Perimenopause – What You Need To Know
As girls, we get told that we will start periods around the age of 12. We are also told that one day, when we’re in our 50’s, our periods will stop, and that this is called menopause. We don’t learn much more than that, other than the parodying of hot flushes that are often depicted in TV shows.
So we happily trot through life thinking nothing of menopause, because that happens to older women. We have children, we get jobs, we have a career, we travel. Once a month we might feel a bit rubbish, but that’s just a part of life, right?
And then for many of us, in our late 30’s or early 40’s things start to change. Maybe initially it’s just that our periods go haywire, or perhaps we find we’re getting a bit forgetful. We might find we’re more tired than we used to be. Maybe we start to google “early onset dementia”; we worry there might be an underlying cancer. We take endless pregnancy tests, but nothing gives us an answer.
This, ladies, is perimenopause. It is the time in our life when our fertility starts to decline, when our hormones start playing up.
A quick semantics lesson: from puberty we are in premenopause until our hormones start changing in readiness for menopause. This phase of change is perimenopause. Menopause is technically when we have been period-free for 12 months (or 24 months if you’re under 50), and after that you go into the postmenopause stage, aka the rest of your life.
Yet the whole transition often gets referred to as menopause. This is unhelpful for women in perimenopause who (understandably) think that because they still have periods their symptoms can’t be linked to menopause. And it is woefully under-understood by women, but also by the medical profession.
The Symptoms of Perimenopause
There is a list of around 40 symptoms linked to perimenopause, many of which are also signs of other conditions, so it’s always worth getting blood tests done to rule out anything else.
Symptoms include:
- Irregular periods – these may be further apart than you’re used to, or they may be closer together; they may be heavier or lighter
- Fatigue – you’ve slept OK, but you could nap every afternoon
- Insomnia – 4am is your new friend (or enemy)
- Breast tenderness – it’s like you’re constantly about to start a period
- Mood swings – one minute you’re laughing, and the next you’re ugly crying. About nothing
- Extreme PMT – you wonder if a judge would look favourably on your murder case as it was your hormones that made you do it
- Weight gain – you’re eating the same as you always have done, but suddenly you’re gaining weight, particularly around your midriff
- Low libido – you think you used to want sex, but now the very idea of it is exhausting
- Vaginal dryness – if your libido is still around, your body might have other ideas about you being able to have sex
- Recurrent UTI’s – as your oestrogen levels change, so you may find you get more bladder infections
- Joint aches and pains – suddenly you find every movement is accompanied by an involuntary noise: are you really only in your 40’s, it feels like you’re in your 90’s
- Memory issues – you go into a room and have no idea what you’re there for; you get half way through a conversation only to realise you don’t know what you were talking about; you’re writing a document and the next word you need is simply not there
And several more, including the better known hot flushes and night sweats.
What To Do?
Go and speak to your GP. In the first instance it is worth ruling out things like thyroid issues, which can show with similar symptoms. Your GP may offer to test your FSH (follicule-stimulating hormones) levels. This can be an indicator that things are changing, but as this level varies throughout even a normal menstrual cycle, it isn’t always a reliable check.
Top tip: when you go to your GP take a list of your symptoms (write them down – see memory issues above), and also have these guidelines to mind:
https://www.nice.org.uk/guidance/ng23 so you can have a frank discussion about what is going on. If you feel you aren’t getting anywhere, ask to speak to your practice’s women’s health specialist. It isn’t that your GP doesn’t want to help, but menopause is considered a specialism in medical training, so it isn’t covered in much detail at medical school.
What Are The Options?
There are several ways to manage your symptoms.
Medically, HRT is the main treatment offered. This comes in various different forms, so it’s advisable to do your research as to what sort you feel you would be comfortable taking. HRT is periodically in the news linked to an increased risk of breast cancer, however, the breast cancer risk from HRT is lower than some lifestyle risks and HRT offers benefits beyond symptom management including guarding against osteoporosis in later life.
Lifestyle changes can help. Review your diet, exercise, stress levels and sleep. These things are often easier to do under the guidance of a registered nutritionist.
Supplements can help with some symptoms – black cohosh, sage, red clover, magnesium and many more are widely agreed to help. Bear in mind that there isn’t much research into side effects from these, and that you get what you pay for – a cheap supplement may not contain the levels you require.
Bio
Emily is founder of the Perimenopause Hub. She started presenting with perimenopausal symptoms when she was 39. She didn’t know there was this phase before menopause, so went through all the emotions and confusion.
Emily found it incredibly frustrating that there wasn’t any resource out there for just perimenopause. To that end, she set up https://perimenopausehub.com/, a one stop shop for women to find information and to access experts who can help them manage their symptoms. Come and join the fun!
Feeling Lost Or Stuck?
If you’re feeling lost or stuck and want to reconnect with yourself, push yourself forward and thrive more – but just don’t know how to – then Lou (founder of Woman Ready) can help you. Have you thought about life coaching? Or why not check out our course, 30 Days To A Happier You?
