If you're reading this, chances are you're middle-aged and may not even realize it.
Perimenopause frequently strikes women in their prime, at the midlife point, just as they are in their 30s or 40s and life is starting to settle and make more sense.
Gone are the late-night escapades at the bar or club. And we’re often past the point of aimless dating, financially indulgent shopping or being way too undisciplined with our nutrition and fitness.
By their late 30s or early 40s, many women are rather settled in their line of paid employment or staying busy in the home, with spouses, children, hobbies, many obligations and perhaps some volunteer or civic commitments in the community or neighborhood.
At the same time, however, there is a reluctance to imagine that by 35 or 40, someone has reached midlife. The 40-something or 50-something year-old woman today typically does not engender the same image of women the same age from half a century ago. They don’t look, act or present like our grandmothers, great-grandmothers or great aunts, if we’re fortunate enough to have seen them alive.
Today we seem younger, more youthful. We see women like Nicole Murphy, Angela Bassett, Cindy Crawford and Elizabeth Hurley and feel certain that the needle has moved in the other direction – away from aging and toward a sort of suspended state of beauty, potential and timelessness. Indeed, “What Age Is Considered Old Nowadays?” shows that as time marches on and people live longer, ideas about what constitutes being elderly or middle-aged continue to shift.
But the truth is that, from your mid-30s through your mid-50s, you are middle aged. In the United States, the average life expectancy is 77.3 years. Half of 77.3 is 38.65. But what your “midpoint” is, is in part influenced by your demographics. For Black Americans, the life expectancy is 71.8. For Hispanics, it’s 78.8. Note that life expectancy fell across most groups as of 2020, due in part to the pandemic.
If you reach the halfway point of your projected life expectancy, then that is the point at which one reaches the midlife category. This is true even for the Millennials, the generation covered so extensively by the media. The oldest members of the Millennial generation are now in their late 30s and early 40s, and Millennials themselves agree that middle age occurs between 35-50 years old.
Midlife Produces Health Changes, Including Perimenopause
This age range is also when common health problems start to pop up. The most frequent chronic illnesses in middle age are high blood pressure, high cholesterol, arthritis, heart disease and depression. This time of life is when people may notice their blood pressure creeping up, their knees sounding like a band warm-up and their ability to perform athletically declining. And, yes, this is also when women start to experience the warning signals of a menopause that may be 10-15 years away.
The 30s and 40s is when women may begin to have night sweats, hot flashes or strange menstrual changes (like a cycle that seems lighter than usual, longer than typical or heavier than normal). They may notice changes in their emotional state, feeling on edge for no reason or tearful for all the wrong reasons.
Even though these women may look youthful, in shape and “good for their age,” they are, in fact, possibly entering that critical perimenopausal stage. Perimenopause is certainly a midlife phenomenon, a flag signaling declining reproductive capacity and hormonal changes that affect entire body systems.
At the same time, there is a paradox in this situation: Women who are experiencing a range of perimenopausal symptoms right on time for their 30s or 40s may be told by their doctors that they are too young to be experiencing perimenopause. This leads to all sorts of problems, including delayed treatment, denial of coverage (by insurance) for certain treatments, a compromised quality of life and, at worst, misdiagnoses and treatments for conditions women don’t even have.
It’s Okay to Be Middle-Aged
The idea of being perimenopausal catches some women by surprise. Many just cannot believe it and will not admit to it. Even if they have every textbook symptom at 45 years old, some women simply refuse to attribute their condition to perimenopause or aging. Ridiculously, some find more peace in thinking they have a thyroid problem or an autoimmune disease than being in the symptomatic twilight years before official menopause.
It’s hard to blame them. In a society where many doctors are under-educated or miseducated about perimenopause and when it happens, and in a culture that prioritizes youth above all, it can be hard to wrap one’s mind around aging and the reality of mortality.
As more women, like actress Gabrielle Union, come clean about perimenopause and change notions of what middle age looks like, maybe things will change.
Actress Sharon Stone said, “It’s not like 50 is the new 30. It’s like 50 is the new chapter.”
Most people have heard of menopause, but far fewer are familiar with the term perimenopause.
Many of the symptoms associated with menopause actually first present and take center stage during the time before menopause, which is is defined as going 12 consecutive months without a menstrual period. Perimenopause typically precedes actual menopause by a minimum of several years.
And it’s much more than hot flashes. If you’re wondering if what you’re feeling may be indicative of perimenopause, see what symptoms are most common, especially after ruling out any other medical condition, such as an autoimmune disease, thyroid disorder or vitamin deficiency.
This list of resources is continually updated.
2017: Management of Perimenopause – Southern Medical Association, Oct. 11, 2018 – https://www.youtube.com/watch?v=_scCqMcxijg
Executive Summary of the Stages of Reproductive Aging Workshop: Addressing the Unfinished Agenda of Staging Reproductive Aging, Various Contributors, April 2012 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/
Menopause – Mount Sinai - https://www.mountsinai.org/health-library/report/menopause
Menopause Diagnosis and Treatment, Mayo Clinic, Oct. 14, 2020 - https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401
Menopause Symptoms, Mayo Clinic, Oct. 14, 2020 - https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
Menopause Symptoms Start Long Before Women Stop Getting Their Periods, Study Shows – Forbes, Deb Gordon, July 29, 2021 - https://www.forbes.com/sites/debgordon/2021/07/29/menopause-symptoms-start-long-before-women-stop-getting-their-periods-new-study-shows/
Perimenopause: Hormone Ups and Downs Can Last Years – Amy Burkholder, CNN, Jan. 10, 2007 – http://www.cnn.com/2007/HEALTH/01/10/peri.menopause/
Study Finds Potential Early Sign of Perimenopause –Health Europa, Feb. 14, 2022 – https://www.healtheuropa.eu/study-finds-potential-early-sign-of-perimenopause/113505/
The Brain Fog of Menopause – Jane E. Brody, The New York Times, Dec. 17, 2018 - https://www.nytimes.com/2018/12/17/well/live/the-brain-fog-of-menopause.html
The Truth about the Link between Alzheimer’s and Menopause – Newson Health Menopause & Wellbeing Centre, Jan. 30, 2020 - https://www.newsonhealth.co.uk/news/the-truth-about-the-link-between-alzheimers-and-the-menopause
Understanding Perimenopause – Sharon Begley - http://www.sharonlbegley.com/understanding-perimenopause
We Need to Know How Menopause Changes Women’s Brains – Kim Tingley, The New York Times, July 21, 2021 - https://www.nytimes.com/2021/07/21/magazine/menopause-brains.html
The Real Peri Meno is devoted to all things perimenopause - the science, treatments, care, understanding, personal experiences, relationships, culture and more. The brain child of Keisha D. Edwards, The Real Peri Meno developed out of her own shock-and-awe experience with perimenopause and navigating the disjointed U.S. medical system in search of answers, support and relief.
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