Navigating Perimenopause with a Spinal Cord Injury

May 06,2022 |
Woman in a wheelchair by a lake.

Menopause is a natural part of aging for women across the world. Unfortunately, it’s often seen as a taboo subject and is therefore, hardly spoken of. Before menstruation stops completely, women go through a period of perimenopause, when hormones fluctuate as the body prepares to end monthly cycles. This can cause a range of symptoms that vary in their severity. While enduring this period of change is difficult in any woman, those with spinal cord injuries face unique challenges. Luckily, with the right information and support, you can get through perimenopause and start feeling like yourself again. To help, here’s more information about navigating perimenopause with a spinal cord injury.


Basic Information About Spinal Cord Injuries

The spinal cord is an integral part of the human body. It’s the primary highway for communication and is comprised of millions of cells and nerves that are bundled together. These neural pathways carry messages from your brain to every part of your body and vice versa. When a disruption occurs, it can result in serious complications and paralysis. Spinal cord injuries (SCI) are a type of injury that are localized within the spinal cord and the associated nerves. This damage can result in mobility issues and disruptions to bodily functions. Spinal cord injuries are classified based on the degree of severity. They can either be an incomplete injury, complete injury, tetraplegia (quadriplegia), or paraplegia. Incomplete injuries can result in a partial loss of movement and control while complete injuries tend to create a total loss of movement and control in affected areas. Tetraplegia is an SCI that affects people from the neck down while paraplegia affects individuals from the chest or waist down.


What is Perimenopause?

Menopause refers to the time when a woman stops experiencing monthly menstruation. However, this doesn’t happen overnight. Instead, women go through a transitional phase known as perimenopause. During this time, the hormone estrogen begins to decrease, which throws off the balance of other hormones like progesterone. In response, hormone levels fluctuate which can result in various symptoms. Perimenopause tends to last between four and eight years, and a woman is only considered to reach menopause when she goes a full 12 months without experiencing a period. During this time, a woman loses the ability to get pregnant. While many women experience perimenopause in their late 40s, it can begin as early as your mid-30s or as late as your mid-50s.

Symptoms of Perimenopause

Due to the fluctuations of hormones, perimenopause can cause a range of symptoms. Some of the most common include the following:

  • Hot flashes
  • Mood changes
  • Irregular periods
  • Night sweats
  • Difficulty sleeping
  • Forgetfulness
  • Difficulty focusing
  • Vaginal dryness
  • Increased infections
  • Headaches
  • Fatigue

These symptoms can cause discomfort in many women, but there are options to help with management. Working with a physician will ensure that you’re properly addressing any symptoms. It’s important to remember that mood swings are completely normal as hormones play a huge role in how you feel on a day-to-day basis. Try not to be too hard on yourself and schedule a little extra self-care to accommodate for periods of sadness or overwhelm. Talk to your doctor if you experience any serious signs of depression or self-harming thoughts.


Differences in Perimenopause with a Spinal Cord Injury

Unfortunately, many women who have a spinal cord injury tend to experience more bothersome symptoms of perimenopause. This is particularly true in regard to bladder infections and diminished sexual arousal. In regard to other symptoms, no significant differences are reported. However, depending on the level of paralysis caused by a SCI, some women may not be able to detect certain symptoms. Continue to monitor your health and perform physical checks on yourself to ensure that you’re staying healthy.

One thing that should be noted is that there’s a degree of similarity between perimenopausal symptoms and other underlying conditions often associated with spinal cord injuries. Some of these conditions include autonomic dysreflexia, infections, spinal cord cysts, and impaired temperature regulation. Symptoms should be monitored carefully to ensure that you’re receiving the correct care. Always talk to your doctor about any concerns or new symptoms to receive the correct treatment plan.

The study of the relationship between perimenopause and spinal cord injuries in women is still a fairly new topic in the scientific community. Since spinal cord injuries aren’t progressive, most post-injury menstruation will resume normally following the initial period of injury and treatment.


Bowel and Bladder Issues During Perimenopause

Individuals with spinal cord injuries are generally more prone to bowel and bladder issues. Some of the most common afflictions that need to be managed include incontinence issues, neurogenic bladder, urinary tract infections, renal function deterioration, kidney stones, and an increased risk of bladder cancer. Having an SCI causes long-term urologic challenges, which require ongoing maintenance and a proactive approach to your health. Unfortunately, when you’re dealing with perimenopause, these problems can become more troublesome.

Fluctuations in hormone levels can impact both the bladder and the bowel. This is especially true around the time of your menstrual cycle. The hormone production that coincides with this time can stimulate bowel movements, which many women grow accustomed to over the years. During perimenopause, you may notice changes in the frequency of bowel movements, which should be managed with your doctor. There is also a greater risk of infections, especially UTIs and yeast infections. Due to the lack of sensation and mobility in these regions, women with spinal cord injuries should proactively monitor their bodies for any changes. Try to keep an eye out for symptoms of a urinary tract infection and see your doctor as soon as possible if you notice anything unusual. There are, however, still treatment and preventative options available. The most effective include intermittent catheterization, indwelling catheters, reflex voiding, the crede maneuver, surgery, and the use of certain pharmaceuticals. Hydrophilic catheters can also help reduce the risk of infection alongside closed-system catheters and touch-free options. Talk to your doctor to learn more about how you can take a proactive approach to your urinary health during perimenopause.


Challenges of Perimenopause with a Spinal Cord Injury

In addition to managing any discomfort of perimenopause, one of the biggest challenges for women with a spinal cord injury is the fact that symptoms can mimic other conditions. Some of these conditions include overheating, various types of infections, and autonomic dysreflexia. Autonomic dysreflexia is a serious condition that occurs from an abnormal reaction of the nervous system in response to stimulation. This is typically an overreaction to the degree of external stimuli present and can lead to a change in heart rate, excessive sweating, high blood pressure, and shortness of breath. This condition should be addressed by a physician to avoid further issues and help pinpoint the underlying cause. To make sure that you’re being proactive, always monitor your symptoms of perimenopause and see your doctor regularly to ensure you’re staying healthy during this time.


When to See Your Doctor

Your gynecologist plays an important role in your long-term health, but you also need a team of medical professionals to properly manage your spinal cord injuries and associated complications. If possible, try to find a gynecologist in your area that is experienced with treating women suffering from spinal cord injuries. While it’s not absolutely necessary, doing so can help streamline the process and avoid the need of cross communication. Your general practitioner may be able to refer you to a gynecologist with this experience, so don’t be afraid to ask.

Regardless, you should always see your gynecologist for a regular wellness checkup at least once a year—more frequently if recommended by your doctor. This allows you to take a proactive approach to your health and address any unknown symptoms or signs of discomfort. As you get closer to the age of perimenopause, or once you start experiencing these symptoms, work with your doctor to discuss expectations, pain management options, and any concerns you may have about dealing with this transition while managing a spinal cord injury. Always be cognizant of your health and if you notice anything that seems off, schedule an appointment as soon as possible. When it comes to your health, it’s better to be safe than sorry.

If you or a loved one has suffered a spinal cord injury, getting the proper support, educational materials, and supplies is essential to navigating perimenopause. To help, Byram Healthcare offers a wide range of urology supplies such as catheters and incontinence care. Browse our products today and have them discreetly delivered at your door—most orders ship within 2-3 days.

Byram Healthcare is a proud sponsor of the United Spinal Association which is dedicated to empowering people with spinal cord injuries and disorders. We are also a member of the National Association for Continence’s Trusted Partners Program, whose mission is to provide quality continence care through education, collaboration and advocacy. We continue to build partnerships in the clinical community to ensure we focus on what’s best for the patient.