You Might be Perimenopausal and Not Realize It

The link between perimenopause and disordered eating...

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Aug 12, 2024

Today I want to introduce you to my new friend Shelby, the perimenopause expert. We met on Substack and have really resonated with each other’s content. We are teaming up to provide you with information on the subject of perimenopause and how it relates to disordered eating and body image challenges.

This information is so needed and nobody is talking about it! So we are here to help give you the answers, support and guidance you need.

We envision the possibility of a monthly article where we dive deeper into these topics, fueled by your questions. No woman is getting through life without going through menopause (unless she doesn’t make it past mid-life for another reason), so let’s dive in!

Introducing My New Friend Shelby

Shelby Tutty, MHA

is passionate about perimenopause awareness and education. She’s a Substack writer for her free publication, The Periprofessional (perimenopause information that won’t bore you to tears!), and is a health coach for a global perimenopause company.

Shelby’s Perimenopause Story

I was 41, 13 years ago, when I had my first hot flash. I had just gotten into bed. My husband was on a business trip, so I looked forward to reading for a bit after putting the kids to sleep.

Once I got settled, a wave of heat came over me, coupled with a feeling of anxiety and doom. I had never experienced any of these sensations before. I knew that hot flashes caused an intense sensation of heat, but I didn’t realize that anxiety could also come along with it. I couldn’t call my husband because it was too late where he was, so I did the next best thing and Googled symptoms of hot flashes to learn that, yes, anxiety often accompanies hot flashes.

A few months later, I spoke with my primary care doctor, and she told me that I was too young for menopause. While she may have been right on that account, perimenopause are the years prior to reaching menopause and can start in your 40s. Although perimenopause was first used in writing in 1962, it wasn’t until recently that it became a part of our language and understanding.

I was very happy to leave her office that day and put this completely out of my mind. Head in the sand can be very comforting. This decision would affect me several years later, at 47, in a huge way when I started to have unusual things happening in my body that I didn’t understand. I wasn’t skipping periods, and I hadn’t had another hot flash (yet), so I didn’t even consider menopause. I wish I had known then what I know now, and I vowed never to let another woman go through the miserable time I did figuring this all out.

What is the difference between Menopause and Perimenopause?

Menopause is one day in your life. It’s the day you have gone 365 days without a period or seeing spotting. The days and years after menopause are called “post-menopausal,” but we usually shorten it to say “menopausal.” In the US, the average age of menopause is 52, but it can range from 45 to 58.

Perimenopause is the adjustment time between your ovaries working and retiring at menopause. It’s the space between these two events and can take 2 - 14 years prior to reaching menopause. It’s a time of huge hormonal fluctuations as the body moves from its regular cycle of releasing hormones to a more sporadic cycle that gradually declines and tapers off. Your body is also switching to a different form of estrogen.

It’s also a time of adjustment as your body learns to live with less of your female hormones and other hormonal changes. This adjustment can cause some uncomfortable symptoms, such as anxiety, difficulty sleeping, hot flashes, brain fog, itchy ears, urinary issues, and mood changes. There are 100 identified perimenopause symptoms. That doesn’t mean you’re going to get all of them, but it’s something that you should be aware of. This article lists them all if you want to read them (and get a feel for my sense of humor)!

The average age of perimenopause in the US is 45. Think Kate Hudson, not The Golden Girls. One of the first signs that you may be perimenopausal is that your periods will start coming closer together than usual. Also, look for subtle changes that are unusual for you, such as skin tone changes, increased itching, allergies to products you’ve used for years or foods you’ve eaten for years, more congestion, feeling generally hotter than normal, sleep issues, and mood changes that feel like you’re on an emotional rollercoaster. These are the early symptoms of perimenopause. Skipped periods and hot flashes usually begin later.

However, perimenopause weirdness can mimic medical conditions such as thyroid issues, insulin sensitivity, blood sugar dysregulation, and heart conditions, so we don’t just want to assume whatever we’re experiencing is definitely perimenopause. A doctor will rule out other issues first, and if everything comes back normal, then you can assume it’s perimenopause-related.

Another common issue during this time is weight gain. Even if you’ve had a consistent weight throughout your adult life, weight gain can become a concern. The things we usually do to lose weight, eat less, and exercise more, no longer work for us (let’s be honest, we shouldn’t have been using this tactic before either). We can’t understand what’s happening, and you’ll often hear perimenopausal women say, “But I haven’t changed anything. Why am I suddenly putting on all of this weight?”

All women, including those overweight and women with a current or prior history of disordered eating patterns or an eating disorder, are especially vulnerable to the appearance of extra weight. Perimenopause can trigger control issues around food, even if you’ve never had an issue with this before. Aside from teenagers, the population most affected by disordered eating are perimenopausal and menopausal women.

Shelby’s Experience with Perimenopause, Food and her Body

As health and nutrition-educated as I am, I personally fell into this trap and became obsessed with only eating healthy foods. I hadn’t even started gaining weight yet as part of perimenopause. I was trying to listen to all of the “good advice” I was reading on the internet, not understanding that these so-called experts didn’t have my best interest at heart. I experienced firsthand the problems that can arise when a person is affected so deeply by what they eat or don’t eat.

I did a lot of work to address this, but it’s still a struggle for me, and I still get triggered many times by being around food and thinking about my weight. However, once I realized that the fluctuating hormones of perimenopause were clouding my judgment and making me more susceptible to irrational thinking, I could show myself some grace and not feel as shameful as I once felt or felt as controlled by it.

Jane’s Note: We will dive further into this topic in future articles. Much of the “good advice” out there may unintentionally lead a person to disordered eating. Yes, there are changes happening in your body and with your hormones that are important to understand. And, making extreme changes is never sustainable. We want to implement changes that feel nurturing, supportive and sustainable to work with the changes happening in your body - not trying to control, stop or “fix” what is happening.

As part of our collaboration, I asked Shelby to share some practical advice that everyone reading this article can take away. No matter where you are in this journey - preparing for perimenopause, currently experiencing it, or post-menopausal - you'll find actionable tips to help you navigate this phase of life.

Top 3 things to do to prepare for perimenopause:

1. Start making lifestyle modifications now to improve your chances of a smoother perimenopause transition. While we can't control how we'll feel during this process, the healthier we are when we get there, the fewer adjustments we'll have to make.

Jane’s Note: Make sure that these lifestyle modifications are something that you can see yourself doing for days and years on end. Remember that mental health is equally as important as physical health. If you create mental stress and anxiety by trying to be as physically healthy as possible - that isn’t good health. Do these modifications feel supportive, nurturing and sustainable or do they feel like something you “should” do in order to prevent a bad outcome?

2. Begin to understand how stress affects you and learn ways to reduce the stress you put on yourself. Reaching perimenopause with high cortisol levels already is not going to be fun.

3. Start bringing more joy into your life. Many of us are burnt out by the time we reach perimenopause. It's important to start counterbalancing negativity with joy. I suggest thinking about something that used to bring you joy as a child that you no longer do. I started ballet lessons again.

Top 3 things to do if you think you're perimenopausal:

1. Understand that any perimenopausal symptoms are hormonal and not your identity.

2. Take the time to learn about these hormonal changes and what to expect so perimenopause doesn't constantly surprise you. My website is filled with science-based information and suggestions written in an entertaining way to help you understand exactly what's going on.

3. It's best not to assume anything health-related is due to perimenopause. Other issues can mimic perimenopause. If you have a concerning issue, please reach out to your doctor.

Top 3 things to do at menopause and post-menopausal:

1. If you're considering starting MHT (menopause hormone therapy, previously called HRT), now is the time to make a decision. You'll need to start this within 10 years of reaching menopause. Some experts say the earlier, the better. All FDA-approved MHT requires a prescription from a physician.

2. Prioritize eating protein. As we age, we need more protein to maintain and build our muscle. Follow guidelines for your age group.

3. Increase your NEAT activity (movement of everyday life like lifting groceries, bending, sitting on the ground). Move it or lose it. This becomes extremely important if you're not willing to or able to exercise.

What do you want to hear more about?

We plan to continue the discussion about perimenopause, menopause and the correlation (not causation!) with disordered eating and body image concerns. Shelby will be a guest on my podcast in an upcoming episode, and we can continue this series for as long as we have questions and topics to explore.

We’d love to hear from you - leave a comment (requires a free Substack account) or reply to us via email with your questions, stories, or anything else you’d like to hear about on this topic. Let’s continue this conversation so that we can all navigate being an aging woman in a human body together in a way that is supportive and sustainable!

The Peaceful Eater

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