Am I Going Crazy, or Is it Menopause? And what the Heck is Perimenopause?


Whether you’ve been longing for it or dreading it, the “change of life,” or, “mental pause” is inevitable. Women have known their menstrual cycles would eventually come to an end since they began. Menopause, also known as “the climacteric,” is defined as, “The time in most women’s lives when menstrual periods stop permanently, and they are no longer able to bear children.” Menopause typically occurs between 49 and 52 years of age.

If only menopause was as simple as that definition. 

menopause insomnia

Perimenopause, or menopause transition, begins several years before menopause. Ovaries go on a roller coaster of producing uneven levels of estrogen before beginning to gradually make less estrogen. The rise and fall of estrogen is the cause of irregular menstrual cycles during perimenopause, and irregular menstrual cycles are one of the most common symptoms to announce that perimenopause is happening. 

During the transition period of perimenopause, the time between periods can lengthen one month and shorten the next, making planning for the menses tricky. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. According to the North American Menopause Society, the average age for a woman to reach menopause in the United States is 51 years and perimenopause symptoms can begin up to TEN YEARS before the menses actually calls it quits. This means women in their thirties can be experiencing the signs of perimenopause. The onset of menopause can also follow a surgery that reduces ovarian function or hormones, such as a hysterectomy where the uterus is removed, or treatments and surgery for cancer. 

fan for hot flashes as a symptom of menopause

Common symptoms during perimenopause include:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Chills
  • Night sweats
  • Sleep problems
  • Mood changes beyond the normal scope- including depression, anxiety, anger, and impatience. 
  • Decreased fertility 
  • Low libido 
  • Weight gain and slowed metabolism
  • Bone loss 
  • Changing cholesterol levels 

Perimenopause symptoms can be quite gradual and almost seem to sneak up on you. 

How do you know you are in menopause?

After experiencing 12 consecutive months without a period, a woman has entered menopause and the ovaries no longer release an egg every month. In addition to the perimenopause symptoms, additional symptoms may add on including:

  • Frequent urination 
  • Vaginal dryness
  • Dry skin 
  • Mood swings 
  • Anxiety or irritability 
  • Insomnia
  • Mood changes

Treatment For Perimenopausal and Menopausal Symptoms 

Although the Massachusetts Women’s Health Study, one of the largest longitudinal studies to focus on middle-aged women, found that most women don’t seek outside help for menopause, many would like evidenced-based options to relieve symptoms of perimenopause and menopause. 

There are hormone replacement options to discuss with your physician, but they are not without side effects such as bleeding, bloating, breast tenderness or enlargement, headaches, mood changes, and nausea. Additionally, according to the Cleveland Clinic, hormone replacement therapy (HRT) may lead to an increased risk of endometrial cancer, blood clots, stroke, gallbladder/gallstone problems, and dementia. Many women question whether HRT is the right choice for them given the risky side effects.

Complementary and Integrative Treatment Options 

As a licensed acupuncturist, I regularly work with women experiencing symptoms of perimenopause and menopause. Often they are receiving acupuncture treatment for unrelated conditions, like back pain, and mention they are dealing with hot flashes, night sweats, and/or insomnia. Recent research shows acupuncture significantly alleviates menopause symptoms. 

Another study found that a course of at least 3 acupuncture treatments was associated with an increase of several quality-of-life measures, like sleep quality and reduction of depressive symptoms, compared with no acupuncture. The clinical benefits of acupuncture persisted for at least 6 months beyond the end of treatment.

A course of acupuncture would also include lifestyle recommendations to help menopausal symptoms, like the elimination of smoking, increasing sleep and water, and focusing on a whole-food-based diet with a reduction in processed foods. In addition, herbal medicine may be recommended as well. Acupuncture in the office and stimulating acupressure points at home would be used together to help reduce symptoms of menopause. 

Essential oils can also be very effective at reducing menopausal symptoms, like hot flashes. 

  • Clary Sage: Relaxes tension and reduces fatigue
  • Peppermint: Cooling and refreshing 
  • Roman Chamomile: Reduces frustration and clears heat 

Blend oils together or use them on their own. An at-home diffuser with this blend of oils in your bedroom can be very helpful for insomnia and night sweats. If you use essential oils on your body, dilute them in a carrier oil like almond, jojoba, or olive oil first. Always wash your hands immediately after using essential oils. 

essential oils for menopause and peri menopause symptoms

Is it Over Yet? Postmenopause 

Life post menses includes the elimination of birth control after 12 consecutive months without a period. It also eliminates the need to manage a period. With menopause also comes age, experience, and wisdom, and many women report reveling in this next stage of life.

Am I Going Crazy, or Is it Menopause? And what the Heck is Perimenopause?


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