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Perimenopause & PMDD

PMDD After Age 40: PMS or Perimenopause?

by Dr. Daniel J. Heller
Dr. Daniel J. Heller Dr. Daniel J. Heller

Dr. Heller is a family practitioner who specializes in helping patients with hormonal conditions like PMS & PMDD; diabetes and prediabetes; and other chronic diseases. He is the founder, formulator, and clinical director of PMS Comfort. [more]


What is perimenopause? When does perimenopause start? When does it end? If your cycle changes when you’re 35, is that perimenopause? If the PMDD symptoms you’ve had all your life get worse at age 42, is that because of perimenopause? If you’ve never had PMS symptoms before but start having brain fog and irritability at age 48, does that mean you’re perimenopausal?

Perimenopause is one of the most confusing women’s health subjects, because perimenopause is not as well defined as other life transitions. Menopause, puberty, pregnancy, getting your first period—these are all usually quite clear—you know when they are happening. Perimenopause, on the other hand, is much more vague.

There are physical, mental, and emotional symptoms of perimenopause. These include spotting, irregular periods, hot flashes, memory problems, and irritability, to name a few—but are these signs of menopause, perimenopause, or even PMDD or PMS? It’s no wonder there is so much confusion, and so many questions about perimenopause, because the symptoms overlap with both PMDD and PMS, and menopause. It helps to remember that throughout your life your hormones and your cycle are changing—not just at perimenopause.

Perimenopause: Your Changing Hormones

This means that during your life, whether when you’re 13 or 30 or 50; whether you’ve just given birth or just gotten off birth control pills, your hormonal cycle shifts subtly, or dramatically, on a daily, monthly, and yearly basis. This is why it’s so difficult to talk about an exact definition of perimenopause. Which exact change is it? Some women suspect they’re entering perimenopause if they miss a period at age 35, when in fact perimenopause almost never begins before age 40. And, in most women, perimenopause won’t start until much closer to age 45 or even 50.

Five Things You Can Do About Perimenopause

Number #1: The most important thing you can do for yourself is to simply understand that it is perimenopause is a natural transition happening in your body and to your hormones. Just because things are changing doesn’t mean that something is wrong. Perimenopause and menopause are part of the aging process, just as puberty is.

Once you accept that your body and hormones are changing, four other healthy changes can help you to feel your best:

Now is the time to stop postponing establishing an exercise routine and healthy eating. The longer you wait, the harder it will be to lose weight and to give yourself a healthy heart.

If your symptoms are interfering with your life, and especially if they include fatigue, depression, hair loss, dry skin, and difficulty concentrating, get your thyroid tested (including the TSH test). Many women have undetected hypothyroidism, and this, just as often as perimenopause or changes in estrogen levels, causes these symptoms.

Undue stress makes everything worse: perimenopausal symptoms, menopausal symptoms, PMS and PMDD—stress and anxiety can cause it, and make it worse. It’s easy to talk about dealing with stress, but here are some real action steps you can take to deal with it:

  • Cut way back on caffeine. It revs you up and contributes to stress and anxiety.
  • Stabilize your blood sugar with our hypoglycemia diet. Blood sugar highs and lows cause stress and mood swings for many women.
  • Meditate. Meditation is not necessarily a religious or spiritual practice: it’s simply a technique of sitting quietly and practicing letting go of your thoughts. When you realize that your thoughts come and go of their own accord anyway, you may find you don’t get stuck in negative thought patterns as often—and, that when they do occur, they are less "sticky," meaning they roll off you more easily.
  • Exercise. Exercise relieves stress, period. This is absolutely one of the best and simplest ways to battle stress and improve your health.
  • Deal with the trauma in your life. So many of us are truly "walking wounded": various childhood and family traumas are buried in our past. We bury them in order to survive and get on with life, but never truly move on from them by ignoring them or burying them. There is a definite and important role for counseling or psychotherapy to help heal and forgive, and let go of the past. Old wounds we carry in our hearts make life harder, and more stressful. Though it can feel scary to face them, doing so can lighten our load, and does make a huge difference to our health.

Natural remedies can make a real difference for perimenopause, PMDD, and PMS. If your symptoms are troubling you, and the suggestions above haven’t yet made a difference, consider trying our exclusive and synergistic herbal formula that includes Vitex Chastetree and Vitamin B6, and which can address the symptoms of hormonal imbalance.

Real, Natural Relief—So You Can Feel Great All Month Long

PMS and PMDD misery aren't always taken seriously enough by doctors, family, and friends. At PMS Comfort, our whole purpose is to empower and educate you about premenstrual symptoms, and to provide real, natural relief so that you can feel great all month long. Our all-natural doctor-designed programs are based on decades of experience helping thousands of women recover from what you've been going through. Our Herbal Relief formula, when combined with our diet and lifestyle guidance, addresses more than just your symptoms—it can help bring your body and mind back into balance, and help you get and stay healthy. Plus, we're here to support you, every step of the way.

To learn more about your PMS and PMDD symptoms, take the PMS Comfort quiz. Or, start feeling better today, for as little as 89 cents per day.

We want to help. Give us a call at 1-800-731-6327, drop us an e-mail, or send us your question.

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Principal Author: Daniel J. Heller, N.D.
Last Modified: April 3, 2014

Perimenopause, PMDD & PMS—Reference Documents and Further Reading


The information and contents contained in this Web site has not been evaluated by the FDA. Products are not intended to diagnose, treat, cure, or prevent any disease. If you are pregnant, intend to become pregnant, or nursing, please consult a physician before taking any dietary supplement. If taking prescription drugs, consult your healthcare practitioner prior to use. You must be 18 years or older to purchase products. Individual results do vary.

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