I remember a sunny afternoon when I was 37, raking leaves in my yard, when suddenly, a wave of shakes, ravenous hunger, and an overwhelming sense of anxiety hit me like a freight train. There was no clear reason for my sudden bitterness, leaving me puzzled. I gripped that rake so tightly, I felt it could snap in half at any moment.
My first thought was that I might be pregnant again; it was honestly the only explanation that made sense at that chaotic moment. I rushed inside, devoured snacks like a hungry beast, and, despite my exhaustion from raking and my frazzled mood, I tossed and turned all night in a sweaty mess. The next day, on my journey to the drugstore for a pregnancy test and a box of Twinkies paired with Doritos, it dawned on me—this was just PMS. The worst case I’d ever experienced. I hoped it was a one-time thing, but the following month brought the same irrational hunger and anxiety.
Fast forward four years, and I find myself on the brink of another PMS episode, craving carbs like there’s no tomorrow and questioning every life choice I’ve ever made. My “shark weeks” now feel much harsher than they did during my teenage years, my 20s, and even early 30s.
After discussing this monthly chaos with a friend of mine, she revealed that her cycle shifted around the age of 35 as well. The intensity of cramping, bleeding, mood swings, and insatiable appetite led her to the store for a pregnancy test, convinced something more serious was brewing. But, like me, she discovered it was just PMS—PMS in those confusing “in-between” years, when many women have concluded their childbearing phase yet aren’t quite in menopause.
If you’ve ever felt like your uterus is staging a rebellion, wanting to wear an “Out of Order” sign around your neck during your monthly ordeal, you’re not alone. Dr. Judith Reichman, a women’s health expert who’s dedicated over 20 years to obstetrics and gynecology, explains that our 40s often bring significant menstrual changes. “During this decade, our ovaries start producing hormones through what I call ‘follicular rejects’,” she states.
Women are born with 1 to 2 million immature eggs, but most of these diminish over time. By the time puberty hits, we’re down to about 400,000. “Over the next 25 years, unless we’re pregnant or on birth control, one of those oocytes matures within a follicle that produces estrogen and, after two weeks, releases an egg (ovulation), along with estrogen and progesterone,” Dr. Reichman elaborates. “Each month, thousands of oocytes die, and this ongoing loss leaves us with fewer, less robust oocytes in our 40s. These older oocytes are less capable of developing into follicles that produce sufficient estrogen and progesterone compared to those in our younger years.”
This decline in viable follicles impacts our menstrual cycles, Dr. Reichman continues. “When a follicle develops poorly, it tends to produce less hormone and may even die prematurely, resulting in a menstrual cycle shorter than the typical 28 days. If the diminished follicle secretes insufficient estrogen, you may experience menopausal symptoms despite still having your period. Estrogen and progesterone levels influence our brain chemistry, impacting our mood. As both hormones decline, especially before and during your period, feelings of depression, hot flashes, night sweats, and insomnia can arise. It can feel like a preview of menopause.”
Not only do we face symptoms reminiscent of menopause, but our periods tend to become more extreme as well. Dr. Reichman points out that a common cause of heavy or painful periods in our “older” years is adenomyosis, a condition where endometrial cells invade the uterine muscle wall, causing it to thicken. This thickening can prevent proper contractions during menstruation, leading to heavier flows and painful episodes.
So, while we continue to navigate our monthly cycles, our bodies are producing less estrogen and progesterone—factors that can heighten anxiety and irritability. Yet, as women, we are known for our resilience, whether we’re running marathons or juggling work and family commitments in the midst of our monthly turmoil. We press on, even when the struggle feels real.
If you’re experiencing significant changes in your cycle, remember there’s a scientific explanation behind it—though that may not provide much comfort. Wine and chocolate might help ease the tension a bit. It’s all part of the process, but if something feels off, don’t hesitate to consult your gynecologist for peace of mind.
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Summary
As women age, many experience intensified symptoms of PMS and changes in their menstrual cycles, often due to hormonal shifts as they approach menopause. Understanding these changes can empower women to seek help and navigate this challenging phase with confidence.