Choosing to Celebrate Perimenopause Awareness Month

I actually was not aware of this awareness month until I saw it posted recently on social media.  There are so many awareness days and months, it’s hard to keep track.

Of note, as I type this, clearly there’s some awareness that remains to be seen because “perimenopause” and “perimenopausal” are currently flagged as spelling errors.

But I’m smack in the middle of this, both personally and professionally, so I’ll take to my page to write about it.

Let’s start with personally.

I’m in my late 30s, I now have two toddlers.  With the growing number of “advanced maternal age” (age over 35 at the time of delivering a child), many of us will be dealing with postpartum changes and perimenopausal changes simultaneously.

Is anyone else in this boat with me?

Weight

I exercised during both of my pregnancies, and starting at two weeks postpartum I resumed walking while pushing the stroller.  I know how the saying goes, but my driveway is literally uphill both ways so this was a challenge.  After my second baby, I felt that my abs had melted away, gone.  I could barely do a plank (really really could not do a side plank).

I continue to prioritize exercise, though I can’t hold myself to a set schedule because of my job as an Obgyn with completely unpredictable and grueling hours.  I did lose the “baby weight” between breastfeeding and walking in the immediate postpartum period after both of my kids.  I actually enjoy walking so I’ve had to push myself to add resistance training back.  I have though, and now I can plank and side plank again.  I can feel strength and see muscle definition.

Going forward, I’m going to add even more resistance training.  This is increasingly important as we age so instead of stagnating, I’m going to progress.

Hair

I had the postpartum shed (of hair), called telogen effluvium.  I have always had thick hair but after my pregnancies I’ve had to use thickening products (I used Aveda) as well as a scalp stimulator.  I’ve continued to take a prenatal vitamin, though admittedly not as reliably as I did during my pregnancies.

I did notice some improvement, then I backslid into losing my hair again.  I’m planning to get detailed lab testing to look for vitamin and mineral deficiencies, as well as use oral supplements depending on the results.  There are so many ads and supplements out there, I really want to tailor this to what my body needs, not just what ad catches my attention.

Skin

My skin has fine lines, I’m eczema-prone.  I used to layer on cosmetics to cover my dark circles and make my eyes look awake (“fake awake”).  I found that these things enhanced what I was trying to cover.  I also thought my skin was even more sensitive so most days I’m now just wearing mascara - which is surprisingly powerful all by itself.  When I use full-face makeup, I’m trying to use clean products.

I’ve started doing microcurrent and red light therapy (at home with a device I purchased).

I’ve started using coconut oil for moisture.

I’m planning to use some additional topical treatments suited to my stage in life.  I’ve definitely lost collagen, so I have to work to preserve what I have remaining by both oral and topical managements.

Pliability

What?  You may not have heard of this one.  If you’re a Tom Brady fan, then you have.

Tom Brady credits his lack of major injury (except his ACL) in a long NFL career to his pliability practice.  It’s more than stretching.

When I feel my body needs space, I do yoga.  When I’m sitting, I’m constantly adjusting myself to try to stretch, especially in the hips and inner thighs.  I never felt stretched, though.

Pliability is a neurologic change to soften the muscles.  Tom uses his trainer to physically manipulate his muscles.  I don’t have a trainer so I’m using some vibrating rolling devices.  This is new for me, so I’ll update as I progress.

In just two very short sessions of using, I’ve noticed that I don’t feel the need to stretch when I’m sitting, so I think it’s doing something.

Sleep

For anyone who can prioritize sleep, please do.  It’s good for our cardiovascular health.  I would love to, but again, I’m an Obgyn so this isn’t in the cards for me right now.

Have a routine that you stick to (sleep hygiene).

Avoid alcohol (or really limit).

If you have nocturia (peeing during the night), don’t consume fluids 2 hours before bed.

Avoid screens and/or wear blue filter glasses.

Let me now talk professionally.

As an Obgyn, we learn a vast breadth of topics and we learn them deeply.  Obstetrics, gynecology, office practices - this is how our exams tend to be broken down.  Some obgyns choose to sub-specialize, meaning they go on to fellowship for years to train even more ( think maternal fetal medicine, or high risk OB doctors).

I’m a generalist, meaning I’m your bread-  and-butter Obgyn who delivers babies, goes to the office to see people of all ages and also do gynecologic surgery.

Maybe because of my experiences discussed above because I’m a woman too, but I’ve become really interested in this midlife transition we go through.  I’ve become so interested that I’ve essentially taught myself how to treat patients.  We get no training on this in residency!   

That is so ridiculous.

Would you go to your obgyn with these midlife issues and expect them to understand, and now how to treat them?  You should expect that.  We should be able to deliver that.

I’m now on sort of a mission to get other doctors - Obgyns, family doctors, or whoever wants to learn - up to speed on caring for women in the midlife transition.  It’s a work in progress, so stay tuned.