own role. Estrogen is the "workhorse" that affects temperature regulation, mood, sleep, and thinking. Progesterone balances Estrogen and supports sleep and a regular cycle. Testosterone, which surprises some people, matters for women too, especially for Libido, energy, and muscle strength. When all three begin to decline, the effects can show up almost anywhere.
The Most Common Symptoms of Perimenopause
For many women, the decline in ovarian hormones brings:
- Hot Flashes and Night Sweats
- Waking up at night and not being able to go back to sleep
- Anxiety, Irritability, or Depression out of proportion to life's situations
- Fatigue and low energy
- Thinning hair and changes in the skin
- Vaginal Dryness and Decreased Libido
- Worsening PMS, and heavier or irregular periods
Many women also describe "brain fog": cloudy thinking, or not being able to come up with a name, a word, or a number when they need it.
It's NOT "Getting Older." It's GYN-Related, and It's Highly Treatable
Women are often told that these symptoms are just a normal part of aging and that there's nothing to be done. That simply isn't true. These symptoms are NOT age-related. They're GYN-related, and they're highly treatable, often eliminated entirely!
As a Perimenopause Medicine specialist, I can tell you that this is one of the most under-treated areas in all of healthcare. The good news is that nearly all of these complaints are fixable, and you don't need to suffer with any of it!
Treating the Root Cause, Not Just the Symptoms
Too often, women in this stage of life are handed birth control pills to "regulate" their cycle, or an antidepressant (an SSRI) for mood and sleep. Those medications can mask some symptoms, but they don't address the root cause or why the symptoms started in the first place.
Our goal is to address the root cause. That means listening carefully to when your symptoms began and what they are, and then tailoring treatment to you. For most women, the decision to treat is based mainly on symptoms rather than on a single blood test. We look for the most effective approach that restores you to feeling like yourself.
So what does "feeling like yourself" mean? I define normal as how you felt at 28, during the week after your period. That's normal, and that's the goal.
What About Heavy Periods?
Heavier or irregular bleeding is one of the most disruptive parts of Perimenopause, and it can lead to anemia and fatigue. For women whose anatomy is normal but whose periods are taking over their lives, Endometrial Ablation can be an excellent option. It's a minimally invasive procedure, with no incisions and no stitches, and most women are back to their normal routine the next day. It's a far less invasive alternative to hysterectomy for problem periods, and it's a big part of what we do. Having done nearly 7,000 of these procedures, I can tell you that the vast majority of women stop having periods altogether, or nearly so.
"But I Already Have an OB/GYN"
Many women love their current OB/GYN, or the practice that delivered their babies, and that's a good thing. But busy obstetrical practices frequently don't have the time, or the inclination, to address these concerns in depth. At The Ashford Center, Perimenopausal Medicine is our special interest. That's all we do.
A Note About Insurance
With many Aetna and Meritain employer plans, our services are covered with no out-of-pocket cost. To view our No Out-of-Pocket Preferred Employer List: Preferred Employer List. We also work with BCBS, Cigna, and UHC, and we offer self-pay options. But the most important thing is getting you the help you need and feeling like yourself again—that's our mission, and we can get you there!
Take the Next Step
You don't have to just live with Hot Flashes, sleepless nights, "brain fog," or periods that run your life. If any of this sounds familiar, please share this post with a friend or co-worker who may be struggling too.
Give us a call today at 706-353-2550 or schedule your appointment at drashford.com. Women deserve to get the help they need.
Clinton B. Ashford, MD, FACOG The Ashford Center
