This is the third article on perimenopause in a series of three written by Dr. Metten. In this article she discusses changes that some women experience in their emotions and desires during this time of transition.

When you ask women who have already entered menopause about their experience with perimenopause the first thing they will talk about is the emotional challenges they experienced.

When you feel challenged in your mind, it is scary and frustrating. Many women say,

“I think I am losing my mind.”

Some of my most calm and even-tempered friends have become anxious and irritated during perimenopause. They erupt in anger over simple issues, become anxious when an elevator door closes sealing them inside which never bothered them in the past, question loved-one’s loyalty and friendship, and can cry while reading a greeting card in a store. They cannot explain the frustration they feel inside and when the emotion passes, they are not sure why they felt so much emotional intensity. Some women have described perimenopause as a multi-year premenstrual time.

Personally, I have been described as a hyperactive adult and so you can only imagine the emotional challenges I experienced during perimenopause! I am normally pretty upbeat and tend to be positive about the future but that was not how I felt during perimenopause. For the first time in my life, I experienced brief periods of depression and isolation. It wasn’t all the time. It seemed to come and go and was not initiated by what was going on in my life. Later I learned that hormones were the culprits. Just as menstrual cycles come and go, so do complex hormone interactions during perimenopause.

The emotional challenges that are part of perimenopause are due in part because the ovaries are winding down.

They had been the major source of estrogen and progesterone during our reproductive years. As the ovaries age, they slowly stop responding in the same way to direction from the brain. This results in fluctuations in the relationship between estrogen and progesterone. If one gets out of balance with the other, you may experience a change in your emotions.

If you chart your emotional state against your menstrual cycle, it will become obvious to you when these different emotions erupt. Throughout most of the cycle you might not notice any change and then all of sudden your response to normal life activity takes a big turn and out of nowhere you are angry and upset.

Although it is not completely clear what is happening in our brain during perimenopause, there are certainly some changes going on.

Be encouraged! It is not “all in your mind” but certainly some of what is happening to you IS because of changes that are actually occurring in your brain. 

Another topic of concern for most women is their sex drive.

Sex drive is a complex issue before perimenopause and becomes even more complicated during this transition. Although parts of our brain are affected by changing hormone levels, the greater challenge to sexual desire has more to do with how you feel about yourself and your relationships. This is a time when you begin to take inventory of your life. You are leaving your reproductive years and this prompts many women to become introspective and question their lives so far. If you are in a supportive, open relationship with someone you love you might not notice a change in sex drive, but because of the many changes taking place inside of you, there might be times of decreasing interest. Take time for reflection and sort out what might be affecting your desire.

There are also some simple physical factors that can have a negative effect on your sexual desire. As estrogen levels go down, the lining of the vagina changes and it can become painful to have intercourse. Who wants to have sex when it hurts? The best solution I have heard for this setback is to have sex more frequently. During sex, glands in the cervix release fluid that moistens and refreshes the vaginal lining. The more sex, the more fluid. A little vaginal lubricant can also help.

Of course, perimenopause does not always come at the best time for most women.

Many women are raising teenagers during these years, caring for aging parents, and possibly facing new challenges in their professional life. Although this is a natural transition, it has its complications.

The one that challenged me most was realizing that a chapter was turning in my life. I was entering maturity and I was not ready for that reality! I started doing crazy things like training for a marathon and I had never run before. I threw myself into new research (I am a scientist) as if I would never have this opportunity again. I didn’t know what to do about my role as a parent so I bumbled along swinging from wanting control to “do what you want.” I read all kinds of books on boundaries and then created some real chaos as I enforced them. It all ended well but not without some pretty remarkable memories for me and for others close to me!

Here are some tips I’ve come up with that helped me through my own experiences:

• Practice thinking happy thoughts. Even putting a smile on your face tells your brain you are happy and then you feel happy. This is certainly a mystery, but it works.
• Strengthen your important relationships by letting them in on what you are feeling and thinking. Don’t isolate yourself.
• Take some time for you and consider how you want the next 20 years of your life to play out. Make decisions and follow through with them so that you can celebrate progress toward your goals and continue to build your self-esteem.
• Be grateful for what you have. I am fortunate to be in a loving marriage and I am working hard to make it stronger for both us. Don’t forget, men also go through a transition during these years and together you can bridge the challenges of maturity!
• Learn how to have a mature relationship with your children that includes healthy boundaries and abundant respect for one another. No matter how old they get, they still need you and maybe even more than before.

I truly hope you’ve found this series helpful. The more you can learn about your body and the changes that are happening to you, the more you will feel in control.

My mission has been to educate young girls about how hormones orchestrate the changes they will experience throughout each menstrual cycle. In the process, I have come to realize that many women have not had an opportunity to learn this same information while they were younger. What I have written about in these three perimenopause articles will give you a good foundation of knowledge that you can build upon as you research information for yourself.

I am always available to answer your questions! You are welcome to post them on my website in the comments section of the posts, or email them to me via the website as well. I strive to have a healthy dialogue with all my readers. We can support and encourage each other along the way!