Am I in Peri-F*ing-Menopause? What Is Happening, and What to Ask For... the 2.0 version!
Happy Sunday.
Mere here! So much to talk about and I do not want to write you a novel, so I will attempt to keep this one short.
There has been a lot of perimenopause in the air lately. Client conversations, coach conversations, conversations with friends who are not clients at all and just want to know whether what they are feeling is normal. Enough of them that when I went back and reread a blog I wrote on this a while ago, I realized she needed a refresh and a resend! Some of our OG's here will find parts of it familiar, yet there is a lot that is fresh! It needed a real update, because my thinking has moved and so has some of the evidence.
So I rebuilt it! yay!
The thing I did not cover well enough the first time is bone. The fastest bone loss of a woman's life happens in a roughly three year window starting about a year before her final period. Density drops around two percent per year during that stretch, steeper at the spine than the hip. Nothing about your cycle pattern tells you the window has opened, and standard guidance does not send most women for a first scan until 65. For a woman whose fast loss runs from 50 to 53, that scan tells her what she lost, more than a decade too late to act on it.
The mechanism section also changed. Perimenopause is not estrogen quietly declining. Nor a perfect fast drop in Progesterone. Although, yes, it usually goes first, dropping out as cycles start skipping ovulation (please note that bleeding is not a sign of ovulation), while estradiol swings and sometimes runs higher than it did in your thirties (yay, so lucky!). That combination is why the symptoms feel so scattered and so hard to pin on any one thing.
And I fixed and expanded the lab section just an itty bit he he. A single normal FSH is not evidence you are in the clear. It is one draw from a system that swings enormously cycle to cycle.
The blog covers what is happening, what to test and when, where the evidence is solid and where it genuinely has gaps, and what to bring to your provider when you are told you are too young and your labs look normal. It is written for women in it or approaching it, and for coaches working with women who are.
If you have a question you would rather ask anonymously, the Ask Fortify form is always open. HERE
If you are a coach who wants to get better at supporting women through this, our group mentorship covers exactly this kind of case reasoning. If you want personal guidance, 1:1 strategy sessions are open. REACH OUT TO US HERE FOR A STRATEGY SESSION . If you are interesting in learning more about MENTORSHIP REACH OUT TO US HERE
in health, with love
Mere and Sarah
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