What is Perimenopause?
Perimenopause is the lead up to the menopause and can be anything from 2-10 years where as the menopause is just a day in time – 12 months after your last period.
The perimenopause usually starts in a woman’s 40s but some start to experience symptoms in their mid to late 30s.
Perimenopause is a natural transition where our hormones fluctuate and we can experience a variety of symptoms. The symptoms can easily be brushed off as being caused by the business of life which is why it is important that we understand what to look out for.
For many women, the perimenopause sneaks up long before they expect it and the changes can be gradual or for some and for others it hits like a bulldozer leaving them wondering what is happening to me?
When we understand what perimenopause is and we know the signs to look out for, we feel empowered. We an start to seek out the knowledge around what changes we can make to help ourselves.
Common Early Signs of Perimenopause
There are now 84 symptoms associated with the perimenopause, although most key health journals will list 34 key symptoms.
Here are some of the most commons early symptoms:
1. Low energy and fatigue
Feeling constantly tired or drained, even after rest or a good night’s sleep you still feel like your energy levels are lower than they usually are. Certain activities which didn’t use to cause a problem can leave you feeling depleted.
Fatigue in perimenopause is often linked to sleep disruption, stress, hormonal changes and nutritional needs not being met. These are the most common reasons, there are plenty of others eg. low iron due to heavy periods.
2. Mood changes
Mood changes are one of the most common symptoms and many women notice they experience:
– Increased anxiety, often worrying about things that have never bothered them previously eg. motorway driving and public speaking.
– Low mood – finding it very hard to find any joy, everything feels grey.
– Lack of motivation.
– Irritable and angry.
– Mood swings – one moment feeling quite happy and the next really cheesed off and down.
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These mood changes are all brought about by the fluctuations in hormones and women can be surprised how strongly it impacts their emotional wellbeing.
3. Sleep Problems
Sleep can become very hard to come by during perimenopause, some women have trouble falling asleep whilst others have no trouble getting to asleep but wake often from 1am onwards and feel like they are never getting into a deep sleep.
Some women also experience night sweats that cause great disruption during the night as they are so intense they need to change their pjs/ nightie.
Poor sleep also feeds into other symptoms such as low mood, irratbility and brain fog.
4. Brain fog and memory issues
Many women start to notice that they find it more difficult to concentrate, have a general ‘foggy’ feeling in their head and start to forget things. Finding words can also be a common issue along with staying focused on tasks.
For some these feeling can be quite extreme and frightening, making them question whether they are showing early signs of dementure.
5. Changes in the menstrual cycle
Periods often become irregular ie. missing a month or two or having a run of periods every two weeks. Periods may also become lighter or for some really heavy which can lead to anaemia.
Heavy periods, otherwise known as flooding can be very difficult to manage at work, especially in a job where you can’t get to a loo easily.
6. Hot flushes and night sweats
Hot flushes typically impact the upper body from the chest to the head and are like a sudden rush of heat making you want to strip off. Many women find they break into a sweat with the hot flush. They can also be accompanied by slight or even moderate feelings of panic.
Hot flushes can be a great source of embarassement, especially when they take place at work or in a public place.
Night sweats are a similar feeling and the amount of sweat can be more intense with some women reporting they have to change their pjs/ nightie and sleep on a towel they sweat so much. Needless to say for some, hot flushes have a significant impact on their sleep.
7. Changes in weight
The changes in hormones can impact our metabolism, appitete and the way fat is distributed around the body.
Many women report gaining weight around their middle, also known as ‘meno belly’ despite not changing anything in their lifestyle.
There are various factors that influence this such as losing muscle mass with age (which is why it is so important to do regular strength exercises), sleep disruption, changes in insulin sensitivity and of course stress.
8. Changes in libido
Many women experience a reduction in sexual desire and this can be amplified by vaginal dryness making sex really painful. Often women find it embarrassing to discuss these symptoms and therefore they can be overlooked. Vaginal dryness can impact all areas of life and for some women causes great discomfort making riding a bike difficult or even wearing trousers. There are products available to help – make an appointment with your GP and don’t suffer in silence.
9. Joint pain
Over 50% of women suffer from joint pain in perimenopause, the symptoms include stiffness, aching and swelling and can often be mistaken for arthritis.
Reduction in oestrogen impacts the joint lubrication and increases the amount of inflammation around a joint. Women often find joint pain and stiffness at its worst in the morning.
Why are Perimenopausal Symptoms Often Missed?
Often it symptoms are missed as women don’t realise the perimenopause can start years before menopause which is why we need to improve awareness and education.
Symptoms of perimenopause are often confused with:
– Anxiety and depression
– Stress
– Busy lifestyles
– Burnout
– Thyroid issues
Often symptoms start to appear gradually and women/ the medical profession don’t necessarily make the connection. Women are also very good at ‘putting up’ with discomfort.
You Don’t Have to ‘Just Put Up With It’
‘Women have to quietly struggle on through perimenopause’ is one of the greatest myths! Greater awareness and education, improved support and identifying lifestyle strategies to help the individual can make an enormous difference.
Understanding what is happening in our bodies is the first step towards feeling more in control of the changes and symptoms we might be experiencing.
Support that helps a lot of women includes:
– A regular exercise program, along with understanding what movement best suits our bodies at this stage of life and adjustments to certain exercises.
– Stress management.
– Guidance around nutrition, our body is less tolerant of low nutritional quality food as it ages. Understanding and experimenting with foods that are going to make us feel at our best has a profound impact for many.
– Support with disturbed sleep – understanding good sleep hygiene practices and for some women who can/ want to take HRT it can vastly improve sleep duration and quality.
– Education around hormones and also what options are available re: HRT (hormone replacement therapy). For some women HRT can literally be lifesaving if they have hit a deep depression or their symptoms are making day to day life very challenging.
– Nervous system support – such as yoga, massage, meditation and breathwork.
– Personalised menopause mentoring – especially good for women who are feeling overwhelmed, lost and don’t know where to start. The mentor will discuss your symptoms and lifestyle with you and help to identify small or large changes which potentially make a big difference.
When to Seek Out Support
If your symptoms are starting to affect your daily life and the quality of your life, your confidence, wellbeing and relationships it would be a good time to seek support.
Every women deserves to feel informed, understand their options and feel supported during this major life stage.
Yes perimenopause is a natural transition but for some women it can be such a turbulent ride where they truly lose themselves. The earlier we understand and recognise the signs, the sooner we can start to access support and work out what strategies we need to start feeling more like ourselves again.
