What is perimenopause?
It might feel like everyone is talking about perimenopause at the moment – and rightly so. It’s been a bit of a taboo subject for far too long and many women have suffered through their symptoms quietly without getting much help. It’s so good to see that this is finally changing and women are happy to talk about their respective experiences and what they are doing to help themselves.
So, what is perimenopause and how does it differ from menopause?
Menopause is unavoidable so it’s important that every woman knows what’s going to happen. Not all women experience the exact same symptoms of course, but the end result is the same for all women or those female assigned at birth (AFAB): our periods stop for good, which means a woman’s reproductive years are over. In fact, the definition of menopause is the time when a woman has not had a period for 12 consecutive months.
It's the time before reaching that point though that comes with all the symptoms that many women struggle with. This timeframe is perimenopause, which can last anywhere between four to 10 years before reaching menopause. Whilst the average age of menopause is 51 in Australia (it’s similar in most other Western countries), symptoms can be experienced up to 10 years before, which is something that many women don’t realise. Some women might experience symptoms even earlier, as menopause can happen any time between the ages of 45-55 (earlier is possible too, although this would be called premature or early menopause). The point is that whilst menopause is regarded as something that affects us in our 50s, the symptoms actually start much earlier, which means that perimenopause is a condition that can start in our late 30s or early 40s.
The perimenopausal years are characterised by a hormone rollercoaster and then the eventual decline of both estrogen and progesterone, and also testosterone (although the latter declines more slowly but will be significantly lower when reaching menopause). It is these hormone swings and decline that lead to the symptoms.
What are the commonly experienced perimenopause symptoms?
Hot flushes/flashes
Onset of night sweats
Mood swings; worsening of mood symptoms such as anxiety, depression
Weight gain without changing your diet or exercise
Irregular menstrual cycles (<25 days)
New heavier periods and/or longer menstrual flow
Vaginal dryness
Reduced libido
New, swollen and/or lumpy breasts
New mid-sleep waking and/or insomnia
New or markedly increased migraine headaches
Brain fog
Cognitive decline
Frequent UTIs
Joint aches
This list is by no means exhaustive, but those are certainly the most commonly experienced symptoms.
As mentioned above, perimenopause lasts several years so symptoms will change throughout that period. Irregular cycles are commonly experienced in the early stages of perimenopause, followed by skipped cycles (60 days or longer without a bleed). However, it’s not always a linear progression – sometimes a woman might skip quite a few bleeds and then get a regular period again (something I experienced myself in fact)! It is therefore a good idea to record symptoms and your cycle in a diary to keep track of all them all and how the various symptoms are changing over time. This is something that I regularly discuss with my clients.
So, once we have reached menopause all is good – right?
Unfortunately, that’s not quite the case. As discussed above, we lose most of our estrogen and progesterone during the perimenopausal years. This has a profound effect on our overall health, in particular bone, heart, metabolic and mental health. Our ovarian hormones have protected us from many diseases over the first few decades of our lives, but now that protection is gone and we need to be more proactive with regards to our long-term health. This is something that I will address in another blog post.
What should you do if you think you are in perimenopause?
I will talk more about treatment options in my next blog post. Diet and lifestyle changes can make a big difference, and targeted supplementation with nutrients and herbs will help further.
HRT/MHT (Menopausal hormone therapy) is certainly a very viable treatment option and can be combined with other treatments and dietary/lifestyle changes. More about all this in the next post.
To start with, do the following:
Track your cycle and symptoms
Get a good understanding of the perimenopause symptoms and what happens during those years and beyond (I like the book “Hormone Repair Manual” by Lara Briden)
Find a GP that specializes in women’s health and will therefore understand what’s going on and not dismiss your symptoms
Work with a naturopath to explore some alternative therapies and herbs that can help with your symptoms
If you experience any perimenopause symptoms and would like to find out how you can alleviate some of them, book in for a 1:1 consult. We can then tailor a treatment plan specific to your individual symptoms.
