When we think of menopause, most of us immediately picture hot flashes, night sweats, and mood swings. But as both a healthcare provider and someone who has experienced it firsthand, I've learned there's so much more to this journey than these well-known symptoms.

Understanding Menopause and Perimenopause

First, let's get clear on what menopause actually is: it's officially defined as going 12 consecutive months without a menstrual cycle. If you make it to 11 months and then have a period, the clock starts over. But what many women don't realize is that the transition phase, known as perimenopause, can begin up to 10 years before your final period.

My Unexpected Journey

As a nurse practitioner with over 23 years of experience in women's health, you'd think I would have recognized the signs immediately.Instead, my journey began with mysterious symptoms that left me and multiple specialists puzzled.

It started with tinnitus – a deafening ringing in my ears that I initially dismissed as allergies or an ear infection. Then one morning,I literally hit the wall with vertigo when getting out of bed. This dizziness continued on and off for about a year, sending me from specialist to specialist seeking relief.

Just when the vertigo finally resolved, joint pain took its place. I found myself relying on daily Tylenol and Advil just to maintain my schedule. My search for answers led me through a maze of healthcare providers:chiropractors, massage therapists, acupuncturists, physical therapists, orthopedists, spine specialists, and even a neurologist who blamed my symptoms on the COVID vaccine – despite the fact that I'd been experiencing them years before the pandemic.

During this time, I also watched helplessly as my body composition changed, my cholesterol jumped 40 points, and my blood sugar climbed to insulin-resistant levels – all despite maintaining my usual diet and activity level. I tried every supplement imaginable and pushed myself to exercise when the pain allowed, following the same advice I'd given my female patients for years. Nothing helped.

The Revelation

It wasn't until I started experiencing night sweats, almost five years after my initial symptoms, that I finally made the connection to hormones. Through research, I discovered that perimenopause can begin as early as age 42, and even earlier for women who started menstruating before age 12 or never had pregnancies. Women who have had both ovaries surgically removed experience an immediate onset of symptoms due to the sudden cessation of hormone production.

Perhaps the most shocking discovery was learning that menopause can potentially manifest in 66 different ways. These symptoms range from the well-known (hot flashes, night sweats) to the surprising (tinnitus, vertigo) to the seemingly unrelated (dental problems, kidney stones). Here are all of them:

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Acid reflux/Gerd         Acne

Alcohol intolerance changes       Anxiety

Arthralgia (joint pain) Arthritis

Autoimmune disease (new/worsening) Bloating

Body composition changes (belly fat)  Body odor

Brain Fog                   Breast tenderness/soreness

Brittle nails                 Burning sensation in the mouth/tongue

Chronic fatigue syndrome                Crawling skin sensation

Decreased desire for sex (libido)          Dental problems

Depression                Difficulty concentrating

Dizzy spells   Dry or itchy eyes

Dry mouth        Dry skin

Eczema                 Electric shock sensations

Fatigue                       Fibromyalgia

Frozen shoulder           Genitourinary syndrome

Headache                       Heart palpitations

High cholesterol/high triglycerides Hot flashes

Incontinence                     Insulin resistance

Irritable bowel syndrome                     Irritability

Itchy ears             Itchy skin

Kidney stones                 Memory issues

Menstrual cycle changes           Mental health disorders

Migraines                               Mood changes

Muscle aches                             Night sweats

Nonalcoholic fatty liver disease           Osteoporosis

Pain with intercourse Sarcopenia (muscle loss)

Sleep apnea Sleep disturbances

Thinning hair (on head) Thinning skin

Tingling extremities Tinnitus

TMJ (jaw pain and clicking) Unwanted hair growth

Urinary tract infection Vaginal dryness

Vertigo Weight gain

Wrinkles

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After struggling to navigate my own health journey and failing multiple times within the healthcare system, I feel compelled to share this information. I want other women to know they're not crazy, and there are options available to help them feel better.

As a healthcare provider, I'm saddened that this information wasn't part of my medical training. I think of all the women I could have better helped if I'd known what I know now. This experience has become the source of my passion for women's health education.

It's important to note that everyone's menopause journey is different. Some women sail through with barely a symptom, while others experience significant disruption to their daily lives. Since women spend approximately 40% of their lifetime in post-menopause, we owe it to ourselves to understand this transition better.

My hope is that by sharing this information and encouraging open discussions about menopause, we can better support each other through this transition. And perhaps by the time our daughters reach this stage, we'll have it all figured out for them. Remember: while menopause isn't inherently negative, its symptoms can significantly impact your life for years. Being informed and knowing your options for support can make all the difference in your journey.

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