Four years ago, when Academy Award winning actor Halle Berry first experienced symptoms of perimenopause, her doctor misdiagnosed her in kind of, sort of a big, big way. Her doctor told Berry, who was 54 years of age at the time, that she had a “pretty bad case of herpes,” in Berry’s words. Yeah, mistaking perimenopause symptoms for herpes is more than just an oopsy. After all, telling someone that they have herpes when they don’t is not like telling someone that they have to do burpees when they don’t.
Halle Berry’s Perimenopause Misdiagnosis Odyssey
Berry recently talked to me about this herpes odyssey that shouldn’t have been. The symptoms in question emerged the morning after what Berry described as “Having a great old time with her partner, a great night of sex. I woke up and couldn’t urinate. It felt like razor blades in my vagina.” When Berry saw her doctor, her doctor gave her the diagnosis of herpes even before any testing came back, because who needs stuff like scientific evidence, right?
The news was a shocker for Berry, as she didn’t seem to have significant risk factors for contracting herpes. Herpes is not something that typically occurs out of the blue like from eating something wrong or seeing a bad show on Netflix. Genital herpes is caused by herpes simplex viruses that are typically transmitted via sexual contact. Therefore, Berry quickly told her partner, who was a new partner, about the herpes diagnosis and asked the natural next by-the-way-do-you-have-herpes question, which her partner denied.
Once the test results came back, though, so did the truth. Berry did not have herpes. “The doctor should have never made that diagnosis,” recalled Berry. But that still left Berry with a medical mystery because not-having-herpes is not a medical diagnosis. “I got on my own reconnaissance,” Berry explained. “I found some specialists. Started taking a different route rather than just through a traditional gynecologist.”
Along the way came other misdiagnoses such as Sjogren’s disease, a chronic autoimmune disease that leads to underproduction of tears and saliva. That typically results in a dry eyes and a dry mouth. Could it have led to a dry vagina for Berry because when do you not think of the vagina when you think of the eyes and mouth? How about playing that game show buzzer sound for wrong answer?
Eventually, Berry learned that her symptoms were likely due to decreased lubrication and elasticity of her vagina, which commonly occurs during perimenopause. In fact, one of the more common symptoms of perimenopause is experiencing vaginal discomfort during or after sex as a result. “My own gynecologist didn’t think of vaginal atrophy,” said Berry. So instead of some kind of infection or disease, Berry was undergoing the totally natural situation of perimenopause, a situation that most women will go through at some point.
Many Doctors Lack Training In Diagnosing And Handling Perimenopause Symptoms
Unfortunately, Berry’s experience may not be unique. Many doctors are not even properly trained in menopause and the issues surrounding menopause, like perimenopause, despite having to care for patients who will go such periods in their lives. A study published last year in the scientific journal Menopause found that only 31.3% of 145 obstetrics and gynecology residency program directors surveyed in the U.S. reported having a menopause curriculum in their residency programs. And only 29.3% reported that trainees having dedicated time to work in a menopause clinic. These are ob-gyn training programs, you know the kind that are supposed to specialize in teaching women’s health. Umm, where then are newly minted gynecologists supposed to learn what happens during, oh, a big part of women’s lives? Some kind of Learning Annex course or TikTok?
Perimenopause Falls Between Premenopause and Menopause
Perimenopause falls between premenopause and menopause, since “peri-” is a prefix standing for around, near or about. Premenopause is essentially your body’s reproductive period or phase, going from your first ever period all the way to the beginning of perimenopause. Another name for perimenopause is menopause transition because it marks time period when your body is shifting from its reproductive phase to menopause.
When perimenopause starts and how long it lasts can range greatly from person-to-person. It can start as early as one’s 30s. While perimenopause lasts on average for about three to four years, this duration can vary from as short as a few months to as long as a decade. The end of perimenopause and the start of menopause is officially defined as not having a menstrual period 12 consecutive months.
Here Are Common Perimenopause Symptoms
Perimenopause is when the levels of two key reproductive hormones— estrogen and progesterone—begin shifting from the more regular patterns typically seen during your peak reproductive years. For example, estrogen levels can drop significantly, which may be behind many of the symptoms seen during perimenopause. During perimenopause, you may experience:
- Menstrual periods getting longer, shorter and/or less predictable. This can include completely skipped periods
- Menstrual flow becoming lighter or heavier
- Hot flashes
- Night sweats
- Sleep problems
- Mood changes such as increasing irritability or depression.
- Vaginal dryness and discomfort
- Painful intercourse
- Increased urinary or vaginal infections
- Loss of bladder tone leading to urinary incontinence
- Lower libido
- Bone loss.
- Memory issues, difficulty concentrating and brain fog
- Increases in low-density lipoprotein (LDL) cholesterol, the so-called “bad” cholesterol
- Decreases in high-density lipoprotein (HDL) cholesterol, the so-called “good” cholesterol
- More irregular ovulation and thus decreasing fertility
Note that the last symptom was “decreasing fertility” and not “infertility.” Pregnancy can still occur. So, don’t equate going through perimenopause with no-need-for-contraception. Otherwise, you could end up with a little surprise.
Treatment of Perimenopause Symptoms May Include Lifestyle Changes and Medications
Conventional medical treatment of perimenopausal symptoms has consisted of different combinations of lifestyle modifications and medications. Your doctor may recommend hormone therapy with estrogen via a pill, skin patch, spray, gel or cream to relieve hot flashes and night sweats and prevent bone loss. Estrogen directly to the vagina could help alleviate vaginal dryness and discomfort. If you still have your uterus, you’ll need progestin in addition to estrogen. Systemic estrogen can help prevent bone loss. If you can’t tolerate estrogen therapy, then your doctor may try antidepressants like selective serotonin reuptake inhibitors (SSRIs), gabapentin (Neurontin) or fezolinetant (Veozah) to help with the hot flashes. But, of course, since the deficiencies in menopause training are enough to give many patients pause, you’ve gotta wonder whether enough attention has been given to developing newer and better treatments for perimenopausal symptoms.
Berry Wants To Bring More Awareness To Menopause
This whole experience has motivated Berry to bring more awareness to menopause. “I realized that I needed to use my voice,” she explained. “Many women are not understanding what’s happening [with perimenopause and menopause]. They are white knuckling it.”
Why isn’t there more awareness of perimenopause and menopause? Well, this could be due in large part to surprise, surprise, existing biases. “As we get older, we are devalued, expected to have given our bodies to bearing and raising children,” said Berry. ‘We are supposed to go off to old age and disappear.”
Nothing could be further form the truth. Berry looks and acts as vibrant as ever. “At 58. I have never felt better,” Berry emphasized. “You don’t have to give up on being a woman. I want help other women at midlife.” She described aging as a “privilege” that should be “de-stigmatized.”
Indeed, there is a positive spin behind Berry’s experience with the healthcare system as well, namely what she is doing with Respin. Respin is the company that Beery launched as part of her second act in life—or is this her third or fourth act? On the Respin website, she’s written, “This year, I am rē-framing our focus at RESPIN to speak to women like me, smack dab in the middle of menopause or on the cusp of it (perimenopause), and those who want to be ready for what is coming down the line.” The Respin platform is planning on launching a new offering for women experiencing peri-menopause or menopause this coming January.
Can Probiotics Help With Perimenopause?
Then there’s been the swing that Berry’s life has taken ever since she learned about Pendulum Therapeutics and began using the company’s probiotic products. A friend who works at the Cleveland Clinic brought Berry’s attention to these products. Berry found that taking one of the Pendulum probiotics helped her better manage her Type 2 diabetes and blood glucose levels. “After being on the product for about a year, my HgBA1C went down by a point,” recalled Berry. “After I understood how it works, I asked, ‘How can I get involved?’” This led to Berry connecting with Pendulum co-founder and CEO Colleen Cutcliffe, PhD, which eventually led to Berry becoming an investor in and Chief Communications Officer for Pendulum. Back on February 23, 2023, Jeff Conway detailed Forbes how this connection evolved, and on August 15, 2023, Isabel Bekele chronicled for Forbes, the history of Pendulum.
You could say that Berry had a good gut feeling about the company because probiotics are about modifying your gut bacteria and Berry has experienced “better sleep and more energy” since taking the Pendulum product. Probiotics are themselves live microorganisms that when ingested may help restore or change the microbiome in your gut. Your intestinal microbiome is the city of bacteria and other microorganisms in your gut that serve all kinds of functions that may affect your health in different ways. When your microbiome doesn’t have the right composition, it could result in a rather “city” experience, so to speak, in different ways.
Cutliffe mentioned to me about how the gut microbiota is involved in regulating endogenous estrogen levels and how studies have suggested that “probiotics may affect the microbiome in ways that increase free estrogen.” For example, a randomized clinical trial published in the Journal of Medicinal Food found that healthy peri- and postmenopausal women who received a probiotic formula containing L. brevis KABP052 had over a 12-week period their estrogen levels maintained over time compared to drops in levels seen among those who received a placebo. Another study published in the journal PLOS ONE revealed associations between probiotic intake higher estradiole levels among premenopausal women and lower testosterone levels among post-menopausal women.
More research is needed, though, to better understand the relationship between the different aspects of the gut microbiome and perimenopause and menopause. Historically, there hasn’t been enough scientifically rigorous research in this area. But the pendulum seems to be swinging in recent years.
Hopefully the pendulum will shift for perimenopausal and menopausal awareness and care in general. If a well-known movie star like Berry can barely get a proper diagnosis, you can imagine what a “Monster’s Ball” the healthcare system may be for the many other women entering perimenopause each year.
