Could you be in the perimenopause?
Have you felt your body’s natural routine changing? Are you noticing your periods becoming irregular, experiencing brain fog, raised levels of anxiety or mood swings, worsening sleep, weight gain or hot flushes? It maybe that you have entered the perimenopause.
FAQs
What is perimenopause?
Perimenopause, menopause, and post-menopause are stages in a woman’s life that reflect the natural decline in ovarian function, where oestrogen production decreases and ovulation stops. This affects the hormones of the menstrual cycle resulting in monthly periods coming to an end and bringing about other associated changes, signalling the end of a woman’s fertility.
Perimenopause is the first stage of this process, referred to as the ‘menopause transition’. It is a delicate transitional period that usually begins 4-10 years before menopause when the ovaries overall produce less progesterone, oestrogen and testosterone, and lasts until menopause, the point when the ovaries stop releasing eggs and when a woman has gone without a menstrual period for 12 consecutive months.
During perimenopause, it is normal for many women to experience menopause symptoms and there may also be changes to the menstrual cycle including heavier or lighter periods, and increasing episodes of skipped or missed periods. Despite the reduction in oestrogen levels, it is still possible to become pregnant during the perimenopause.
When does perimenopause start and end?
Women can experience perimenopause at different ages. Some women notice signs of transition to menopause in their 40’s while others notice changes in their mid-30’s or even earlier.
The length of each stage of the perimenopause can vary foreach individual. While the average length of perimenopause is between 3-4years, some women may only be in this stage for a few months, but it can extend as long as 10 years for others.
What are hormonal changes that can occur in perimenopause?
During perimenopause, the ovary’s output of oestrogen, can fluctuate significantly and then overall declines. This, together with a reduction in progesterone and often a decline in testosterone together with other potential hormonal factors in perimenopause such as in insulin resistance or cortisol changes and more can impact on symptoms such as changes to the menstrual cycle and a range of perimenopausal symptoms such as bloating, breast tenderness, hot flushes and night sweats and issues with mood, memory and concentration.
How do you know that you are starting perimenopause?
8 out of 10 women will experience an array of symptoms as they transition to menopause. Each woman experiences perimenopause differently, while some have few or no symptoms, others will suffer from debilitating symptoms. As hormones shift during the years leading up to menopause, frequency, intensity, combination, and duration of symptoms vary widely from one to another.
Diagnosis of perimenopause is usually made on the history of symptoms. Blood testing for follicle stimulating hormone (FSH) is often normal in the perimenopause, particularly the earlier stages. Investigating for other causes of symptoms other than perimenopause is important.
What are 5 examples of signs and symptoms of perimenopause?
1. Changes in your menstrual cycle
The early transition of perimenopause is defined by almostregular periods and occasionally skipped cycles; as ovulation becomes moreunpredictable, cycles can become more irregular with periods becoming lighteror heavier, and the length of time between periods might be longer or shorter.
There can be phases of skipped or missed cycles that canlast over 60 days and then your cycle could run like clockwork once again. Thismenstrual irregularity lasts until reaching menopause.
2. Worsening premenstrual syndrome (PMS) symptoms & moodchanges
PMS often occurs 1-2 weeks before menstruation and symptoms usually ease after a period arrives. PMS symptoms may vary between individuals and include mood swings, anxiety, irritability, breast tenderness, bloating and more. There are many potential different PMS symptoms that may occur.
Some women are more likely to experience heavier PMS symptoms during perimenopause due to the body’s enhanced sensitivity to hormone fluctuation and irregular ovulation. PMS symptoms affect 20-40 percent of women during the perimenopause. For women who haven’t had PMS before, they may find the mood changes and physical symptoms difficult to adjust to.
3. Hot flushes and night sweats
Hot flushes one of the most common symptoms of the perimenopause, affecting 75% of women going through menopause. Hot flushes are characterised by feelings of intense heat spreading through your chest, face and neck, accompanied by sweating, rapid heartbeat and a flushed appearance.
4. Fatigue, poor sleep and emotional changes
Melatonin, the hormone which regulates sleep patterns can be impacted as a result of perimenopausal changes, leading to sleep disturbances and increased fatigue. Fatigue, poor sleep and mood swings affect more than three quarters of women during menopause.
Oestrogen and progesterone are powerful hormones that affect all tissues in the body, including the brain. The shifts in hormone levels during perimenopause may lead to mood swings or not sleeping well, causing a variety of emotional changes including lack of energy, difficulty concentrating and insomnia, which can lead to anxiety and depression.
5. Weight gain
Fluctuating hormones in perimenopause and the natural ageing process can disrupt your metabolism and impact lean body mass, resulting in women often losing muscle and gaining fat during this phase.
These hormonal changes, along with lifestyle factors may increase the risk of weight gain, particularly around the abdomen area, which has been linked with worsening hot flushes and night sweats.
Why is the impact of perimenopause different for each woman?
There are many factors which can influence the balance of hormones and how you respond to them – from stage of perimenopause you are at ie early to late, other hormone imbalances playing a role, oestrogen metabolism factors, gut health, diet, lifestyle, emotions, vitamin/mineral deficiencies, genetics and more – we are all different.
How is perimenopause managed?
Management of perimenopause and menopause is not one size fits all. Options for hormone replacement therapy if indicated will be discussed as well as alternative options if unable to take HRT or you would prefer not to. Addressing different factors that can impact on symptoms is part of the management, including focus on diet and lifestyle factors (and supplements if indicated).
Stay informed and take control of your health during the perimenopause and menopause!
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