For the past 10 years, women have been streaming into my office often reporting the same symptoms:

I do not recognize myself!
I am cranky and a bit depressed.
I can’t sleep.
I have no sex drive.
I cannot remember anything!
I have hot flashes, and my period is early/late/irregular and making me nuts!

Honestly, everyone says the same thing, mostly with some bewilderment and surprise.  The truth is, if you are over 35 and under 55, you are likely suffering from hormone changes that are totally normal for the peri  menopausal women. Often my patients are shocked when I tell them that they are peri menopausal. Often some of them are contemplating having another baby and do not at all relate with being close to menopause.

I feel that there are several reasons that we have so much difficulty believing we are in peri menopause. First, many of our mothers either had hysterectomies and consequently, never went through the “change’ in front of us; so we did not experience it as young women. Secondly, many of our mothers never talked about their symptoms and changes related to hormonal shifts. Most important to the confusion about our proximity to menopause is that we are truly a younger generation, and as they say, “40 is the new 30.” So, there are a great deal of women who are in their 40’s feeling like they are still 30, which is fabulous!!!

Today’s woman is interested and engaged in her health and wants to be involved in a graceful transition through peri menopause.  There are several things you can do to find out where you are in the transition and what you can do about it. First of all, get some hormone testing done. Saliva and urine tests are superior to blood tests. However, depending on your insurance situation, blood testing may be the most viable as it is either less expensive or completely covered.

Tests to ask your doctor for:

1.     LH, FSH, Estradiol, Progesterone (ideally tested on day 21 of your cycle), Testosterone Free and Total, DHEA.

2.     Adrenal testing, which must be done with a saliva test, is vital to figuring out how to use the best approach to helping someone address fatigue associated hormone changes. Your adrenal glands are small glands that sit atop of your kidneys. These small glands communicate with the brain and are responsible for hormonal secretions. If your adrenals are under performing, this has am impact on your estrogen, progesterone, testosterone and DHEA.

3.     Thyroid tests: TSH, Free T3, Free T4, T4, T3, TPO ab and Reverse T3. Most physicians will only test the TSH, but this is a very insensitive measure of the thyroid function.

The ultimate goal for all peri menopausal women is to manage symptoms as you progress on the journey. This starts with finding your hormone status and working with your doctor to create the best treatment protocol for you.