#Perimenopause #nonspecific #symptoms #Balance
São Paulo
“I don’t feel the same anymore” and “Am I going crazy?” These are thoughts that have become constant for Karina Mouhanna, 42, over the last year. She’s not the only one. The feeling is common to women who go through perimenopausea period between five and seven years prior to the menopausedefined one year after the last menstrual period.
And there’s even an acronym to define it: NFLM (not feeling like myself, or “I don’t feel like myself anymore”, in Portuguese). The phrase may be associated with non-specific symptoms of the period, mapped by a published research in the journal Menopause, of the North American Menopause Society.
Among them are insomnia, fatiguesadness, feeling of overload, anxietyirritability, forgetfulness, excessive worry, difficulty calming down, making decisions and concentrating.
For the study, 1,263 women ages 35 to 55 — mostly residents of the United States and Canada — responded to a questionnaire for a multivariate analysis that included the question: “Many women report simply not feeling like themselves during this phase of life. How often has this been true for you in the last 3 months?”
Of the total, 63% responded that the feeling was common for at least half the time. Only 12% stated that they had not had the sensation during the period analyzed. The study concluded that recognizing symptoms associated with NFLM can improve care for women at this stage.
Menopause usually happens between the ages of 45 and 55, which means that the perimenopause (first stage of climacteric) can affect women, in general, from the age of 38, says gynecologist Igor Padovesi, member of the North American Menopause Society and the International Menopause Society.
The classic heats, called hot flashes, therefore, they usually come at the later stage of the transition process to menopause and, sometimes, only after it. Around 20% of women may not even experience the symptom.
“Women often have the idea that an exam will indicate how their hormones are, as if it were mathematics, and it isn’t. Often there is no way to know through exams. Perimenopause is a clinical syndrome, a set of symptoms, due to progressive ovarian failure”, says Padovesi.
Women often have the idea that an exam will show how their hormones are, as if it were mathematics, and it isn’t. Often there is no way to know through exams. Perimenopause is a clinical syndrome, a set of symptoms, due to progressive ovarian failure
When the ovaries fail, the concentrations of female hormones, estrogen and progesterone, begin to fluctuate. Symptoms, therefore, are caused by hormonal changes, and their variety can cause confusion.
Karina came to take insomnia remedies after recommendation from a psychiatrist. But it began to seem strange when other symptoms appeared: hot flashes, irritability and dry skin were some of them.
“The reasons for the irritability were varied, even for silly things. I usually pack my children’s lunch boxes every morning. But, one day, I woke up and I felt irritated looking at the lunch boxes I had to pack , something I do with the greatest pleasure, are my children. From then on, I thought ‘I’m not normal'”.
The report made Karina’s psychiatrist note that the situation was not under his control: it was a hormonal issue. “I told him: ‘I’m going crazy'”, says Karina.
Other episodes also made her alert: when she had insomnia, she heard songs “playing” in her head. “Afterwards, reading materials, I saw reports of women who also listen to music. I spoke to a friend and she told me that she had already been through the same situation”, she says.
She says that, even among her group of friends, she sometimes notices that not everyone is comfortable talking about the subject. “We go through a period of shame and fear of talking about it, because it still symbolizes that women are getting older. And it’s a subject that isn’t explored much. There is prejudice among women themselves and others as well.”
The issue is not usually debated much, not even within medicine, according to Padovesi. “It is common for women to bounce from one specialist to another, treating symptoms rather than the main cause, which is hormonal. Many medical schools and residency programs do not explain to aspiring doctors the clinical signs of menopause and perimenopause.”
Doctor Mariana Vilela, 37, began to notice about a year ago that she began to have difficulty concentrating and maintaining her line of reasoning when speaking. Along with this, symptoms such as lack of energy and dry hair appeared. When seen by a professional, he related the case to the post-covid and the overload of double journey motherhood and work.
“I didn’t recognize myself. Both physically and emotionally. I was always very active, calm and suddenly everything started to change. I worked with difficulty, always very tired. I didn’t have the energy to play with my children.” The symptoms disappeared after she started taking hormone replacement therapy.
“The professional didn’t think about perimenopause. I believe that many women go without adequate treatment,” she says.
In addition to hormone replacement, which helps alleviate symptoms, they can also be controlled with lifestyle changes, such as regular physical exercise and a balanced diet.
Karina chose to try all methods. “You can’t suffer in silence. You can go through this without suffering,” she says.
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