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Peri(meno)pause

[00:00:00] Thursday and we are shifting gears. We're not talking about pregnancy today. We are going the opposite extreme into my world. My world ladies, ladies who are in their forties and fifties. Okay? I'm actually 51, so it's really not my world, but cuz you guys are in your forties maybe, or fifties. Cuz we're gonna talk about perimenopause, menopause, I've talked about it before. 

I'm gonna talk about it again. I have a few video. You can scroll back called the other P word. Get it. The other P word. The P word that we don't like to talk about. Nobody likes to say the P word. The P word I love to talk about is the perimenopause. I love to talk about it because people don't understand it and they freak out and they get confused and they think it's something terrible, or they think it means they're getting old. 

Jen Gunter gynecologist, who you may have heard of, she's awesome. She has. Systematically been very vocal in a very appropriate way, um, in trying to decrease, um, [00:01:00] people's attention on things like goop. Unfortunately, goop and platforms like that have misled women into misunderstanding their bodies and purchasing large amounts of very expensive products that do not help them in doing so. 

Jen Gunther, who again, is a very, very well known and very b. Gynecologist, I believe from Canada, did a great article that I will link about menopause, which is so good because I love to talk about it. Menopause and perimenopause. So this is gonna be just some definitions and some understanding. And she highlights what I think is really great and I talk about it in my office a lot, which is menopause is not the end of anything. 

I mean, this is a whole new. When we initially were, were created, or the inception after the Big Bang, obviously humans did not last very long, right? We weren't living past, who knows, thirties, forties, fifties. But now with the age of modern medicine, we're living into our eighties and nineties, [00:02:00] which means when you get to 40 or 50, you really are midlife. 

Last time I checked mid, anything is not the end. It's literally the middle. So why do we behave as if. When women get to like their late forties or early fifties, they're like, in the end they're not. So just so you all understand menopause and perimenopause, this is what you need to understand and know. 

Menopause by definition is not until a year with no period, and this is where the vernacular becomes a little confusing. And she really does a great job in the article that again, I will link and I'll put a link in. Menopause is a year with no period. Perimenopause is the kind of nebulous time that surrounds and leads up to menopause. 

And if you look at different data and different textbooks and different articles, they will say that perimenopause can last anywhere from 10, maybe even more years. . Most women will go through menopause around 50 51 ish, which means by [00:03:00] definition, if you have 51 a year with no period, therefore you are in menopause or menopausal or post-menopausal. 

That's kind of the vernacular we use, which is confusing, right? A year with no period. In menopause or post-menopausal. Then up to 10, maybe more years before that you are perimenopausal, meaning going through fluctuations, which we'll discuss. That means that that could start as early as 40 or earlier. Is that something dreadful? 

Is that something terrible? No, not at all. That's just the natural fluctuations of how our hormones go. Is it abnormal? Is it irregular? Is there something wrong with it? No, no, and no. Just like when you're going through puberty, these are natural fluctuations that are supposed to occur. Now, some of those natural fluctuations suck and feel bad. 

Therefore, because we like to go against nature every day, hence we're talking to each other on video, we will talk about potential ways to fix it. If you talk to your doctor or a nurse [00:04:00] practitioner or a naturopath, or go on. , but be careful because there are a lot of things that people will try to sell you to try to fix things that don't always try to fix things, and they still cost a lot of money. 

So let's get back to the definitions. Perimenopause, nebulous time leading up to menopause. Menopause defined by when you've had one year with no period. Again, assuming that you were in the right timeframe and you don't have any other reason to not have a year with no period. If you're 34, you've had a year with no period. 

The assumption is that your doctor has looked into other causes that a 34 year old may not have a year with, may not have her period for a year. Okay? And we're not gonna go through all that because this is not a lesson on which is lack of a period. Now, when women do go through menopause, they sometimes feel lousy, and that is not something that, because it's natural. 

We have to just lay down and accept. We go against nature every single day. So while I'm the first to try to explain to women this is [00:05:00] actually really natural, like this is, this is actually not only natural, this is normal, right? So I very clearly want to explain to women what is normal versus what is common, right? 

So it's very normal to have these changes. Now, what is common? Friend and during this perimenopause menopause time, life can be confusing. It's very common and actually very normal because of the fluctuations in your hormones to feel mo maybe moody, maybe hot flashes, maybe breast tenderness, maybe ovulation pain, maybe a myriad symptoms that you just are like, Ugh, I don't like them. 

You should talk to your doctor. She will ensure maybe through testing, maybe through other means that there are not other cause. For example, if you said, I am like, not only I'm sweaty but my heart is racing, she might say, probably it's perimenopause, menopause, but let's make sure it's not your thyroid, for example. 

There are other things she might need to do, but could she test for perimenopause? [00:06:00] Doc, I think it's perimenopause. Can you test my hormones? If you've asked me that before, you've heard this little Diddy from me, what do I say? I'll say, listen, you want me to test your hormones? I'll send you to lab and I'll test your hormones, but it's not gonna tell me anything. 

If you tell me that you are in the age range, that's appropriate for perimenopause, which to me is anywhere in your late 30. To early to mid fifties, and you tell me you have any one of these symptoms again, I wanna kill my family right before my period. My boobs hurt a little bit more than usual, especially at certain times of my cycle. 

I feel my ovulation, I think a little bit more. My period is a little bit different, a little bit longer, a little bit shorter, a little bit heavier, a little bit lighter. Any of those differences. A little bit schnitzer and hot at. These are all things that to me, are very common in perimenopause, and if I check your hormones, guess what? 

It's not gonna help because your hormones fluctuate day to day, week to week, and month to month. So this month it might even look like you're in menopause if you missed your period at age 48, [00:07:00] for example, and the next month. They're back to normal cuz you got your period. So it doesn't tell me that you're in menopause. 

I cannot tell you how often patients will come to me or any gynecologist with lab papers from their internist, from their naturopath, from their whoever, and say, look, look, look, look what they did. They did my blood work. And it says I'm in perimenopause. And I literally am like, yeah, by the way, the way, I don't even need to look at your lab slip. 

You're in peri. , you're 48. You tell me you're hot at night, you're in perimenopause like, and again, it's not like I'm so brilliant. I felt your aura and could tell you're in perimenopause. It's like you're 48 and you're hot and sweaty, you're in perimenopause. There's no way to diagnose it and there's no need to diagnose it. 

What we need is to understand what it means. To understand if there's anything pathological about it, and then decide together, do we wanna go against nature and say bye-bye. Nature. You know, like I've said, I love Mother Nature, but I'm not always gonna listen to her and I'm not always gonna accept what she does, like high [00:08:00] cancer. 

I see you, but I'm gonna actually kill you with drastic chemotherapy. Right. That's me acknowledging mother. You're trying to do what you're trying to do, I'm gonna say, fuck you, mother Nature, right? Same thing, perimenopause. I see you. I know who you are. I give cheer about, bye-bye. I'm gonna actually do things to help. 

This is not, again, about treatment for perimenopause and menopause. I've talked about it in another, in another video. Scroll back and look. So again, do you need blood tests? No. Can they actually. The picture. Hell yeah. Because what also happens is patients will say, I thought I was in perimenopause, but my hormones like totally normal. 

Yeah. Cuz your hormones can't look normal because guess what? Perimenopause is not hallmarked by ho, by irregular hormones on paper. It's that your normal sine wave of your hor of your hormones, like in your irregular cycle, it'll look like a sine wave where your FSH or lh, your estradiol, your progesterone, they're all going in a. 

Nice symphony, but they're a little bit off, but not off in ways that are [00:09:00] measurable on paper. So don't bother WellDoc. Should I do salivary testing? Should I do this thing called, um, gosh, what's the blood? The urine test, I just literally slipped my mind cuz that's what happens in menopause. Perimenopause, you will have some short-term memory loss where. 

recall words, I can't believe I'm forgetting right now. Someone write it to me when you know what I'm talking about, that urine test. Listen, I'm not gonna tell you guys what to do and what not to do. I'm gonna tell you, if you are my sister, what would I tell her if my sister calls and says, oh, I heard about this test. 

It's a urine test. That I can do, I feel like it's a man's name. No, I can't think of it. Anyway, a urine test or blood test and you know, all the, all the other judges, my sisters, the judge, all the other judges did this urine test or salivary test and it told them that they're perimenopausal and it told them when in their cycle their hormones changed and then their, and then their naturopath gave them stuff. 

I'm not knocking naturopath, by the way. I love naturopaths. Like Kelly Livingston, if you're watching this, you are my heart. You're amazing. I'm just saying that that's often what they do, or functional doctors love them, but they do [00:10:00] this. With all due respect, I will start out with them any day of the week and say you can't give them any information that we can't give them based on symptoms. 

So when anyone tells you based on this cycle and your salivary tests or your whatever urine test that I can't remember. This is what I've seen happen. The honest answer is, but Doc, I just heard this, this doctor on on the Instagram saying that next month, all these tests you just did might be different because that's the truth, right? 

So this month, your salivary hormone tests and this urine test that people do might say, oh, at this part of your cycle, your progesterone is doing this and that and this. The next month it might be different because that's the hallmark of perimenopause. So again, can you tell what I'm saying? 

Perimenopause can last 10 plus years all through your forties. Menopause is a year with no period. The transition is confusing. You could come to me at 50 and say, Shiva, I haven't had my period in nine months. Let's even say [00:11:00] 11 months. I haven't had my period in 11 months. I'm 50 years. , I must be in menopause. 

And my response to you is, yep, you probably are. But this is how we think. Until you are a year with no period, you're in this like nebulous time where we're kind of waiting. So I'm still gonna call you perimenopausal until you hit that year. Then I will say your menopausal. , right? And I'm sure you walk outta my office thinking should know what she's talking about. 

I'm in menopause. And then guess what? Like that week you get your period and now it turns out you were only perimenopausal and you get your period back regularly for two or three months at age 51. We see that happen all the time. Do you have to worry about getting pregnant? The answer is yes. Is it likely, doc, I'm not gonna get pregnant at 51 when I get my period. 

I say to patients all the time, you never know. Is it likely? No. Is it likely to be viable? No. But is it possible to get pregnant? The answer is hell yes. As long as you are ovulating, it is possible to get pregnant. Is it likely no. But unless you are willing to accept the consequence of [00:12:00] getting pregnant and unfortunately either miscarrying or choosing to have a baby or choosing to stop the pregnancy, you have to accept it. 

So if you've come to me saying, well, my doctor said I don't need to use birth control because I'm 50 and I haven't had a period in six. I'm gonna say back to you, you are rolling the dice. You'll probably will win that bet. Let's face it, facts are it's odds. You're probably gonna win that bet. I personally would not take that bet, nor would I let my sister. 

Okay. I hope all that makes sense. But really, you gotta read this article because it is just great in delineating it. And ladies, let's just stop. Stop. They like, oh, I'm in menopause to period. Menopause. Like it's not that bad. I'm 51. I'm full on in menopause. I was in surgical menopause. My ovaries were removed five years ago, almost five years, June 17th, um, when I had the ovarian cancer at age 46. 

And I'm gonna go through that in June when I'm my five year anniversary. I'm gonna talk about that because I would've thought it would be ho. There were moments of horrendously and then there were [00:13:00] ways I fixed it. So there's things we can do. You know, nature sometimes wants to screw with us, then we're gonna be like, fuck you right back. 

Cuz we are bucking nature every day by living longer. This is not what nature intended. The sooner we accept that and acknowledge that, The better off we're all gonna be. We love nature. We have to honor nature. While being very clear and very honest about the fact that every single day that we've increased our longevity, that was our way of saying, I see you, but I'm not actually respecting what you're trying to do because you were trying to get me to lead this earth at probably 40 to 50 and I keep living on, so now I have to accept what comes with that longevity brings. 

Going against nature. It is a fact. Okay. All right. I'm gonna go see patients. Y'all have a good day. Bye.