Perimenopause, in my opinion, is like God's practical joke on women. We, for the most part, have finally reached an age where we are comfortable in our own skin. We have fully formed points of view, a healthy attitude toward men and their place in our lives, we have defined our style and found our passions. We have survived the physical torture of puberty and the emotional ignorance of our twenties and thirties and have finally arrived at our graceful, gracious forties and are ready to rock.
    And that is when it strikes. For a while I have been able to pretend it wasn't happening. The mood swings could still be blamed on PMS. The occasional night sweats I could pin on my furnace of a husband infringing on my side of the bed and my two cats who love to drape themselves all over me at two in the morning. But the other day I was getting ready for work, putting on my make-up, and I was suddenly looking at a flushed face in the mirror and feeling sweat run down my back. I checked the thermostat and almost wept when I saw that it registered 71 degrees as it usually does. I could pretend no more. Perimenopause has arrived and there is nothing I can do about it. Or is there?
    First, let's take a look at the signs and symptoms of perimenopause so we know what we are dealing with. In our thirties, our ovaries start to pack up for their permanent vacation and they produce less estrogen and progesterone. This signals the end of our reproductive years and is a natural part of aging. If only the symptoms seemed natural. Some of my favorites are:

Hot Flashes: Those moments when you suddenly, inexplicably feel like your upper torso has suddenly burst into flames and you are fanning yourself and plucking at your damp t-shirt and glaring at the younger women in the room who look so cool and fresh.
Night Sweats: All the joys of a hot flash, only at night so you can wake up at 3 a.m. with the sheets stuck to you, then lay there for what feels like an hour waiting for the fires of Hell to assuage so you can chill for another 30 minutes thanks to the damp linens.
Trouble Sleeping Through the Night: Even WITHOUT the lovely night sweats
Moodiness, Crabbiness: Probably due to lack of sleep.
Weight Gain: Probably due to feeling cranky and hence hating working out and not being able to fight off the urge to live on chocolate because it is the only thing that makes you feel better.
Trouble Focusing and Feeling Confused: I can't remember why this happens.
Less Hair on Your Head and More on Your Face: Could this suck any more?

    Fortunately, it is no more complicated than the formula for feeling great that we followed prior to this madness. Exercise, eat well, and get plenty of sleep.
    The charming term middle-age spread is partly attributed to the hormonal changes brought on by perimenopause. The decline in hormones not only can cause weight gain around the belly but it can also cause an increase in appetite as much as 67%. We also experience a decline in metabolism as we age due to loss of muscle mass. We lose about a 1/2 a pound a year if we don't put an effort into preserving it. Regular exercise helps manage several menopausal symptoms. Exercise helps to create a calorie deficit and can help control weight gain. Strength training helps maintain muscle mass and your metabolic rate. Resistance training also can strengthen bones and prevent osteoporosis. Exercise can increase estrogen levels, thus decreasing the severity of hot flashes and night sweats. For those of us that fear the menopause monster lurking in us, exercise has been proven to reduce stress and improve your mood. Aim to get active for at least 30 minutes a day.
    Once perimenopause begins, because the risk of osteoporosis and heart disease increases, a healthy diet becomes even more important. Focus on whole grains, vegetables, and fruits. Calcium rich foods like milk, yogurt, and cheese are imperative. If you can't tolerate dairy make sure you take a high quality calcium supplement. Vitamin D is important at this stage of life, whether you get an adequate amount from sunshine or a supplement. As if we didn't have to put up with enough suffering during this change,  alcohol and caffeine are generally no-no's as they can trigger hot flashes. I personally think I am willing to suffer a little sweat for a truly great pinot grigio, but I am definitely cutting back.
    As for the sleep issue... I have always been an eight hours a night kinda gal (except for the insanity of my twenties). These days I feel like I am lucky to get six hours or so. Rare is the night when I don't lie awake in the wee hours of the morning waiting for the ceiling fan to cool me down, or simply wake up in the middle of the night and cannot fall back to sleep to save my life. How do I get an adequate amount of sleep under these hormonal circumstances? Enter the nap. There is generally some point in the day when I can shut my eyes for 30-60 minutes and that can do wonders for curbing the beast within. It also helps combat the fuzzy factor that occasionally plagues my brain.
    It is no deep dark secret. And really, it is no surprise to me. It's actually a relief. Perimenopause is something that happens to all of us in time. There is no escaping it. There are a few choices we can make. Hormone therapies, homeopathic aids, even acupuncture have been proven to help alleviate some of the symptoms of perimenopause. But at the end of the day, common sense healthy choices, like we strive to make our whole lives, are the best bet for easing us into this new phase of womanhood. When my body feels like it is at the mercy of what seems like a cruel trick of nature, I remind myself that while it is a natural progression, I don't have to roll over and take it. I grab a bottle of water and head out for a walk. I may be hormonal, but I am also healthy, and that helps.

Anneliza Itkor has been in the health and fitness industry for over 20 years. The Center for Health, Fitness, and Sports Performance, which offers a wide variety of fitness and massage services, is where she exercises her passion for total body wellness. Any fitness questions or comments are welcome and can be sent to This email address is being protected from spambots. You need JavaScript enabled to view it..

ASK A.J.

Dear A.J,
   "Which is better for you. free weights or machines?"

    Some prefer to use resistance machines, believing that machines are safer and will offer the same benefits as free weights. First of all, no machine automatically makes a situation safer.  In fact, research has stated that relaxed unloaded sitting can increase the stress on the lumbar spine by 40% when compared with standing. What kind of stress do you think would be placed on the lumbar spine while pressing weight overhead in a seated position on a resistance machine? Furthermore, most weighted machines follow a two-dimensional linear path which could result in unbalanced muscular development and reduced motor skill proficiency. When performing an exercise on a seated machine, some possible training effects are lost or greatly reduced such as balance, stabilization, and decreased core activation. In the end, I think that there is a time and place to use machines as well as free weights. If balance is a serious issue with you, then maybe most of your routine should be focusing on machines until your balance improves. If you are an athlete, I strongly recommend that you utilize free weights for most of your training because of the athletic benefits that would be lost from too much machine usage. Even for the athlete, some machine usage may be beneficial from a variety standpoint or certain physical limitations. In essence, both machines and free weights offer benefits and disadvantages. The type of equipment that you use very much depends on your specific goals and physical abilities.

A.J. Kelly BS, CSCS, is a Fitness Consultant / Certified Strength & Conditioning Specialist at The Center for Health, Fitness & Sports Performance. He has a Bachelor's in Exercise Science and has completed his Master's curriculum (Master's to be awarded after thesis completion). A.J. is also the Hilton Head Christian Academy Head Strength Coach. He has worked with all ages and fitness levels from youth to seniors as well as all skill levels from amateur to professional athletes. A.J. can be reached at 843.338.8752 and by email at This email address is being protected from spambots. You need JavaScript enabled to view it..