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At 40 years old, Susete Ferreira would wake up “drenched” from her night sweats. In addition to a swollen abdomen and skin irritation, it crossed her mind she might be going through perimenopause, the period when your body transitions to menopause characterized by hormonal changes. After all, she was around the common age it begins and had heard a lot about women experiencing night sweats, so she “didn’t give it too much importance.”
Months later, Ferreira would have to go to an emergency room in Toronto because of a sharp pain coming from under her rib. “I couldn’t walk and I couldn’t breathe,” she said, adding an oncologist came to see her after an ultrasound and CT scan. “She said my body looks like it’s full of disease.”
A biopsy confirmed what Ferreira initially thought of as perimenopause was stage 4 follicular lymphoma, a cancer that appears in the lymph nodes. “It’s so easy to ‘explain away’ your symptoms,” she said, noting people should advocate for themselves and go to the doctor if they notice something changes in their body.
Ferreira began to share her journey online and would hear similar stories from women who thought their cancer or condition was something else. It’s not uncommon to “explain away” symptoms as Ferreira said, especially when it comes to menopause, which has more than 30 symptoms.
Yahoo Canada recently spoke to an OBGYN and menopause expert on how to tell if your symptoms might be part of menopause or could be a sign of something else, and when you should seek medical attention.
Dr. Kelsey Mills, a board member of the Canadian Menopause Society and a menopause society certified practitioner, said several different disease states can mimic the symptoms of perimenopause. She added it can be tricky considering perimenopause can present differently in each person.
“So when people have hot flashes or are sweating at night, or a change in their bleeding pattern or breast symptoms, those may absolutely be a part of the pre-menopausal transition. But those are just a few examples of some things that can also be a harbinger of a worse diagnosis,” Mills said.
In her practice, Mills has seen some patients who believe they are going through menopause, but have uncontrolled diabetes or uncontrolled thyroid disease, both of which can cause flushing or sweating, or people who have leukemia or lymphoma, cancers which can also cause night sweats.
Mills said she looks to the patient’s age as one indicator if something is awry. The average age women experience menopause in Canada is 51. So if patients are referred to her at age 65 or 70 with new menopause symptoms, something might be off. “If your period has been gone for a long time and you’re now starting to have symptoms, that’s very suspicious,” Mills said.
She added people can certainly have changes in their bleeding pattern as they approach menopause and their period stops, but if someone is experiencing any “erratic, unpredictable, heavy bleeding” over the age of 40, they should seek medical attention. “Once the period has been gone for one full year, seek medical attention for any bleeding whatsoever.” Mills noted 10 per cent of people who bleed in menopause will have uterine cancer.
Other red flags Mills pointed to include sudden symptom onset — symptoms that develop very quickly — or other associated symptoms like new onset itching, changes to your bladder or bowel or sudden weight changes.
“I think people also have to trust their intuition. And if you feel like your health is rapidly changing or declining, or something is out of the ordinary, then you deserve medical attention,” said Mills. She added if you experience issues with abdominal pain, bloating, abnormal bleeding or bowel and bladder changes, you should be receiving a physical examination or pelvic examination from a physician.
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