What do brain fog, leaking pee, broken bones, and irritability have in common?

Perimenopause!

Whether you have/had a uterus and are somewhere between 30 and 60, or you have a client or know a person meeting those requirements, this video is for you! (Psst. There's no way you get out of this one!)

And those symptoms may start as early as 10 years before menopause!

I know. Heck of a stat!

And considering how pervasive/common/normal this is, most doctors haven't been trained to treat it and people aren't clear on what to expect and who to see to try to make the whole thing a little less terrible.

Hence this email and video.

I even made it into a game! Sort of. I mean, I say a thing and then in your head you can guess if it's due to perimenopause or typical for aging. Game-adjacent.

It's called: Hormones Raging Or It's Just Aging!

I know, the name is not the best. I was going to call it Hot Flash or Old A** but thought maybe that wasn't very nice (although my old a** thought it was pretty funny!)

So here you go!

​9 minutes of perimenopausal information packaged as a "fun" game!

For more resources you can check out my favorite website for this info: The Menopause Society!​

And if you want the answers without playing or watching, here they are!

Symptoms Directly Related to Hormonal Changes During Perimenopause and Menopause:

1. Vaginal Dryness: Declining estrogen levels during perimenopause lead to thinning and drying of vaginal tissues, resulting in discomfort.
2. Hot Flashes and Night Sweats: These vasomotor symptoms are hallmark signs of the menopausal transition, experienced by many women.
3. Irregular or Heavy Periods: Fluctuating hormone levels during perimenopause can cause menstrual irregularities, including changes in flow and cycle length.
4. Decreased Libido: Hormonal changes, particularly reduced estrogen and testosterone, can lead to a diminished sex drive during the menopausal transition.
5. Increased Risk of Osteoporosis or Fractures: Lower estrogen levels accelerate bone density loss, increasing the risk of osteoporosis and fractures.
6. Increased Cardiovascular Disease (CVD) Risk: The decline in estrogen’s protective effects can lead to unfavorable changes in cardiovascular health, elevating the risk of heart disease.
7. Brain Fog: Many women report cognitive changes, such as difficulty concentrating and memory lapses, during perimenopause, likely due to hormonal fluctuations.
8. Irritability and Anger: Hormonal changes can affect mood regulation, leading to increased irritability and episodes of anger during perimenopause.
9. Depression and Anxiety/Panic: The menopausal transition is associated with a higher risk of mood disorders, including depression and anxiety, due to hormonal shifts.
10. Insomnia: Hormonal changes can disrupt sleep patterns, leading to difficulties falling or staying asleep during perimenopause and menopause.
11. Incontinence: Decreased estrogen levels can weaken pelvic floor muscles, contributing to urinary incontinence during the menopausal transition.

Age-Related (or Multifactorial) Changes:

1. Hair Loss: While hormonal changes can contribute, hair thinning is also associated with aging and genetic factors.
2. Weight Gain: Both age-related metabolic changes and hormonal shifts can lead to weight gain, particularly increased abdominal fat.
3. Increased Abdominal Circumference: A combination of aging and hormonal changes can result in a redistribution of body fat to the abdominal area.
4. Frozen Shoulder: This condition is more common with age and is not specifically linked to hormonal changes.
5. Unwanted Hair Growth: Hormonal changes can influence hair growth patterns, but this can also occur due to aging and genetic factors.
6. Memory Loss: While some cognitive changes occur during perimenopause, significant memory loss is more commonly associated with aging.
7. Word-Finding Difficulty: This can be related to both perimenopause and normal aging processes.
8. Skin Changes/Wrinkles: Primarily associated with aging and environmental factors, though hormonal changes can contribute.

But that's not very fun, is it?? Go watch the video! It's much more interesting!​

And if you're not a woman who cares about this stuff right now, share it with someone who does (or will in the future)!

A lot of different things impact the people we take care of, including hormones and aging.

CBT and education are both great for helping with symptoms of perimenopause so keep that in mind when you see someone who has a collection of these symptoms!

Cheers to healthy brains,

Dr. B

Jessica Beachkofsky, MD

Your friendly, online psychiatrist!

P.S. I often use the term 'women' to describe people born with a uterus and/or ovaries, as they are the group most commonly affected by perimenopause and menopause. However, I want to acknowledge that not everyone with these biological traits identifies as a woman, and not all people identifying as women experience menopause. While I use 'women' for simplicity and clarity, this information is meant for anyone navigating the hormonal changes associated with this life stage, regardless of how they identify.