Ann Louise Gittleman - Before the Change: Taking Charge of Your Perimenopause

The single best book you can read on cooperating with nature as your body shifts gears in preparation for the powerful menopausal years.

Joan Borysenko, Ph.D., author of Minding the Body, Mending the Mind and A Womans Book of Life

American natural health doyenne Ann Louise Gittleman describes the changes women experience before the change and presents a program for countering unpleasant symptoms.

Natural Health

Loaded with exactly the kind of information women need to support their bodies during perimenopause.

Christiane Northrup, M.D., author of Womens Bodies, Womens Wisdom

To all the courageous women everywhere who

are entering a brand-new stage of life

Many times a day I realize how much my own life is built on the labors of my fellow men, and how earnestly I must exert myself in order to give in return as much as I have received.

ALBERT EINSTEIN

I especially want to acknowledge the remarkable women who have influenced my life and touched my heart in very profound ways. These women have all passed and are no doubt entertaining the angels. The list of these women of valor includes my mother, Edith; my teacher, alternative medicines grande dame Dr. Hazel Parcells; my herbal healing guru, Hanna Kroeger; my personal friends the great Gracie Aldworth, Ann Oliphant, Wilma Keller, and Dr. Ann Wigmore; the unforgettable Barbara Carmichael; Jane Murray Heimlich (the daughter of the dancing great and wife of the doctor who invented the Heimlich maneuver); and Sondra Metzger. Not a day goes by that I dont think about one of you.

And my heartfelt gratitude to the other women who have personally changed my life with their open hearts and outrageous graciousness: the one and only Gloria Bein, Susan Meredith, and the legendary Patricia Bragg.

The late screen star Gloria Swanson was also a personal friend of mine and a true health pioneer, years ahead of her time.

Id also like to extend my heartfelt gratitude to the whole hardworking team at HarperCollins, including Hilary Lawson, Sydney Rogers, Adia Colar, Julia Kent, and Adrian Morgan.

Grateful thanks to the entire HarperOne team, especially Gideon Weil, Mary Duke, and the entire publicity team. Finally, kudos to my ALG team on the home front, including Ally Mortensen, Stuart Gittleman, Emily Carmichael, Carol Templeton Volanski, and Shae Janda. A special shout-out to my tireless and terrific literary agent, Coleen OShea, who has been with me throughout my career. Love you all!

Im just too young for this!

These may be the most frequently spoken words you will hear yourself say as you begin your menopausal journey during your thirties and forties (and for some, the journey may begin as early as your late twenties). This time in your life is when a whole host of environmental, dietary, and lifestyle factors seem to conspire against your body, creating an array of seemingly disconnected and utterly annoying symptoms. Among them: mood swings, a lagging sex drive, sleeplessness, exhaustion, GI woes, belly fat, hot flashes, depression, and a sluggish metabolism.

It has been almost twenty years since I wrote the first edition of this book. Since then, the perimenopausal landscape has greatly evolved.

In 2002, the Womens Health Initiative, a major national long-term study involving hormone replacement therapy, which was the go-to treatment for women during the menopausal years, was abruptly halted. The study had utilized a combination of popular synthetic hormones called Prempro (a mix of estrogen and progestin). Why was the study halted? In the initial stages of the research it became clear that the risks of hormone use far outweighed the benefits. Those risks included a 26 percent greater chance of breast cancer, a 41 percent higher rate of stroke, a 29 percent greater risk of heart disease, and double the rate of blood clots in the legs and lungs. Women were frantic and scared, with many questions and concerns about the synthetic hormone replacement therapy (HRT) they had been on for years or were contemplating. Many felt they no longer had any safe treatment options for the symptoms of perimenopausewhat ideally should be a natural and freeing transition into a brand-new phase of life. So only five years after the initial printing of Before the Change, I felt compelled to update the first edition with a section on the pros and cons of hormone therapy as well as how to wean off the synthetics and transition to more natural, bioidentical hormone treatments. After all, hormones are the chemical messengers of the body. They influence everything we think, feel, and do. In spite of that, we dont know much more about their intricate workings than we do about the surface of Mars. The more we learn about hormones, the more we find how little we know.

In the first update, I expanded upon the pros and cons of phytohormones (like soy) and offered new insights into bioidentical hormones as effective and safe alternatives to HRT. Bioidentical hormones are the real deal: hormones that are identical to what the female body has been producing naturally for roughly two hundred thousand years. They are far different biochemically from the hormones found in Premarin, the common HRT made from hormones concentrated in horse urine. They are also far different from Provera, or medroxyprogesterone, the synthetic progesterone that is harmful to a womans heart.

After an appearance on Dr. Phil, which swept Before the Change onto the New York Times bestseller list, I continued to hear from women everywhere who had more questions that the first updated edition hadnt addressed. They needed advice about frustrating weight gain, leaky gut syndrome, fibromyalgia, chronic fatigue, polycystic ovary syndrome (PCOS), Hashimotos thyroiditis, and what to do to restore balance after a hysterectomy. They were concerned about breast health, bone strength, signs of accelerated aging, and a relatively new area of study: pelvic floor dysfunction. I felt all these women deserved drug-free, proactive solutions to their problems, or, at the very least, some type of direction as to where to go for proper care.

Many of these issues are now discussed in , Secret Cures for Perimenopause Problems. Throughout the book I also answer the most prevalent questions I was asked over and over again during the past two decades:

While bioidentical hormones may be natural, are they always safe?

Youll be surprised to learn that large quantities of bioidentical estrogens, for example, can increase the risk of blood clots and stroke. Ill tell you how to avoid estrogen-related blood clots easily and entirely.

What are the latest findings about calcium? Is supplementation of calcium still the gold standard to prevent osteoporosis?

Ill discuss the reasons that calcium is no longer the go-to remedy for thinning bones and why magnesium, vitamin D (which is actually a hormone), vitamin K2, and strontium are your bones besties. Research now suggests that calcium can cause arterial congestion, digestive issues, calcification in cancerous tumors, and many more unwanted conditions.

Why cant I lose weight?

Youll be astonished to find out that hypothyroidism is now approaching epidemic proportions among perimenopausal women, and most women go undiagnosed. In this new edition of Before the Change, youll find updated and expanded discussions of the glutenthyroid connection, the role of bile, how thyroid function relates to hormonal imbalances, why your doctor cant tell you whats wrong, and what you can do to keep your thyroid in tip-top shape.

In addition, youll discover a brand-new Peri Zappermy tried-and-true remedies for perimenopausal symptomsthat focuses on a properly nourished liver (the livers production of quality bile is absolutely essential for optimum hormone support) as well as a whole-body detoxification. This, in and of itself, may be the