It’s no secret that we’re all dealing with more stress than usual these days. But here’s something you might not realize: all this extra stress can cause perimenopause symptoms to be even more intense and difficult to manage.
I recently spoke with Dr. Brooke Faught, a board-certified women’s health nurse practitioner, to learn more about how our emotional states can impact our menstrual cycles and heighten hormone-driven symptoms, including mood swings, during perimenopause. Plus, she provides us with her insight on what we can do to start feeling better.
What happens to your hormones during perimenopause?
Perimenopause is like an accentuated experience of PMS. There are erratic fluctuations of hormones, like big peaks of estrogen or progesterone and then a sudden drop.
The result can be irregular periods, but that’s not all. These hormonal fluctuations are stressful to the body. Often women going through perimenopause report mood swings and emotional changes. When hormone levels plummet, you experience almost withdrawal-like feelings like anxiety, stress, and even body trembling.
Does the body’s response to hormonal changes during perimenopause resemble what happens to the body during times of intense stress?
Intense situations can also cause hormonal changes. Stressful situations trigger the release of fight-or-flight hormones like cortisol and adrenaline. They’re exactly what the body needs to deal with a threat, like driving safely in a bad storm or getting people out of a building when a fire alarm goes off. They enhance focus and the ability to multitask, so you can figure out how to react and reach safety.
But these hormones are only meant to flood the body for short periods of time. When they’re continually pumped out during long stretches, like juggling too much at work, caring for an aging parent, going through a divorce, or during symptomatic perimenopause, it can lead to feelings of overwhelm and chronic stress.
Can chronic stress affect a woman’s menstrual cycle, specifically?
Yes. Stress hormones can disrupt the normal ovulatory pattern that produces estrogen and progesterone. That can lead to irregular or missed periods – something you may already be dealing with as you enter perimenopause.
Stress can intertwine itself with other perimenopause symptoms too, like hot flashes, night sweats, and fatigue. When we’re stressed we might get sweaty or clammy, or find it hard to fall asleep, causing us to feel more tired the next day.
In short, the effects of stress can overlap with the symptoms of perimenopause. And stress can exacerbate and heighten perimenopausal symptoms, causing a woman to feel even worse.
So if a woman’s cycles are changing, is it possible to tell whether it’s perimenopause or simply stress?
It can be difficult to differentiate whether your symptoms are from perimenopause or stress because everyone’s perimenopause experience is so different. One woman might just stop having periods one day. Others have cycles that fizzle out. Some have dropped cycles for eight months, then a period, then no cycles for another eight months.
Unfortunately, there’s no test, but if a woman comes to me and is extremely miserable about her perimenopause symptoms, I’ll do a really comprehensive assessment to see if other factors are playing a role. It takes some thoughtful conversation to sift through the details of an individual woman’s story and determine whether outside stressors are affecting her symptoms.
It’s important to point out that perimenopause itself can trigger intense feelings of stress and anxiety that can sometimes be brushed under the rug. I had a new patient who was experiencing symptoms of perimenopause but had been blown off repeatedly by other healthcare providers because, at age 42, she was deemed to be too young. Having her concerns dismissed only caused her anxiety to snowball. But with a thorough assessment, we confirmed that she really was going through perimenopause. That alone helped her feel a little better.
If it seems like stress is making your perimenopausal symptoms worse, what can you do to feel better?
Sometimes just validating a woman’s feelings is really powerful. Hearing that you’re not alone, that this is actually quite common, can make a difference. I always recommend talking with other women. That could be a counselor, or even a trusted friend to help uncover stressful patterns and identify ways to deal with them. But it could also be asking your mother, aunts, or sisters what their experience was like, because there is a strong genetic correlation.
Try also to practice deep breathing during very stressful moments. It’s simple, free, and powerful. Just take a deep breath, hold it for 5 to 10 seconds, and exhale slowly. You’d be surprised by how much better that can make you feel.
Healthy lifestyle habits can make a big difference, too. Any type of physical activity that gets the body moving is often therapeutic. Also, try to eat clean, drink plenty of water, and make an effort to get 7 to 8 hours of sleep at night. They’re basic steps, but they can go a long way towards helping you feel your best.
If your perimenopause symptoms are making it difficult to stick with basic healthy habits, like getting enough sleep, talk with your healthcare provider. He or she can offer more ideas for managing them. If you only have hot flashes I might suggest hormones, but there are alternatives. I might start by recommending something like Serenol for a woman who’s primarily experiencing emotional ups and downs and doesn’t want to resort to hormone therapy. At the end of the day, it’s all about working together to find the solution that’s right for you.