For generations, much of what women know of perimenopause and menopause came from watching our mothers navigate this stage of life, often without fully understanding what they were experiencing.
Perimenopause and menopause are natural transitions in women’s lives, yet we’re only starting to open conversations around these topics now.
In this special Allure Philippines wellness feature for World Menopause Day, we asked three Filipinas one question: What do you wish women knew about perimenopause and menopause before experiencing them?
Below, Amy Perez, Joey Mead King, and Suzie Entrata-Abrera share what they’ve learned along the way, while Filipino doctors and experts also weigh in.
Get to know the stage
Perimenopause is the transition before menopause. It can start as early as your late 30s or early 40s and can last for years before your last period.
Perez shares that her symptoms started in her early 50s, and when she was 54, she hit the one-year mark without a period. Abrera places hers roughly 8 to 10 years before menopause.
Lizzette Caro-Alquiros, MD, MBA, FPOGS, FPSMFM, previously explained that menopause occurs between the ages of 45 and 55. On perimenopause, she said that “there is no clean starting line.”
OB-GYN and reproductive medicine specialist Marie Josephine Almaria, MD, MSc, FPOGS, FPSRM, explained the definition of this natural biological transition. “Perimenopause is an actual stage before a woman’s last menstrual period. Some women may have symptoms; others may not. But regardless, it’s actually a very important phase, health-wise,” she said.
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Learn the signs beyond hot flashes
Abrera was surprised by symptoms she’d never heard of: cold flashes, which she describes as “shockingly cold”; itchy skin and ears; balance issues; shortness of breath; and palpitations. Some, she says, are things “you wouldn’t think would be related to perimenopause.”
King agrees. “It’s not just about hot flashes. There’s so much more that comes with it,” she shares.
The Australian Department of Health, Disability, and Ageing lists trouble sleeping and fatigue, anxiety, brain fog and forgetfulness, dry or itchy skin, bladder problems, changes in periods, and joint pain, among others, as symptoms.
OB-GYN and pelvic floor specialist May Anne Tabaquero, MD, FPOGS, FPSURPS, of St. Luke’s Medical Center said, “The signs and symptoms of perimenopause overlap with the signs and symptoms of menopause; it’s bits and pieces of temporary changes leading up to the more permanent changes.”
Abrera’s advice is simple: “Do read up about it. A lot of that information, more and more, thankfully, [is] available online.”
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Reframe your mindset
It’s not always easy to navigate. Abrera describes the symptoms as “kind of like PMS or premenstrual syndrome, only 10 times worse.” The symptoms feel familiar, she says, but “it seems like the worst version of that.” The irritability “just goes into a rage almost,” and the brain fog, insomnia, and anxiety were all new to her.
“I still felt a little blindsided by some of the symptoms,” she shares, noting how the fog and sleepless nights affected her work as a morning TV host.
King adds the grief nobody mentions. “It’s the grief of remembering who you were or how things were for you, for us in our 20s and 30s, where that just doesn’t work the same way anymore.”
Perez says the rage she felt made her feel like a different person during the pandemic, so she talked to her family. “I had to talk to my family, even ‘yung mga kasama ko sa bahay, for them to understand what I’m going through, kasi mahirap siya talaga, ‘yung rage. ‘Yung talagang may anger ka na hindi mo ma-explain, konting bagay lang, naiinis ka.”
King’s advice is to let yourself feel all those emotions, and she says she now feels stronger, more conscious, and more “unapologetic” than before. She may call perimenopause “the zone of chaos,” but she views it differently now than she did before. “I’m no longer fearful about it,” she says. “I can joke about it, but I also have the right management tools.”
Master Rega Stellar Pe, Director at the World Institute for Incurable Diseases (WIID), previously recommended doing breathing exercises and stretches to clear and relax the mind and body, and also regulate emotions.
Dr. Tabaquero’s advice is to see it as a natural transition for women. “It should be something that we look forward to, and not fear!”
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Listen to what your body is telling you
Apart from the hot flashes she felt during her perimenopausal period, Perez noticed other symptoms. “Na-notice ko rin na nagkaroon ako ng frozen shoulder, na nag-gain ako ng weight, and then yung visceral fat sa stomach, siyempre doon na pupunta lahat,” she shares. Her OB-GYN told her this was linked to inflammation and high cortisol.
Dr. Tabaquero explained that estrogen and progesterone levels naturally start to decline during this time. “During perimenopause, blood pressure may have mild elevations, and there may be metabolic changes that can make it difficult for women to lose weight if they need to, especially if it’s necessary to control their blood pressure and blood sugar.”
Perez changed her morning routines to keep her cortisol low. “Every morning, pagkagising ko, I go out, nagpapaaraw ako mga 5 to 10 minutes. I do some exercises, and then after that, I take a protein-heavy breakfast.”
Build muscle, build momentum
Perez now strength trains on Mondays, Wednesdays, and Fridays, and mixes in yoga, balance training, and jump exercises. Abrera’s advice on workouts is brief: “Stay healthy, eat well, build muscle.”
Mitch Felipe Mendoza, PTRP, a licensed physical therapist and an American Council on Exercise-certified personal trainer, shared previously that lifting weights can help regulate hormones like insulin and cortisol. “When those [hormones] are in balance, you sleep better, have more energy, experience fewer mood swings, and carry less belly fat.”
In that same article, Irish Kathryn Olaguer, MD, a board-certified OB-GYN who practices at The Medical City clinics, shared that resistance training is “a natural, accessible way to support hormone health.”
Ask your OB-GYN about your options
Perez shares what she does to keep her symptoms in check, apart from undertaking hormone replacement therapy (HRT) with the guidance of her OB-GYN: “What I’m using is the estradiol gel. And since I still have a uterus, I take progesterone at night.”
She’s clear that it isn’t a one-size-fits-all answer: “It’s still best to consult your doctor, your OB-GYN, if you’re a good candidate.”
Abrera also stresses the importance of seeing your OB-GYN. “Check in with your doctor. See what kind of supplements might work for you. Get tests first. Of course, the doctor will likely suggest that you get tested before prescribing any additional supplements to you.”
Dr. Caro-Alquiros noted that HRT used to carry a heavy stigma with risks, but conversations surrounding it have now shifted. “Yes, there are risks, but you have to weigh the benefits. And you have to be screened,” she said.
Dr. Tabaquero also stressed that there are risks and benefits to HRT, “and they should be properly explained, and the patient should be evaluated to see if these medications would benefit her more than put her at risk of possible cancers of the breast, ovaries, and uterus.”
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Find your people
Perez says that support starts at home. “Women should also understand that if you have a husband who is of the same age as you, and he might be going through andropause, it’s best that you talk about it and your feelings.” This doesn’t stop with your partners, as well. Teenagers also have their own hormones to deal with, and Perez says, “It’s best to talk to your children about it, too.”
Beyond the house, Abrera says to find your group, or “batchmates,” as she calls it. “Be in a group, be in a community, and laugh about it sometimes.”
King adds that talking about perimenopause and menopause openly is what helps make this stage feel normal. “I really think that the women going through perimenopause and menopause in this stage are just so different,” she says. “They’re just different when it comes to being so informed as compared to boomers or from the silent age, whereas [now] we like to talk about it more.”
Dr. Tabaquero also highlighted this importance in a previous article. “It is also good to have a support system,” she said. “By preparing for it ahead of time, proper diet and exercise, regular OB check-ups, and curating your own tribe to help you with the changes that you will experience, perimenopause—and eventually menopause—will be easier to go through.”
Here’s to the women who talk about it
Perez, King, and Abrera could have kept this chapter of their lives private. Instead, they channeled the changes into an inspiring message for the rest of us. That’s worth celebrating, and so is every woman working through her own version of it.
Give your mothers a hug, and tell them that they’re not alone. Then book that OB-GYN appointment.
