How to cope with perimenopause stress

This article originally appeared in DIVACup’s Conscious Cycle.

Perimenopause and stress. Often, the two go hand in hand. Unsure of what to expect, many navigate perimenopause full of questions, shame and discomfort. While some have very minor symptoms, others can find it impacts their ability to function. 

Unfortunately, public understanding and medical support for people entering menopause is lacking. Though you may have seen headlines about menopause lately, there’s still a lot we don’t know about the experience.

Perimenopause defined

Simply speaking, perimenopause refers to the beginning of hormone fluctuations, which may manifest as cycle irregularity, such as late periods, short periods, light periods, missed periods—it signals dramatic hormone level variations with symptoms ranging from:

  • Irregular periods

  • Mood changes

  • Sleep disruption

  • Hot flashes

  • Night sweats

  • Vaginal dryness

  • Brain fog

  • Headaches

  • Weight gain

  • Changes in libido

  • And many others 

Why perimenopause creates stress

Perimenopause can be a very stressful transition, with fluctuating hormones causing physical and emotional symptoms. 

During perimenopause people generally experience a progesterone variation and then decline. This is paired with, or shortly followed by, œstrogens fluctuating, then declining.

These hormonal ebbs and flows, as well as the sudden drop that follows, can trigger feelings of overwhelm and stress. 

Progesterone normally acts as a mood stabilizer due to its sedative effects and how it contributes to the regulation of many cognitive functions. With its decline, mood changes become frequent and harder to manage.

Enter various stress responses.

Perimenopause and the nervous system

Hormone shifts during perimenopause can destabilize the nervous system’s stress response. 

Our body’s stress response is mostly governed by the autonomic nervous system (ANS) made of the parasympathetic and the sympathetic branches. The sympathetic branch switches “ON” when we experience stress. Things like fear, anxiety and anger constitute our “fight or flight” response and are all normal sympathetic system responses to perceived threat.

Although normal and necessary, during perimenopause, ANS responses can get stuck in constant activation. As a result, stress peaks along with feelings of irritation, anxiety, impatience, anger, and low tolerance, often leading to constriction in the chest, rumination and sleep difficulties, including insomnia.

Fluctuating through these states can create a huge sympathetic charge, called the allostatic load, causing people to feel trapped in a very painful, negative cycle.

Activation of the ANS is normally a good thing, as it allows us to act when there is real danger. But when we experience increasing stress that lasts for too long, it becomes chronic and can last for a few months to decades. Breaking this cycle and regulating ANS is important for overall health and quality of life. 

Advocating for yourself

When you are coping with the onset of perimenopause and learning how to manage symptoms, it can be pivotal to feel understood. Creating dialogue around the experience with friends, colleagues, partners and family can be incredibly beneficial.

Track symptoms to clearly articulate how perimenopause affects you. Be sure to present facts about the effects of perimenopause and ask for specific means of support.

Support can look like:

  • Distributing household tasks differently with your partner.

  • Shifting day and nighttime routines to ensure better sleep.

  • Encouraging children to be more autonomous and to take on more tasks around the house.

  • Asking a friend to be an active listener and support person.

  • Finding ways to create more flexibility in your work schedule.

It’s important that we develop the ability to properly advocate for ourselves, especially during what can be a dramatic transition.  

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