Sunday Edit: Warm-up to menopause

Are you in the midst of life? Do you notice mood swings, changes in the body, trouble sleeping, feel your skin get dryer, and the intimate area too — or do you just feel weird lately? Then your hormones might be going through a tumble dryer, and you might be heading into menopause. What is also known as 'perimenopause.'

That's what Maria Trier, 46, and Tatjana Haddow, 48, know all about. They have founded Menokind, which you can find on Instagram (@menokind) and Facebook. A community about all the many nuances of menopause, perimenopause (the time leading up to menopause), and postmenopause (the time after).

The time leading up to menopause is significant to focus on because there is so little knowledge and talk about it, according to the Menokind women. Not many know that declining hormone levels can cause turmoil as early as in the mid-30s and can last for several years — on average, from four to ten years. Signs of perimenopause can be experienced both physically and mentally: night sweats, insomnia, irregular menstruation, hot flashes, anxiety, zero stress tolerance, and a lot of other more or less "obscure symptoms," as Maria describes them. She continues: "Being in perimenopause can, for some, feel like quite a roller coaster ride. We don't say this to scare anyone, but because understanding the process can take the fear out of the experience and help to feel more in control and understanding as our reproductive system's second act approaches."

"We would like to emphasize a fact — namely, that perimenopause exists. What many women in their early 40s think is stress or newly discovered anxiety or depression can be progesterone, dropping quite heavily, and estrogen, rising and falling, almost from hour to hour. This is where hormones go berserk, and body and mind are seriously overworked. And when hormones rage in that unpleasant way, and you seek help from the doctor, it is simply so disheartening to be told that, 'no, you are not in menopause because you still have your period, so what you feel, experience, and perceive is... imaginary.' Or that's how it can feel. So, we also face a task where doctors in training and doctors and gynecologists in practice need much more knowledge," says Maria.

The most common physical symptoms of perimenopause and menopause are irregular cycle, hot flashes and night sweats, joint and muscle pain, vaginal dryness, brain fog, headaches, migraines, lack of libido, fatigue and tiredness, palpitations and arrhythmias, nausea, and digestive problems, sleep problems, and weight gain — to name a few. The most common psychological symptoms are stress, anxiety, depression, irritability and anger, worsening of PMS, panic attacks, and loss of confidence and self-esteem. Some of the lesser-known symptoms are body odor, burning mouth, feeling cold to the bones, tingling sensation in hands and feet, and itchy skin. It's quite a lot!

"Peri- and menopause can be gentle, smooth, and kind to us. It can be okay, but it can also feel like standing in the middle of a storm, where symptoms are being thrown at us — and one of them tends to hit us right in the face," says Maria.

And speaking of the face… When we enter menopause, estrogen levels decline, and estrogen helps keep our skin tight and elastic. Estrogen is the 'engine' for collagen production. So, as estrogen decreases, the skin slowly becomes looser. The skin also loses its fullness, resulting in deeper circles under the eyes and more hollow cheeks.

Additionally, the skin usually becomes drier. But it's not only estrogen that is to blame. Testosterone and the balance between estrogen and testosterone also have a say. The declining estrogen makes the skin dry, thinner, and less elastic while losing the otherwise moisture-retaining collagen. Still, because testosterone declines more slowly and gradually than estrogen, the temporary excess of testosterone and generally the mismatch between hormone levels can trigger a range of issues, including acne.

The intimate area also transforms. Up to 84% of women in menopause experience dryness and pain during intercourse and a burning sensation when urinating. In menopause, the body produces less estrogen, which means a reduction in blood circulation to the vulva, clitoris, and vagina, which can cause the mucous membranes in the vagina — which are normally moist, elastic, and pink — to become drier and paler. The lack of estrogen tends to change things 'down under.' This results in a burning sensation, irritation, pain during sex, bleeding, urinary tract infections, and incontinence. And the result? Reduced quality of life.

It's quite an ordeal that women face in their mid-40s. But it's not a natural law that EVERYONE experiences the hardcore symptoms of perimenopause and menopause. One-third of all women sail through menopause. So don't worry prematurely. However, if you experience some or all of the symptoms, talk to others in the same life stage.

"When we know more and talk more together, we don't get so darn scared when our minds suddenly play tricks on us so much that we doubt our sanity. When we open our mouths about the places that used to be supple and elastic suddenly becoming dry and vulnerable, we don't feel as ashamed. When joints and muscles hurt so much that we're about to cry and don't share with like-minded people, we can quickly think that something more serious is going on. When we suddenly become absurdly stressed and don't understand ourselves, it can be nice to hear, 'Hey, it happens to me too.' When memory fails, and we know it's a sign of declining estrogen levels, we spare ourselves the thought that we're becoming demented. When menstruations turn into something that could resemble a massacre, only to disappear, and knowing that it's a quite common symptom of perimenopause… when we talk, share, and educate ourselves, it's so much easier to be in this. Then we know it's hormonal, and it will pass. That it's okay," concludes Maria.