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specific test that’s needed to diagnose menopause or perimenopause. Second, testing may not yield a definitive answer. During perimenopause, hormone levels fluctuate a lot, and a test one day may look very different than one the Look At Me Being All Festive And Shit Christmas T-Shirts Also,I will get this next. There are limited circumstances where testing could be beneficial. For example, someone who has had their uterus removed but not their ovaries won’t be menstruating. Also, women who are using hormonal birth control such as the oral contraceptive pill may not experience changes in menstruation, as their other symptoms could be masked by these hormones. They may want some way to see if they are reaching menopause. People under 40 who have stopped having periods may also want to be tested to see if they have something called premature ovarian failure, also known as primary ovarian insufficiency. Other types of tests can be done, too. Just because someone is in the time in their life when they could be perimenopausal doesn’t mean that all their symptoms are due to hormone changes. It’s sometimes necessary to rule out other medical causes. : Does weight gain go along with perimenopause? Wen: This is a real phenomenon. Part of the weight gain is due to aging and the slowing of metabolism and loss of muscle mass that comes with aging. The estrogen change during perimenopause also can lead to the redistribution of more body fat around the midsection. Lifestyle changes can play a role, too; stress, responsibilities of work and caregiving, and fatigue may lead to reduced physical activity or less attention to nutritious diets. RELATED ARTICLE Your body needs these three forms of movement every week Some things can help with perimenopausal weight gain, starting with a diet that emphasizes whole foods like fruits, vegetables, nuts, meat,

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fish and whole grains. Try to decrease consumption of ultraprocessed foods, which are associated with obesity, diabetes, heart disease, cancer, dementia and a whole host of negative health outcomes. People who smoke should try to quit. And women should evaluate how much alcohol they are drinking, as it adds to excess calories. Regular physical activity is also important. People who have primarily desk-based jobs should especially pay attention and work to incorporate short bursts of exercise throughout the Look At Me Being All Festive And Shit Christmas T-Shirts Also,I will get this day. The best exercise regimens are those that not only focus on cardio aerobic exercises but also incorporate weights for strength and resistance training. And prioritizing sleep is another key component, as consistent poor sleep is a risk factor for weight gain. : Speaking of sleep, what can be done for perimenopausal women who are having trouble sleeping? Wen: It’s crucial to understand the underlying causes of poor sleep. Is it night sweats — are you also experiencing hot flashes doing the day? If so, treatments are available. Is

it stress, depression and/or anxiety? Mental health issues also should be addressed. Otherwise, good sleep hygiene is always a great place to start — including establishing a sleep schedule, avoiding naps and alcohol, and stopping screen use in bed. RELATED ARTICLE The new secret to unlock restful sleep: Evening exercise breaks : Is hormone treatment appropriate for women in perimenopause? Wen: It’s important to distinguish between hormone therapy that is systemic, meaning it goes throughout the Look At Me Being All Festive And Shit Christmas T-Shirts Also,I will get this body, and therapy that contains hormones that target specific body parts. For some women, systemic hormone treatment is appropriate. For instance, women who have substantial problems with hot flashes may benefit from it, which can come in the form of a pill, a patch, a spray and so forth. Individuals should discuss their symptoms and go over eligibility with their primary care provider. : What about other symptoms, such as vaginal dryness? Could that be alleviated with targeted hormone treatment? Wen: Yes. There are a variety of vaginal tablets, creams and rings that can deliver estrogen directly to the vaginal tissue. They can help reduce vaginal dryness, pain with intercourse and some other urinary symptoms. : Where should people go for more information

on perimenopause and menopause? And what sources should they avoid? Wen: People who have a trusted primary care provider skilled at managing menopause patients should go to them. A resource I recommend highly is the Look At Me Being All Festive And Shit Christmas T-Shirts Also,I will get this The Menopause Society. A number of companies sell products related to menopause and perimenopause. Some of them have useful information but use caution and recognize that they have commercial interests that may not always align with what is best for individual patients and their specific needs. RELATED ARTICLE An experimental pill cut hot flashes and improved sleep for women in menopause — without using hormones Another way to address the anxiety and stress that some women may experience is to lean on friends, both in person and virtually, who are going through this life change. These groups also can be a good way to share information, though, again, it’s important to make sure that the information can be traced back to reputable sources.

Editor’s Note: This story contains details of self-harm that some readers may find upsetting or triggering. Help is available if you or someone you know is struggling with suicidal thoughts or mental health matters. In the Look At Me Being All Festive And Shit Christmas T-Shirts Also,I will get this US: Call or text 988, the Suicide & Crisis Lifeline. Globally: The International Association for Suicide Prevention and Befrienders Worldwide have contact information for crisis centers around the world. — Megan walked the halls of her suburban Houston junior high in shame. It was the first time she had to attend school with bruises on her face from the abuse by her father, who was an alcoholic. “I was really frustrated about that and just how unfair it was, and how embarrassed I was,” Megan — who is now 35 and asked that her last name not be used due to the sensitivity of the subject — said of that moment that occurred over 20 years ago. “And I couldn’t escape having to continue to go to (my dad’s) house.” When Megan got home from school and found herself alone, she grabbed a kitchen knife, locked herself in the bathroom and cut her forearm open. She had just recently learned about self-harm after asking a friend about her many bandages and long sleeves. RELATED ARTICLE Suicide attempts increased among transgender teens when states passed anti-trans laws, study says “It was always after the visits to (my dad’s) house,” Megan said. “I would come back (to my mom’s house) and just have all of this frustration and not know what to do with it. … At my dad’s house, there was no control. I had no control. So (harming myself) was more of a way that I was in control.” Over the next few years, Megan’s father continued to abuse her and she self-harmed to cope, as it helped her focus on the physical pain instead of the emotional pain. After getting kicked off the cheerleading squad at age 15, she

ran upstairs to her bathroom with a knife in tow, Megan said. But her mother had caught on and tried to break the Look At Me Being All Festive And Shit Christmas T-Shirts Also,I will get this door down, “scared sh*tless that I was trying to kill myself.” A couple days later, Megan began therapy to hash out her trauma and learn different ways to process her pain. Though her mother feared Megan was suicidal, Megan insisted the behavior had nothing to do with wanting to die — instead, she said, self-harming was a desperate attempt to keep her unbearable feelings of anger, sadness, guilt and shame from running wild. What is self-harm? Self-harm commonly takes the form of cutting or scratching until the body bleeds, but it can also include burning, bruising or even intentionally breaking bones, said Dr. Janis Whitlock, founder and director of the Cornell Research Program on Self-Injury and Recovery at Cornell University in New York state. Some experts refer to the behavior as non-suicidal self-injury, or NSSI. In 2019 there were 363,000 emergency department visits for self-harm, according to the US Centers for Disease Control and Prevention. The following year saw a 48.5% drop, likely due to the tendency to avoid medical care to not overburden medical providers or risk getting sick during the Covid-19 pandemic, Whitlock said. RELATED ARTICLE

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