Perimenopause Symptoms

Perimenopause means the process or journey towards menopause. It’s the body's way of making the transition to the end of your reproductive years. Learn more:

What is Perimenopause?

Simply translated, Perimenopause refers to the process or journey your body takes towards menopause. It’s the body's way of making the transition from your fertile years to the end of your reproductive years.

What causes Perimenopause?

Perimenopause is a completely normal and natural process and it’s caused by decreasing oestrogen levels in the body.

Oestrogen is stimulated by the Follicle Stimulating Hormone (FSH). During your normal menstrual cycle, levels of oestrogen rise enough for a surge of Luteinising Hormone (LH) to be released which in turn prompts the ovary to release an egg.

During perimenopause, the production of oestrogen can be erratic. Lower levels one month will prevent ovulation, and this will prompt a lowering of progesterone levels too. 

The imbalance of hormones responsible for ensuring your period takes place each month can result in missed periods and other symptoms, which we’ll go over in this article.

What is the average age for perimenopause?

According to the NHS, perimenopause usually starts between the ages of 45 and 55, which is quite a large range. Every woman is different, so there is no real way to know when perimenopause will begin. Keeping a track of your cycle can help.

How long does perimenopause last?

The time a woman will remain in perimenopause varies too. It could take up to 10 years to reach menopause as the ovaries gradually stop working.

Do you still ovulate during perimenopause?

Because the levels of oestrogen are so erratic during perimenopause, ovations does still take place when oestrogen levels are high enough. Because of this, there is still a chance that you could get pregnant during perimenopause.

What is the difference between menopause and perimenopause?

Perimenopause is triggered when the body releases uneven levels of the hormone oestrogen. The menopause is considered to be when a woman hasn’t had a period in 12 months or more.

What is early perimenopause?

Premature Ovarian Insufficiency (POI) occurs when the ovaries stop working earlier than the age of 40. 

According to The Daisy Network, around 1 in every 100 women under the age of 40 will experience POI, 1 in every 1,000 women under the age of 30 could be affected, and 1 in every 10,000 women under the age of 20 could also be diagnosed. Just 5-10% of these women have a chance of getting pregnant.

Why women go through POI is not fully understood, which can be difficult for someone to understand, especially if they wanted to have children- but doctors do believe that there could be several factors that could increase the risk of POI:

• Smoking
• Family history
• Cancer treatments
• Hysterectomy

There are also some health risks associated with POI, as the changes in hormone levels can also put women at a higher risk of heart disease, osteoporosis and changes to cholesterol levels. 

Signs and symptoms of perimenopause

There are a wide range of symptoms associated with entering perimenopause, but not everyone will experience all of them. The severity of symptoms can also vary from person to person, and from month to month too.

Some of them include:

• Irregular periods
• Heavier or lighter periods
• Spotting between periods
• Breast tenderness
• Weight gain
• Bloating
• Changes to the hair
• Increased heartbeat
• Headaches
• Change in sex drive
• Concentration difficulties
• Forgetfulness
• Urinary tract infection
• Fertility issues
• Dry/ itchy skin
• Fatigue
• Sleeping problems - night sweats
• Hot flushes
• Vaginal dryness
• Mood changes/ anxiety

Tracking your cycle along with any symptoms you exocrine will help you to understand more about what’s happening and whether or not you’re experiencing perimenopause. 

What are periods like during perimenopause?

One of the fist indicators of perimenopause is often changes to your cycle. According to this study, 25% of women experience heavy periods during perimenopause, and many also have shorter cycles overall. 

Lots of women also report that period cramps are more intense, and those suffering with endometriosis may find their symptoms worsen too. 

Health risks associated with perimenopause

Some health risks increase after menopause, mainly due to the fact that oestrogen is a protective hormone. Conditions such as heart disease, osteoporosis and urinary tract infections (UTIs) are more common post menopause.  

Sleep disturbances with perimenopause

According to this study, the most common reason for sleep disturbances during perimenopause is nocturia- waking up to use the loo. This is usually down to decreasing levels of oestrogen alongside lifestyle factors, such as fluid intake before bed. 

The study also found that being too hot can also affect sleep during perimenopause. 

Weight gain with perimenopause

Additionally, other changes that are normal as you age can also have an effect on your health, such as a slow down of the body’s metabolism (leading to weight gain). This study found that the rate of fat gain can actually double as perimenopause hits, and lean mass drastically reduces too.

Diagnosing perimenopause

Some women may not visit the doctor to be diagnosed with perimenopause. Other women will speak to their doctor and from the symptoms explained to them, the doctor will determine that they are in perimenopause.

It’s common for the doctor to take a blood test to check hormone levels. If a woman is experiencing POI they may be invited for a scan of their ovaries or further gynaecological tests.

When to see a doctor about changes in periods

Changes to your normal cycle aren’t usually a cause for concern- but if you’ve noticed significant changes that worry you, and you’re under the age go 45, the NHS recommends speaking a doctor about what might be going on. 

There can be several causes of irregular periods that your doctor can investigate.

Treatment for perimenopause

                                                  There are a few options for women to consider when it comes to treating the symptoms of perimenopause. Some women choose to treat and manage their symptoms naturally, but remember to always check with your doctor before taking any herbal medication.

Hormone Therapy

Hormone replacement therapy (HRT) replaces low levels of hormones, which can be very helpful in easing symptoms of perimenopause. 

Oestrogen can be taken in the form of patches to wear on the skin, gels or sprays to apply to the skin, implants that are placed under the skin, or tablets that can be taken orally.

Progesterone can be taken in the form of patches, IUS or coil, or in tablet form. 

According to the NHS, HRT can “relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.. Taking HRT can also reduce your risk of hormone-related health problems including osteoporosis and heart disease.”

Antidepressants

Your doctor may also prescribe antidepressants, to treat perimenopause symptoms such as anxiety, low mood or depression. 

Vaginal oestrogen cream

To combat vaginal dryness, your doctor might recommend oestrogen cream to help ease discomfort. These are safe to use, with no reported side effects. 

Birth control pills

Birth control pills may also be effective in treating symptoms of perimenopause. 

This is backed up by this 2009 study, which concluded that birth control pills are effective “not only for their contraceptive effect, but also for the improvement of various symptoms that commonly appear during perimenopause, including menstrual irregularity, heavy menstrual bleeding, menstrual pain, and vasomotor symptoms.”

Managing perimenopause symptoms with lifestyle changes

There are certain lifestyle changes that you can make that can ease symptoms of perimenopause, and that can help to prevent POI too. 

These include: 

• Regular exercise, such as yoga, can help to reduce weight, improve mood, and anxiety
• Avoiding alcohol and caffeine
• Stopping smoking
• Eating smaller meals to help with bloating
• Eating a balanced diet and increasing protein (helps with muscle mass), omega 3 fatty acids (improves mood), fibre (curbs cravings), and calcium (improves bone density)
• Takins vitamin supplements
• Increasing levels of vitamin D and calcium via supplements
• Practising mindfulness- taking a warm bath before bed, listening to relaxing music, and meditation to help with stress and poor sleep

The bottom line on perimenopause

Entering into perimenopause at any age can be scary, as changes to your body and mind take place. It can be a significant time of adjustment, both physically and emotionally.

It’s important to remember that there are treatments available and that changes to your lifestyle may help improve any symptoms you are experiencing.

Starting the journey towards the menopause can be seen as a new phase in your life, as one chapter ends, a new one can begin

FAQs

What is the typical age for perimenopause?

Everyone is different, so there is a fairly wide age range when it comes to perimenopause. For most women, it is between the ages of 45-55, but in some cases it can be younger. Speak to your doctor if you believe you are experiencing symptoms and you’re under 40.

What does perimenopause feel like?

There are a range of symptoms, one of the first being notable changes in your period. Lots of women report that their cycle becomes irregular and cramps are more intense, with heavier bleeding and other symptoms such as headaches, sleep disturbances and hot flushes. There are treatments available to ease these symptoms.

What happens in perimenopause?

Perimenopause is the transition towards menopause. Levels of oestrogen drop sharply and fluctuate more than usual, causing changes in your period. Eventually, the ovaries stop working as oestrogen drops away and ovulation ceases. Menopause is reached when you do not experience a period for 12 months.

Can you check if you are perimenopausal?

Because perimenopause is a process, the transition towards menopause, there isn’t one simple test that can be done to check if you are experiencing it or not. Your doctor can take into consideration your age and other symptoms you’re experiencing and may order hormonal tests. 

What vitamins should I take for perimenopause?

 There are some vitamin supplements that could help ease the symptoms of perimenopause, but you can also supplement your diet with natural foods too. 

Its important to take enough calcium (1200mg per day for women aged 31 to 50 and up to 1500mg per day for women over 50) to protect bone health. Its also a good idea to consume iron-rich foods, and foods high in Omega-3s too.

Speak to your doctor about suitable vitamin supplements to support the body through perimenopause.

How can I balance my hormones during perimenopause?

Eat plenty of oestrogen-rich foods such as soya, nuts, seeds, fruits, pulses and beans. Take steps to manage stress, exercise regularly and tackle any digestive issues you may be experiencing. Speak to your doctor about the best ways to do this, and the best supplements that may help too.