Your Perimenopause Handbook

Instead of Sneezy, Sleepy and Happy, you’re living with Bloaty, Headachy and Hot Flashy. Our guide explains how to handle what’s going on

by Stacey Colino
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Photograph: Illustrated by Eduardo Recife

SYMPTOM: Breast Tenderness
If your breasts frequently feel swollen and achy, it could be because you’re not ovulating regularly, which means you might be exposed to abnormal hormone levels, says Jan L. Shifren, MD, director of the Vincent Menopause Program at Massachusetts General Hospital in Boston. Breast pain can be bothersome, but rest assured: It’s rarely a sign of breast cancer.

How to Handle

If you can stand it, try cold packs Putting them on your achy breasts can provide relief, Shifren says. Anything cold should do the trick; try bags of frozen peas.

Weigh the Pros and Cons of diuretics They remove fluid from your system. Ask your health care provider about them if tenderness is really bothering you.

SYMPTOM: Forgetfulness or Difficulty Remembering
You walk into a room only to forget what it was you came for. You have trouble paying attention or focusing on what you’re supposed to be doing. More likely than not, this brain fog is due to hormonal changes, sleep disturbances, depression or stress overload—not Alzheimer’s.

Consume caffeine It will give you a mental boost, Landau says, but don’t drink it all day long, or you’ll just get edgy.

Say new facts out loud In a study of women ages 40 to 60, those who complained of memory issues tended to do more poorly on tests of “working memory,” which is the ability to hold data, such as a restaurant bill, in your head and then manipulate it—for example, by calculating a tip. If this sounds familiar, here’s advice from lead study author Miriam Weber, PhD, assistant professor of neurology at the University of Rochester Medical Center: “When someone gives you a new piece of information, you may grasp it better if you repeat it back to the person speaking.”

Consider taking atomoxetine (Strattera) If you’re really being driven around the bend by perimenopausal brain fog, says Santoro, this nonstimulant drug, often used to treat adult attention deficit disorder (ADD), can help. In a recent study involving healthy perimenopausal women without adult ADD who were having memory and concentration problems, researchers at the University of Pennsylvania found that taking this drug daily was associated with significant improvements in short-term memory, attention and concentration.

SYMPTOM: Insomnia
Up to 40 percent of perimenopausal women experience disrupted slumber, according to sleep experts. If you’ve always had trouble falling asleep or staying asleep, that’s likely to get worse during perimenopause. “The erratic production of estrogen often exacerbates women’s original tendencies,” Goldstein says.

How to Handle

Try mindful meditation A Massachusetts study that involved eight weeks of training in mindfulness-based stress reduction found that following this widely available relaxation technique significantly reduced sleep disturbances among women in late perimenopause and early postmenopause. It also helped them feel less bothered by hot flashes. For more info, click on “The Stress Reduction Program” at the site of the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School (

Take Benadryl “If you have trouble falling asleep, this antihistamine works surprisingly well and is very safe,” Shifren says.
Go for stronger medicine If your sleep troubles persist, talk to your doctor about whether you might benefit from gabapentin, which has a sedating effect (and also helps with hot flashes) or a prescription aid such as Ambien.

SYMPTOM: Headaches
If you’ve suffered menstrual migraines in the past or you’re prone to headaches in general, be prepared. “In perimenopause, the rise and fall of estrogen levels can cause headaches to become more frequent,” Goldstein says.

How to Handle

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Hawt Flash07.11.2013

Read about a woman who get's superpowers from her perimenopausal sysmptoms!

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