Perimenopause Struggles


I’m 46 yrs old. I know that I’m in the perimenopausal stage. My periods are not at all regular. Once I even went 6 months with no period, but it came back. I have the hot flashes like crazy, and the night sweats. I feel pregnant although I know I’m not. You know that sick nauseous feeling, like I am going to puke and food makes me gag. Just like when I had my 3 children (ages 25, 20, 17). Is this normal?? I can’t take it. It brings me down to not feel good. Do other women experience this, and if so, what do you recommend?  I do smoke and I don’t get any exercise, and my eating habits contain too much sugar and not enough fruits and vegetables! Help me!!!! It is making me extremely depressed!!!!


Last Updated: July 12, 2013
Dear Mary:

Certainly the symptoms you describe can be associated with menopause. However, it seems that there are many other things contributing to your poor health such as poor nutrition, smoking, and low levels of exercise. These things would need to be addressed whether you were entering menopause or not.

I would worry about some other things such as underlying depression or acid reflux/stomach ulcer problems. The hormone changes associated with menopause can look like these things or at least make them worse if already present.

Despite all of the press about not using hormone replacement, the use of hormones in the menopausal woman still has its place. It can be used for women who suffer greatly from the hot flashes, mood swings, headaches. Yet, the risks of blood clots increasing heart attacks and stroke must be weighed. If you had a family history of heart attacks or increased risk from other diseases, you would not be a good candidate for hormone replacement, especially since you smoke.

I think the best thing to do is make changes in your nutrition (no soda or junk food, increase fruits and vegetables, eat regular meals, etc), increase your mobility (daily walks, use the stairs, join a group with people like you), and get rid of the cigarettes. If you can locate a natural family planning teacher, you can learn to chart your cycles. This is of enormous benefit to you and your physician. Quite possibly there are other problems that can be discovered such as low thyroid.

Take care of yourself because there is only one you and you are certainly worth it!

Gretchen Marsh, D.O.

Answered By:

Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via

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