1. What inspired you to write The Fifth Decade: Is It Just My Life or Is It Perimenopause?
I became inspired to write The Fifth Decade: Is It Just My Life or Is It Perimenopause when I saw women struggling with the perimenopausal transition without the benefit of understanding what was happening. There was some information available on the physiological changes that women experience, but too many people thought of menopause simply as something that happens to older women and primarily was about hot flashes.
Women and their families need to know that this transition can start as early as the late 30s, takes up to 10 years to finish, and has an enormous psychological impact. It can disrupt sleep, cause anxiety and depression, and can reduce overall quality of life.
2. Why are depression and anxiety so closely associated with perimenopause?
Depression and anxiety have always been associated with times of significant hormonal changes in women--puberty, pregnancy, and the premenstrual period. Now we are beginning to realize that the perimenopausal transition is no different.
During perimenopause, estrogen levels are vacillating wildly--sometimes they are very high, other times, very low. These levels can be swinging between lows and highs within hours. In the meantime, progesterone, a hormone that tends to balance the effects of estrogen, is steadily declining throughout perimenopause.
The erratic hormones, alone, creates risk for anxiety and depression, but the risk increases when women are not aware of what is happening physiologically and why they feel so out of sorts emotionally.
In addition, perimenopause brings significant sleep disruption. When women suffer from exhaustion and sleep deprivation, they are more vulnerable to suffering from anxiety and depression. Each of these challenges tends to exacerbate the others.
3. Do you think most women are aware of different possibilities for options to help them manage their well-being during this time, or do many women suffer in silence, thinking they just have to "deal with it"?
The assumption in this question is that most women are aware that the difficulties they are experiencing are due to perimenopause. Unfortunately, most women are still unaware of this connection.
I still hear women complaining they cannot sleep, are gaining weight, are very edgy, do not feel nurturing and more, and do not know why. These symptoms are often not attributed to perimenopause.
Enlightened women, those who are well versed in the many effects of perimenopause, do often feel they just have to "deal with it." Many wrongly believe their only option is to go on the very controversial HRT (hormone replacement therapy). This is far from the case. There are many healthy ways to manage the symptoms of perimenopause, all outlined in The Fifth Decade.
4. What do you suggest that women do to explain their symptoms to doctors as well as loved ones to make sure women receive the care and support they need?
Women really need to advocate for themselves with their doctors. I have heard from frustrated women all over the country whose doctors have not been able to give them safe, reasonable, and long-term help with their symptoms.
The best advice I can give women is to become as educated as possible about what happens during this transition. Know what is normal and what is not. Know what remedies are available and what their risks and benefits are. Engage the support of your family. In my book, I devote an entire section to educating the men and other family members about perimenopause. It is critical that they understand, so they can be supportive rather than frustrated bystanders. This is a time when women need as much love, support, and understanding as they can get.
5. What are some of the ideas, advice, and stories that will women find in your book to help them?
The Fifth Decade gives information on the physiological and psychological changes that accompany perimenopause, and how they interact. Women will also learn about the stages of perimenopause and how the thyroid is impacted.
The many symptoms of perimenopause are discussed, some in humorous or touching vignettes, such as the woman who poured orange juice in her coffee instead of milk, or the woman who secretly cried every morning, unable to figure out why.
In this book, the reader also explores a host of suggestions, choices, and remedies women can utilize during this difficult transition. Women will learn about traditional therapies, the approaches of eastern and western medicines, diet, supplements, and lifestyle approaches that will impact their experience.
There is comfort in understanding the process, knowing how to help oneself, and learning that when it is over, women will feel better and more empowered than in a long time.