Part 3: Our Perimenopause Experience - Maria

This is part 3 in a series of conversations about perimenopause and menopause. I've heard from so many women who felt like they went through it alone, or didn't have anyone to confide in or help them through it. So let's normalize talking about menopause - what it can look like, what to expect, and ideas for how to best navigate the inevitable changes that come with this phase of life.

Maria's story is different than Lisa's and Nancy's, in particular because she had 2 babies in her 50s, but if you've listened to all 3 conversations about perimenopause, you will surely recognize some commonalities. And if you are noticing these symptoms yourself - you're not going crazy! There is support available- information, treatments, other women having similar experiences.

Our stories are unique. We are not doctors, nor are we giving medical advice. Please talk to your doctor about your health and follow their professional advice.

Here are some books we mention that we have found to be helpful on this journey:
-The New Menopause by Dr Mary Claire Haver
-Outlive by Dr. Peter Attia
-Estrogen Matters by Arum Bluming, MD, and Carol Tavris, PhD

Transcript

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Hi, I'm Adriana Medina Kagan. Welcome to Bien Fuerte. It's time to speak. This podcast was created to connect our community to others who are interested in exercising not only their physical bodies, but their mind, spirit, and soul as well. Listen to life experiences, themes, and topics that have taught us how to shed those limiting beliefs. Get advice from fitness experts. clients, business owners, and other community members that have inspired us to embrace abundance and freedom in all departments of our lives. Be brave enough to borrow other people's courage until we find our own strength to blaze our own way in this life and know that you are not alone. Hola, Madria. Thank you for joining me again. I loved speaking to you. And this, is an hour dedicated just to you and your experience with perimetopause. I love having great conversations with you as we're training. about our experience and what we're reading and everything that we're learning I appreciate you taking out the time of your busy schedule to do this for me. Thank you, mujer. Thank you for having me. Gracias. De nada. Okay. Tell me all about it. This is something that we can share with your wine night friends. Yeah. So I have a confusing perimenopause journey because I decided to do IVF to have babies I decided at 48. But by the time I delivered that first baby, I was 50. And I think I was still pretty good. I don't think I was perimenopausal yet because I was just telling Matt, my husband, this morning that between pregnancy one and pregnancy two, I see pictures and my body went back to what it was. I had a nice waistline. I was slender. And I had energy things were, you know, within like a newborn wakes you up and all that, but I got back once you're past that initial, like really rough two to three months, I got back to fairly normal and I wasn't. Exercising at the same level as I used to. So I should have blown up or, my health should have suffered dramatically, but it didn't. So that's a sign to me that I was not yet in that last perimenopausal period. But I feel like my body got pretty back to normal, but then with my second pregnancy I delivered right before turning 52. And then I thought I had postpartum depression and I was, you know, I like to gloss over things and there's always a questionnaire for you at the pediatrician, at the lactation consultant, they're really looking for it. And I remember being one shy of Positive for referral to treat your postpartum depression with my lactation consultant and, but I was sobbing during that visit. And so she handed me the questionnaire and I was very close, but looking back now, I think I had the combination of you have that estrogen drop, deliver your baby. Plus I also probably went into. Deep perimenopause at that moment. And you knew it was coming because you mentioned that if people haven't listened to her, the first podcast of her pregnancy journey at 50, you should listen to that because this is like a part two for her because as she was talking about that, I was going through the signs of perimenopause and I was like, we got the, this target, that little spot of life right now. So pause on that. Here it is, people. Yeah, I told my obstetrician in the middle of my second pregnancy, I said, I'm terrified. I'm terrified that the second this baby comes out, I'm going to sink into menopause. And she said, no, you probably won't want, but when you stop breastfeeding, you will. So I breastfed that baby for two years, not just because I thought, Hey, these are good hormones. These are keeping me young and They say that when you stop breastfeeding, you put on weight. That did not happen to me the first time that I had the opposite reaction where I had to stop breastfeeding in order to stop eating like a maniac and finally lose some weight. But with my second one when I finally stopped breastfeeding, I did not drop the weight. I did not lose the belly fat and I just thought it was because your second pregnancy stretches out your abs in a way that the first one doesn't because things have already been relaxed and then you build on that. So I assumed it was like, Oh wow, well the second kid really undoes your abs. But then it was everything else. It was the distribution of that fat. It was the fatigue. And the low mood and I was like, I'm just not interested in socializing that much right now and I would go to things and sort of be almost a little anxious about talking to people and I just assumed, well, it's because I'm a busy mom. I have two kids under the age of three but then there was the one thing that just didn't get better that really bothered me. The vaginal dryness was really bugging me. And that was the thing that was like, In my face, like you can't look away from this. You can't keep ignoring this. You can't keep thinking you're not in perimenopause because this is very different from my younger life. And your younger life. Exactly. First. And you got the support that you needed because you were going post having a baby. And it's funny how you said the questionnaire about depression and all that. There's so much support for you when you're having a baby. But what if you're not? Right. And you're in perimenopause. Where is the support? Correct. And I, I just read the new menopause by Marie Claire Haver and and she mentions that like every single place you go to after you have a baby, they're asking you like, are you depressed? they're really screening for it. It's a super important time too, because you're not only responsible for your own life, you're responsible for another person's life now that you brought into the world. So I get that. That carries a, an additional weight to it, but this is another massively changing time in a woman's body and hormone life that just gets overlooked. I went to see the primary care update at my hospital where I work. And. One of the speakers was talking about menopause. I was so excited about this. This, like, in the whole day, I was like, great, high blood pressure, great, diabetes, I'm gonna learn about all that, but really, really, I'm here for the menopause talk. And then I was so disappointed to learn that treatment is only approved for hot flashes. And it's not even like the, like estradiol isn't necessarily the first choice either. They'll offer you gabapentin or, you know, like so many women have been complaining about all these different symptoms, which I'm going to get into now. Yes. That are all you can fix with one Pill or two, because if you still have a uterus, you also need progesterone, but all the ways that we treat the perimenopausal symptoms, like the mood changes, you get an SSRI, you get antidepressant, the hot flushes, you get gabapentin, which is a nerve medication I, you know, I'm not going to list every single one, but the point is that when I started taking So, Estradiol I started with a vaginal because that was the one thing that was really bothering me. And I had enough absorption that all these other things started to get better. And I was like, Oh my goodness, I'm not as tired. My mood is better. I'm not as irritable. And it just dawned on me that all these things have been perimenopause, perimenopause signs. And you were stronger in your workout. I remember you said that. And I got stronger, right? It's definitely a good combination of exercise plus the, hormone replacement has helped a lot because they like work together. So yes. I'm stronger because I'm working out, but I can work out better and more effectively because I have the muscle reserve and the energy to do it. So this week I've also noticed that, you know, I'm recovering from having a Mohs procedure and I haven't been allowed to work out for a week. And I can tell that I don't feel as good. And the exercise has really made a difference, but I don't think I felt like I could. exercise. It really took me a long time to have my mind wrapped around getting back and do a good exercise routine because I was so tired. And I was just like, I don't even know where I'm going to fit it in. I feel like my body needs to preserve energy. And it was really hard to stick with something because I felt like I was balancing getting enough sleep and so on. But part of why you don't get enough sleep is because when your hormones are off, you're waking up. And it's not the hot flushes. I've never had hot flushes. I've had like a slightly, probably different version of it. Whereas. where I will get more sweaty in the armpits than I used to. And like my smell changed a bit before I started treating. So that was an indication. These were all little things that no one ever talks about, but then you're like, but something's different about me. Something's different about my body. And I just want us to be able to normalize and talk about it. I do too. That is having these conversations on any part of my podcast from trauma to relationships to having kids to managing life to death to your support system to all of that. So I'm glad that you're talking about it. And it's great to be able to talk to other ladies, Having been through it and then myself going through it and I feel like I would have prepped a little bit more for my clients had I gone through it. Now, from here on out, I feel like you guys are gonna get it. You're going to get all the support because of the fact that I'm experiencing it now. And then I'm going back to my clients that have had it and what their experience was because some of them, I mean, you're going to hear Lisa and Nancy, they couldn't talk to their parents. That generational gap is such a big deal and you just tough it out. What is your support system and who do you talk to and do you have other people to support? Like, I'm glad you have that group that you meet with and you can chat about it, but are they a little bit further along? Are they just going through it a little bit of both? Right. I tend to have like, even before I had kids, I tended to have younger friends. Because I didn't have kids until I was older. So I was still doing the stuff that younger friends were doing. And most of those friends I have here don't have kids, but now that I've made new friends with, as parents, their kids are my kid's age. So they're younger. So I basically am leading the charge for most people that I'm around as far as experiencing menopause early. And at first, it's kind of embarrassing. You're like, Oh no, this thing, like I was just like everybody else. And now There's a change and I'm not, I can't just keep up with everyone, but then you discover that you could replace your hormones and then you can again, and you're never going to be 20 or 25 again, but you are able to adapt to the, you know, the slight differences and still keep a pretty high level of activity and everything and that, and then, and that all feeds itself. It does, because even some of the signs like joint pain was a big one for Lisa. Yeah. So, and you as well felt your joint pain and then having had the medication. Yeah. These are all things that no one ever mentioned. And you know, my mom died a couple of years ago as anybody who listened to the last podcast knows. So, I don't have anyone to talk to because when I really started experiencing these symptoms, she was already, like, I wasn't going to talk to my mom about vaginal dryness. Because we had a good relationship, but not like that kind of good relationship. No se habla, you know. No se habla, we're Latins, you know, it's kind of hard to talk about sex with your parents, but we got a little bit better. But every little thing you're like my body's changing in a way and it like I said in my case It was confusing because I didn't know if what I was experiencing was sleep deprivation, exhaustion from parenting two kids and working. And so, each time you're like, am I imagining this? Do I really wake up with joint pains everywhere? And do I have rheumatoid arthritis? Like, what's going on? And all the things that swirl in your head, which don't help at all, because you get anxiety from menopause. And perimenopause. So then you're like, everything just swirls like, Oh no, I'm getting old. I'm going to die younger than I actually thought I was going to die. I can't do this. And then all of a sudden when I started just kind of dipping my toe into treatment, everything started to fall into place. And another symptom is tinnitus ringing in the ears. That I have to admit has not gotten better, but it's not a bothersome tinnitus. The other book I really loved even possibly more is Estrogen Matters. Estrogen Matters. Yes. It's so good. Basically, his wife was diagnosed with cancer and her hormones changed as a result of medications that she had to take. And he did a very deep dive into all the research because he couldn't support his wife. Yeah. I wanted to support his wife. The author is Avram Blooming, M D and Carol Tavris, P H D. Great. That's good. It's good. I would say estrogen matters is slightly more scientific and the. Okay. Thanks. New menopause is more like a, it has a toolkit and it lists all the symptoms and I feel like it's a reference. Estrogen matters debunks the whole reason that we stopped treating women because the women's health initiative, the news got ahold of it like a day before they actually released information about it. And all they highlighted was that there was an increase in breast cancer and the increase in breast cancer was so small. And they also did the study on women who were obese. Past 60 smokers, there was just a very big population of unhealthy women who had been past menopause for 10 years. So that this is one of the important things is if you are experiencing perimenopause, you need to jump on treatment before you have lapsed 10 years. Or before you turn 60, because after that, it's not that it's impossible for you to treat it, but the scales start to tip as far as risks go. So if you have all your receptors intact and you are jumping on it while your body is still ready to receive estrogen and convert things the way it's supposed to, then it's good, but if you get past 60, your body has kind of already changed. And then it can potentially give you an increase in those risks, but again, they're tiny. And the other thing is they used Premarin, which they don't do that now. Now, you know, we know estradiol is what you should take. And a lot of people do either a patch or oral. Some people compound, but I'm not a fan of that because compounding is less regulated. I mean, it's basically a pharmacist mixing it up. Mm-Hmm. It could work fine. A lot of people, my best friend loves it, but I personally feel like orals or the patch, which has a consistent delivery amount, what are you taking? That's my preference. So I take estradiol by mouth. I increased to 1.5 milligrams like probably two months ago, three months ago. Because at one milligram I was doing really well. But there were still some things that weren't quite right. And, oh, my libido still wasn't quite back to normal. And like your orgasms get more flat, that's another symptom. And so we increased to 1. 5 and I feel great. So you, there are certain things that you have to go through. So at the beginning, because of all this, you can have spotting. Like when I first started, I was on a combination patch and I had bleeding. Like four times I had a period or whatever it was bleeding. I mean, it wasn't a real period cause it was, I had gone at that point six to eight months without a natural period. But because of that, you have to just, I mean, you have to balance. Waiting out the side effects. In my case, we did an ultrasound of my uterus to make sure I didn't have fibroids because I do have a history of fibroids. And although with my last C section, she took out the fibroid I had and I should be fine. I actually had no fibroids and we just made an adjustment to the medication and moved on. And so you're. Potentially going to have two to three months of spotting or other things like breast tenderness. And if you can tolerate it, I say, stick it out. And then at the end of three months, if it hasn't gotten better, like right now, I'm coming up on three months of this new dose and my breast tenderness finally got better. So You know, it just depends. If you tell me I'm going to have a little bit of breast tenderness, but I'm going to have everything back. Sure, I'll take it. I'm done. Because the other thing with me with, perimenopause was I felt like I was in PMS all the time. I don't know if anybody suffered from PMS. But it was like, it was so rough because my whole life I've had it and probably every other month that would get it pretty intensely. But you know, it lasts two or three days. And then you get your period and you're like, Oh, thank goodness. That's why I was a raging, bad person. But the other thing was I had a 40 day cycle, my whole life. And then, oh, so here's an interesting thing. So when we talk about perimenopause, like the actual symptoms that start to bother you, they'll probably start like late forties to early fifties. And so I didn't have anything until I was what, 51, 52, right? Right. But prior to that, when I remember my forties that all of a sudden I on a dime changed to a 28 day cycle. And it was so weird. Cause I had just had this very regular 40 day cycle and it was, for a long time, I was like, am I late? Am I late? No, no, no, and I would watch it and it would hit 40 days and be like, okay, I'm still good. But that's the thing that if you notice it's happening to you, that is the beginning of your body starting to change, shift its hormones. Yeah. And then with your medication for your pregnancies, did it change even more so or because you're, you are prepping your body for pregnancy. Well, so they put you on birth control pills like a month before. Your scheduled embryo transfer and that's just so you won't ovulate because if you ovulate well, number one, it also preps your uterine lining cause you want it nice and thin because the embryo attaches when the lining is thin. So you take a birth control pill, that's really just to prevent the drama of you got pregnant and now there's this embryo and all this other stuff that we had planned. It just keeps things clean. Then you start injecting estradiol at some point, I've forgotten now, but there was always like an elaborate calendar of what day you start this and when you do that. But the estradiol is actually then I think to prep your lining, but then six days before the transfer, you start injecting progesterone because the embryo is six days old when they put it in. You start your progesterone and then you just start making HCG, which is the hormone of pregnancy. And then you get that embryo and you're, you're levels are already starting to kick in because I mean, the body's amazing. Then you just start making HCG, which is the hormone of pregnancy. That, helps the embryo grow and, they check you two days after the embryo goes in and then two days after that, and it's like, yeah, my numbers doubled. And so I had no problems with that. I don't know if that's a sign of the fact that I was still in an okay place or hormonally or what, when I started hormone therapy, my lab work actually showed that I wasn't quite, I wasn't postmenopausal. I was peristal. So I had low estrogen, I was going to say, but the hormone, so FSH, I believe was the one that was still a little low, but not completely out. So my body was still trying to tell my ovaries, Hey, it's time to work. It's time to put out an egg, but I just didn't have the estrogen levels yet. Right. So that's crazy. I was also going to mention that you had read Peter Attea's book and he was also talking about when you are on hormone replacement, it does really counter the cognitive loss or the brain fog or the dementia or it just goes on, right? Yeah. So this is funny because now in retrospect. One thing I did have in my late forties was brain fog. There were just moments in the workday where I was like, I can't access what I need from my brain. And I've always had an easy time with school, with learning stuff. I mean, I was like a sponge and I remembered so much actually that it was sometimes a burden. And then I finally just attributed it to, I work with brain surgeons. They're just really smart. And I just feel stupid around them. But then now looking back, I feel like, Oh, those were probably times where I was having a hormonal imbalance. Yeah. And it's hard to monitor also because it changes hormones, your body at different times to check those. I did it twice and saw that my. Estrogen was fine, but my progesterone was in the dump. Yeah. Isn't that crazy? The progesterone, by the way, is the sleep one. So now that we split it, and I don't just do it as a patch, I take the progesterone at night. I sleep like a tired teenager. I love it. I dream. I have vivid dreams. Again, it's the best. Thank you for all the time that you spend here. You're welcome. Thank you for joining me. Okay. It's my pleasure. Yes. Yeah. And we can always do a book review on any of those. I just got my copy of the new menopause. Okay. Awesome. I look forward to it. Okay. Bye. Bye. Adios. Thanks for listening to today's podcast of being. We would so appreciate it. If you would write a review on whatever podcast platform you are using so that we can get the word out. And please, if you find a podcast episode, useful, share with a friend. Be in front. It's powered by my company. For the fitness at for the fitness. com connect with us on all of our social media at where fitness, let us know what you want to hear more in depth Competition, nutrition, workouts, or how to find a balance. We will be interviewing gym owners, trainers, coaches, clients, friends, and many others in our industry. Connect with us at Fuerte Fitness on Instagram or on our website. Gracias y adios.