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I am 50 a year woman and four months ago I began having erratic periods and fell into a pretty serious depression. About an month into this I started having symmetrical joint pain in my fingers, wrists, toes and ankles. I am in the process of trying to understand if I am having perimenopausal symptoms and that is why the depression came about or if I am having a depression that caused joint pain. Is the joint pain related to either hormonal imbalance or to depression? I also had significant fatigue and felt almost like I had flu like symptoms--achy and cold for the first three weeks of the initial joint pain. After about 3 months I got a very heavy period and my mood lifted a lot. It's not great, but it's so much better. I am not a depressed person. I never had joint pain before. I went to a rheumatologist hoping for an RA test and he said I didn't need blood tests-- that I was getting better. This is true. I have gotten less and less pain in my joints. However I dont know whether to treat with hormones or antidepressants. Both have side effects that concern me. I have seen 2 gynocologists hoping for advice about perimenopause. The first said He doesnt believe in mood swings in perimenopause. The second gave me the birth control pill Yaz. I dont know how to know how to proceed. I am afraid of the depression or joint pain returning full force. I would really appreciate any thoughts.


Dear Amynell,

Oh man....I am so sorry you are having such a difficult time.

Why didn’t anyone prepare us for perimenopause and menopause (I call it PM&M for short!)? Yes, the period becomes quite the drama queen. You never know when it is coming or going or how long it will stay. Really it should be called a question mark instead of a period!

During PM&M our hormones take a dive south! Low estrogen can cause crying, tension, hyper-sensitivity, mood swings, depression, poor self esteem, inability to concentrate, anxiousness, outbursts of anger, sleep disturbances, joint aches and pains, night sweats, hot flashes...just to name a few! Low testosterone can cause fatigue, dry skin, low libido and headaches. Of course, there is no “one size fits all”. Every woman is different. (As a side thought– Do you take a statin drug for high cholesterol? Some people experience muscles and joint aches. If this is the case, be sure to see your doctor immediately.)

The most important thing is to find a gyno that specializes in PM&M. One that understands how to balance the results of your blood tests with how you are feeling and functioning. I went through several doctors before I found a great one. I found it helpful to interview them first. I always offered to pay for the interview, but no one charged me.

You do not need to suffer. If your doctor is not helping you, change doctors – no divorce attorney needed!

Next, educate yourself on what the symptoms, tests and options are. For example, have you had your TSH (thyroid stimulating hormone) checked? Many women in PM&M find that they also have a thyroid condition. There are two kinds of thyroid conditions...hyper or hypo. Some of the symptoms are similar to PM&M... such as depressed mood, muscle aches/weakness, and all kinds of sluggishness! It is important to make sure you know what you are treating.

You could have a combination of many things going on. A simple blood test - along with an honest open discussion about how you feel will help your doctor help YOU! You do not have to live like this.

There is a lot of information out there. I know it can be confusing and overwhelming. That is why I wrote the book, Shmirshky: think inside the box by E. I made the book simple and easy to read. I am not a doctor or a scientist. I am an ordinary woman. Think of it as your PM&M cliff notes! I was originally writing it for my daughter. But, soon I realized that the entire sisterhood and the people who love them needed this information too! You can feel comfortable giving this book to those you love, so that they will be able to understand and support you. I call it a small book with a big story!

Please keep in touch with me at our communication headquarters, At Your Cervix!

The most important thing to remember is: Reaching out IN! Suffering in silence is OUT!


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