My Hormones Are Throwing a Party and I Wasn’t Invited: Hello Perimenopause!
- Raemona
- 10 hours ago
- 4 min read
I just turned 50 last month and I feel incredible! A momentous milestone and I’m honestly grateful for it. I’m welcoming this new phase of my life like a champ. But looking back, I can’t help but wonder why nobody warned me in my late 30s about what to expect in my 40s.
We get the puberty pep talk during our pre-teen years but no one grabs us to the side at 40 and says: Hey, just an FYI, in a couple of years from now, your hormones are going to go out of whack and throw a fastball at you. It’s going to get a little crazy so brace yourself.
Sadly that conversation doesn’t happen often enough during the years leading up to perimenopause, but it darn well should! So why aren’t we talking about it more often? Is it the shame or the fear of getting older? Or is it the lack of information from previous generations, our mothers who simply endured this phase of womanhood? Why was I thunderstruck by my own biology at 49 and arriving to the party unprepared? Why did I have to spend hours if not days rummaging through Google to find articles or any sort of information on the symptoms I was experiencing, what to do, what not to do, to medicate or not to medicate, what is Hormone Replacement Therapy (HRT), what is the difference between bio-identical and the other forms of HRT... It would have been oh so helpful to have a baseline at about 35 of potential symptoms to look out for – a perimenopause starter kit or a girlfriends guide, (that’s what Tamsen Fadal calls it, she's a famous American journalist and menopause advocate that I started following last year on Instagram. She’s making a lot of noise about this menopause silence that I’m referring to).
Something was off; my body didn’t feel quite right and so I decided to get a blood test done to check if my estrogen and progesterone levels were still in the normal range. They were not. They were lower, indicating that I was indeed in perimenopause and the loss of estrogen was actually contributing to my symptoms. Needless to say that estrogen is a super important hormone!
Luckily for me, my symptoms weren’t too bad: a mild dose of daily brain fog, abundant menstruation making an appearance not once but twice a month, unusual weight gain, especially around my abdominal area (I would just look at a carrot and gain a kilo, probably related to increased insulin sensitivity during perimenopause), but my main issue was with the changes happening in my gut and gastrointestinal tract. Estrogen and progesterone affect GI tract motility (the movement of food through the intestines) and this caused me significant bloating and constipation. (I will spare you the details on that last bit)
After my blood test indicated low estrogen levels and that I was indeed in perimenopause, I needed to speak to a professional about what to do next. I didn’t want to self-diagnose and make uninformed decisions about the loads of information I had gathered from the internet so I booked a consultation with the incredible Dr. Eleanor McCarthy at King’s College Hospital Dubai Hills, as she came highly recommended on a variety of platforms in Dubai. Dr. McCarthy explained the different options for HRT (estrogen and progesterone supplementation), she gave me the pros and cons and debunked a lot of my misconceptions. She was fantastic and I left feeling empowered with knowledge. FINALLY. There was a plan! I was not going to live with an estrogen deficit and that was my decision.
I also received valuable insight from the Middle East Menopause Organization, a lovely Facebook group founded by Donna Howarth, a Menopause and Health Coach, with 4000 + members sharing their stories and asking loads of questions, offering direction and guidance with all things menopause & perimenopause in the UAE.
But here’s the thing: I wish I’d known about all of this sooner, I could have prepared. I would have known what symptoms to look out for. The fact that we don’t openly discuss hormone health and the physical and emotional changes that come with it, leaves us unprepared when these changes actually happen. We are at a point where women’s health issues like perimenopause are still not serious enough to discuss, and if they’re not that serious, then I shouldn’t be complaining about the symptoms or even inquiring about estrogen supplementing, right? My mother didn’t complain. And the cycle repeats itself. But did you know that taking estrogen and progesterone during perimenopause can help prevent or reduce the risk of several conditions and diseases that become more likely due to declining hormone levels. Here's a breakdown. I was shocked and relieved at the same time to have known this sooner rather than later. I’m all about preventive rather than reactive living:
Estrogen helps maintain bone density and therefore reduces the risk of osteoporosis and related fractures
If started early in the menopause transition (typically before age 60 or within 10 years of menopause), taking estrogen may reduce coronary artery disease risk
Estrogen may improve insulin sensitivity and glucose metabolism, lowering the risk of developing type 2 diabetes
Estrogen can have a positive impact on mood, especially in early perimenopause and may help prevent perimenopausal depression or moderate its severity
Estrogen helps maintain Vaginal tissue integrity (vaginal dryness or vaginal atrophy which has to do with the thinning of the walls)
There’s some emerging evidence that early use of estrogen HRT might delay or reduce risk of Alzheimer’s or other dementias
My message here today to my younger sisters reading me is simple: Why should we have to endure the symptoms, the hot flashes, the insomnia, the vaginal dryness, the more frequent UTIs, the GI issues, the depression, the anxiety? These symptoms are NOT normal and they can be overcome. Suffering through perimenopause or enduring this phase of womanhood is not required anymore and is most definitely not a rite of passage.
So to my sisters: don’t wait for an invitation to this party. Crash it! Crash it early! Ask questions, demand answers, and most importantly, talk about it, to your friends, your doctor, your mother, your daughters! Put an end to this silence around perimenopause, its gone on for far too long. Replace the confusion with clarity, there is no medal of honor in silent suffering.
With love, Alexandra Topalian
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