Are you in perimenopause?

40-something age woman looking and smiling into camera

If you’ve been feeling ‘not quite with it’ recently – forgetting things, lethargic, slow (mentally and physically) and have noticed your periods are a bit more erratic – you’re not going mad! It’s possible you’re experiencing the perimenopause…

Most women have an idea what to expect with the menopause and a rough idea that it will happen sometime in their fifties. But what’s less spoken about is the years leading up to it.

What is the perimenopause?

In our late thirties and early forties, our menstrual cycle may become more erratic as our bodies experience a decline in hormones on the way to our menstrual cycle fully stopping and losing our fertility. This drop in oestrogen, progesterone and testosterone can lead to many issues.

Perimenopause can, symptom-wise, be likened with the menopause: the main difference being that your ovaries are still functioning and therefore you are still fertile.  Starting as early as 35, with the average age of 45, the perimenopause can last anywhere from 4- 8 years before your periods stop.

Perhaps you’re noticing that your usual diet, exercise and lifestyle are no longer giving you the same results as before; or you’ll generally feeling a bit ‘out of it’.

It’s easy to ignore these symptoms, especially if you’re still living life in the fast lane. This time of life is often characterised by a busy job, ageing parents and young children, both of whom are dependent on you. You’re juggling a lot and may notice what seems like symptoms of stress. But it’s very possible that it may simply be an indicator of your next life stage, often known as the third age.

Perimenopause: physical symptoms

The list of symptoms of the perimenopause is long, but don’t be alarmed! It’s important to note here that whilst the decrease in oestrogen during the perimenopause can lead to many of these symptoms, none of them exist in isolation from one another. For example, suffering night sweats and therefore poor sleep is likely to lead to fatigue, irritability and weight gain as a result of the tiredness. 

Here are some of the most common things to notice which may indicate your body is going through perimenopause::

Irregular periods

One of the most noticeable changes during perimenopause is your periods changing. They may become heavier, lighter, shorter, longer or skip a month all together. As we approach menopause, our body is getting ready to stop ovulating and we therefore ovulate less frequently. This then results in heavier periods due to the uterus lining having had more time to grow thicker. Conversely, a lighter period may be due to lower oestrogen levels. If your periods are a lot longer, heavier and more frequent, it’s time to talk to a GP. 

Hot flushes

Yes, they can begin even before the menopause begins! If you’re suddenly finding that you’ve got the fan on at work whilst your colleagues are shivering next to you, it’s possible you’re experiencing a hot flush. 85% of women get them so it’s completely common and is caused by the changes in your hormone levels affecting your body’s temperature control. Feeling a creeping feeling of intense heat as if you’re suddenly in a furnace is one way it’s describe them. They can happen day or night, hence, night sweats and palpitations. They can occur ten times a day or a few times a week and unfortunately are not discerning about when to turn up – during a job interview; sex or an important meeting, they will let themselves be known through sweating, upper-body flushing, chills and sometimes confusion.

Hair loss, dry nails, weight gain

If you’re experiencing any of these things, blame your hormones (again). In the same way that soaring oestrogen during pregnancy often gives us thick hair and strong nails, the opposite effect occurs during perimenopause and menopause. A good hair and nail vitamin supplement may help to some extent, as well as trying new hair styles.

Weight gain, and in particular abdominal weight gain, is slightly more complicated. Yes, there is some relevance to it being affected by hormonal loss which shifts fat to the midsection but it’s predominantly a consequence of getting older. Add in other perimenopausal symptoms such as sleeping problems and mood swings, and it becomes harder to control our willpower around eating and exercising.

Other perimenopausal symptoms:

  • Vaginal dryness and urinary incontinence – if you’ve been itching and feeling irritated down there, it may be due to your vaginal tissue thinning. This loss of tissue tone can also make you more susceptible to urinary or vaginal infections as well as incontinence. Incontinence is never ‘something to put up with’ though – there are lots of things you can do to improve it. But if you’ve been feeling you have less control recently – yes, perimenopause may be the reason. These symptoms are also likely to lead to a lower libido.
  • Migraines and allergies – have you suddenly started to suffer with hayfever, migraines  or food intolerances? As we move closer to the menopause, our immune systems can become weaker due to the stress out body is going through.
  • Muscle tension and joint pain – As we age and our hormones drop, our bone strength decreases, often leading to more aches and pains than before. Dental pain may also be a symptom to look out for.

 Perimenopause: mental symptoms

  • Mood swings, irritability, panic and depression – having your hormones going up and down constantly, it’s hardly surprising to feel irritated and unsure of what mood you’re in. The drop in oestrogen affects the way our bodies manage serotonin, a hormone linked to depression. Higher levels of a protein linked to depression is also found in women experiencing perimenopause. You may also feel tearful and as if you have no control of your emotions. So if you’ve suddenly burst into tears for what feels like no reason at all, it’s possible there is a reason after all! And look at the tears as a way to release all that pent-up stress – you’ll feel much better afterwards.
  • Tiredness, ‘brain fog’ and memory problems – if you’re experiencing symptoms such as night sweats, brain fog or irritability, it’s inevitable you’ll be exhausted too. As mentioned before, the perimenopause begins at one of the busiest times of our lives and once you take into account all the hormonal shifts occurring, our bodies and brains are processing a lot. 

 How to reduce perimenopausal symptoms

As a long list, these do seem overwhelming, yet taking note of familiar symptoms gives you the opportunity to reassess how you’re looking after your mind and body right now. Multiple lifestyle changes, some big and some small, will help with balance when your body is beginning to feel unbalanced.

  • Exercise: this is when strength training should become a part of your fitness routine. It will help to build your bone strength as a drop in oestrogen leads to weaker bones. Aerobic exercise is still as important as ever too, producing stress-reducing hormones. Aim to exercise for at least 30 minutes 5 times a week.
  • Diet: alcohol and caffeine can disrupt sleep and bring on hot flushes, night sweats and palpitations so it’s a good idea to reduce these both. Hot, spicy foods can trigger hot flushes. Needless to say, smoking will also exacerbate symptoms.
  • Medication: hormone and non-hormone replacement therapies could help to rebalance your hormones – talk to your GP to see if there is anything to help.Other supplements could also help such as ashwagandha to support the nervous system, mood and sleep. A decent multi-vitamin, omega 3 fish-oil and vitamin d are also all round good supplements to support you at this time of life.
  • Mental load: as we reach middle-age, we can feel all manner of emotions; reflecting both on our life so far as well as what’s to come. In western culture, older women are sadly not as respected and valued as younger women and it can be hard to move into this different stage of life with positivity. Talking things through with friends and family and not being ashamed of your symptoms and feelings is a start in normalising this time of life. Getting professional help, whether through a GP or a therapist, in order to help you come to a good place is a step in the right direction. Things you can do for yourself include writing down how you’re feeling (perhaps keeping a symptom diary to keep track of them) and meditating to help with feeling gratitude and calm.

We know that menopause can sometimes seem to carry a stigma, making you worry about getting old and becoming infertile. However, we prefer to look at it as an opportunity to reassess where you are in life right now. Look at the people and things giving or taking your energy and how you look after your body and mind. Doing this can help you see perimenopause as a fresh beginning and a way to get to know yourself even better.


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