The top 20 questions about perimenopause answered right here

The top 20 questions about perimenopause are answered right here.

As women, our bodies go through many changes throughout our lives, with perimenopause being one of the most confusing and sometimes overwhelming transitions. This period (great choice of words here, hahaha) is often accompanied by a range of symptoms that can leave us feeling uncertain and out of control. However, understanding the changes happening in our bodies can help alleviate some of the stress and confusion.

In this post, I’ve included the top 20 questions about perimenopause that I’ve come across on the web so that you (and I) can gain further clarity and understanding of this important topic. Even if you may know the overall gist of things, there always seems to be something new to learn.

From what perimenopause is and when it starts to how you can manage symptoms and what to expect from your doctor during this time, I’ve got you covered. So, let’s get started.

What is perimenopause and when does it start?

Perimenopause is essentially the period of a woman’s life shortly before the occurrence of menopause (no periods for a full year).

Perimenopause is a natural transition that happens to all women as we age, marking the end of our reproductive years. It typically starts in a woman’s 40s or 50s but can start earlier for some women. This transition to menopause is gradual and can last anywhere from a few months to 10 years in some cases. Perimenopause is the time period in which this transition begins. When you completely stop having your period for a full year, you have entered menopause. This usually occurs between the ages of 45 and 55.

During perimenopause, a woman’s hormone levels start to fluctuate, which can cause a range of physical and emotional symptoms.

What are the most common symptoms of perimenopause?

During perimenopause, hormone levels start to fluctuate, and the body experiences several physical and emotional symptoms.

The most common symptoms of perimenopause include hot flushes, night sweats, irregular periods, vaginal dryness, mood swings, fatigue, sleeping difficulty, and a diminished sex drive. However, there are about 34 perimenopausal symptoms and we know that every woman’s experience is different. Some women may suffer many of these symptoms, while others only experience a few. And some may find their experience debilitating while others sail through perimenopause with mild symptoms.

The most common symptoms are:

• Vasomotor symptoms – hot flushes, night sweats, heart palpitations, chills, changes in blood pressure
• Psychological/Emotional symptoms – anger, forgetfulness, mood swings, anxiety, depression, panic attacks, loss of confidence, poor focus
• Physical symptoms – headaches, migraines, dizziness, dry skin, joint pain, sleep problems, thinning hair, weight gain, muscle pain and stiffness, fatigue, osteoporosis, bleeding gums, tinnitus, dry mouth, increased facial hair, brittle nails
• Urogenital symptoms – painful sex, low libido, vaginal dryness and discomfort, urinary incontinence

It’s essential to note that perimenopause affects every woman differently, and each woman’s experience will be unique to her.

Understanding the signs and symptoms of perimenopause is crucial in seeking proper medical attention and managing the transition.

Will perimenopause symptoms go away?

Perimenopause symptoms vary widely from woman to woman, but generally, symptoms only really go away or decrease significantly when a woman has gone through menopause. This typically happens between 45 and 55, although some women may experience it earlier or later. However, women can continue to experience symptoms when they’re post-menopausal, for example, some women continue to experience hot flushes well into their 60s, 70s and even their 80s.

Is there a test for perimenopause?

Most people don’t need a test to check if they are in perimenopause. You are deemed likely to be perimenopausal if your periods have stopped or become irregular and if you have symptoms of perimenopause.

A blood test can check the levels of two hormones, FSH and oestradiol. And as you approach menopause, FSH levels rise and oestradiol levels drop. However, these hormone levels can vary greatly from day to day, so they are not reliable tests of perimenopause.

These tests are only really used when the diagnosis is not clear, for example, if you’re under age 45 and your periods have stopped.

Can perimenopause affect your mental health?

Yes, perimenopause can affect a woman’s mental health in various ways. Hormonal fluctuations during this time can lead to mood swings, anxiety, depression, difficulty concentrating and many other symptoms. These symptoms can affect a woman’s quality of life and make it challenging to navigate through work and personal relationships.

It’s crucial to acknowledge the impact perimenopause can have on one’s mental well-being and seek appropriate support. Therapy, medication, and lifestyle changes can help alleviate these symptoms and improve overall mental health.

What changes can you make to help manage your symptoms?

Therapy, medication, and lifestyle changes have been effective in alleviating perimenopause symptoms and improving overall mental health.

Making changes to your diet, exercise routine, and sleep patterns can make a significant difference. Including more fruits, vegetables, and whole grains in your diet could also help. Moderate exercises, such as walking or yoga, can improve mood and reduce stress levels. Getting enough sleep is essential for hormone regulation and may help reduce symptoms such as night sweats and mood swings. By making these lifestyle changes, women can improve their quality of life during perimenopause.

Does perimenopause cause weight gain?

Fluctuations in estrogen, progesterone, and other hormones can lead to increased appetite and fat gain during perimenopause. And with the decline in our oestrogen levels comes weight gain around our tummy area. A bit like during puberty when oestrogen tells the body to store fat around the hips and thighs (in anticipation of pregnancy), during perimenopause, dropping oestrogen levels cause this fat to be stored in the abdomen instead. We don’t know exactly why this happens, but it does.

In addition, our declining oestrogen levels can lead to a loss of muscle mass. And weight gain occurs because when you lose muscle mass, your body slows the rate at which you use calories. So ultimately, if you continue to eat like you always have and don’t increase your physical activity during midlife, you’re likely to gain weight.

Also, we do lots of physical activity when we’re young, but during midlife, when it becomes increasingly important to maintain decent levels of activity, we tend to become more sedentary.

All of these factors are reasons why we may gain weight during perimenopause.

How to deal with perimenopause weight gain

Are there dietary changes I should make during perimenopause?

Protein, Omega-3 fatty acids, fibre and calcium should be a priority in your diet during perimenopause. Generally, a whole-food diet that is high in fruits, vegetables, whole grains, high-quality protein and dairy products may help with menopause symptoms. Phytoestrogens and healthy fats, such as omega-3 fatty acids from fish, may also help.

How long does perimenopause last?

Perimenopause lasts for different lengths of time for every woman. While the average duration of perimenopause is four years, it can range from just a few months to up to ten years. Factors such as genetics, medical history, and lifestyle habits can all influence the length of perimenopause.

It’s important to keep in mind that perimenopause is a normal part of the ageing process for women. While the duration can feel challenging, it’s a natural process that every woman goes through. By understanding what to expect and seeking appropriate support, women can navigate perimenopause more easily.

Can you get pregnant during perimenopause?

Perimenopause is a stage during which a woman’s reproductive system begins to transition towards menopause. And while the chances of conceiving naturally during perimenopause are lower than during a woman’s 20s and 30s, there is still a chance you can get pregnant.

During perimenopause, there may be fewer viable eggs left in a woman’s ovaries, which can make it more difficult to conceive. But hormonal changes can lead to irregular menstrual cycles, which make it harder to predict ovulation. So it’s important to keep in mind that women can still become pregnant during perimenopause, and therefore using contraception is recommended for those who don’t wish to conceive.

What’s the difference between perimenopause and menopause?

Perimenopause is the stage in a woman’s life when her body begins to transition into menopause. Menopause, on the other hand, marks the end of menstruation and ovarian function. The fundamental difference between these two stages is that perimenopause is a gradual process that can last several years, while menopause is a single day event that usually occurs between the ages of 45 and 55.

During perimenopause, a woman’s hormone levels fluctuate, and she may experience symptoms such as irregular periods, hot flashes, mood swings, and sleep disturbances. These symptoms can last for years and can have a significant impact on a woman’s quality of life. Menopause, in contrast, is defined as the absence of menstrual cycles for 12 consecutive months. At this point, the symptoms of perimenopause usually begin to subside, and a woman enters a new phase of her life.

How can you manage hot flushes and night sweats?

One of the most common and disruptive symptoms of perimenopause is hot flushes and night sweats. These sudden bursts of heat can be uncomfortable and embarrassing, causing women to feel self-conscious and anxious. Fortunately, there are several ways to help manage these symptoms.

One approach is to make lifestyle changes that reduce the frequency and severity of hot flushes. This might include avoiding triggers such as spicy foods, caffeine, and alcohol, as well as wearing loose, breathable clothing and keeping your bedroom cool at night. Regular exercises, such as yoga or meditation, can also help regulate hormone levels and reduce stress.

Another option is to use hormone replacement therapy (HRT) to alleviate hot flushes. HRT involves taking estrogen (and sometimes progesterone) to replace the hormones that are declining during perimenopause. While HRT can be highly effective, it is not suitable for everyone and should be discussed with a healthcare provider.

Finally, some women turn to alternative therapies such as herbal supplements and acupuncture to manage hot flushes and other symptoms. While these treatments may offer some relief, it’s important to talk to your doctor before trying any new therapies to ensure their safety and effectiveness.

Why does menopause affect sleep?

Disturbed sleep is one of the most common menopause symptoms. The reason for this is fluctuating hormone levels which make it harder to fall and stay asleep. Between hot flushes and night sweats, it can be difficult for women to get a good night’s sleep.

Is HRT safe?

HRT can’t be described as safe or unsafe. It depends on the types of hormone used, the form in which it is used (pills, patches or gels), and when it is started (around menopause, or later). Personal medical history and genetics need to be factored in too. HRT may be a fantastic solution for one woman but not suit another.

However, most doctors and scientists agree that HRT relieves menopausal symptoms. None of the alternatives like diet, exercise, herbal remedies such as red clover and black cohosh, or natural hormones is as effective as HRT when it comes to managing symptoms.

Also, HRT has been shown to reduce the risk of bone fractures in postmenopausal women. And this is significant because osteoporosis and bone fractures become more common as women get older.

Which hormone replacement therapy will be the best solution for you?

What’s the difference between HRT (Hormone Replacement Therapy) and MHT (Menopausal Hormonal Therapy)?

When is the best time to start HRT?

The most beneficial time to start HRT is when you’re under the age of 60 or within 10 years of your last period. This greatly reduces your risk of future cardiovascular disease (heart and blood vessel problems) which may be lost if you started at a later age.

What is Sequential HRT?

If you’ve decided to start HRT and you’ve had a period less than 6-12 months ago, you’ll need to take sequential HRT. This means you’ll continue to have a period (although it may be irregular). Most women take this type of HRT for about four years, or until they reach 55 whichever comes first. By the age of 55, most women’s periods have stopped.

Sequential HRT contains oestrogen and progestogen. You take oestrogen every single day and the progestogen is taken for 12 days of the month. This causes a withdrawal bleed similar to a period.

If you don’t want to have a monthly bleed and it’s less than 6-12 months since your last period, you could opt to have a Mirena (coil) fitted instead and use this to protect the lining of the womb, along with oestrogen.

Most women experience no or minimal bleeding with a Mirena, and you can keep the Mirena in for five years. It’s also a contraception so it could be a good option if you need that.

What is Continuous Combined HRT?

If you’ve decided to start HRT and you haven’t had a period for about 12 months, you can start continuous combined HRT. This would mean that you take oestrogen and progestogen every day. If you start this treatment too early in your menopause transition while you’re still having periods, you may have irregular, frequent bleeding.

HRT: What’s the difference between body-identical and bio-identical hormones?

What should you expect from your doctor during perimenopause?

During perimenopause, women may turn to their healthcare providers for support and guidance. Your doctor should be able to help you understand the physical and emotional changes taking place during this transitional phase of life, and offer options to help manage your symptoms. This may include prescription medications, hormone therapy, or lifestyle modifications such as dietary changes and exercise.

It’s important to have an open and honest conversation with your doctor about your symptoms, concerns, and overall health history. They may recommend routine screenings and tests to monitor your health and identify any potential risk factors associated with perimenopause. Your doctor can also help you weigh the risks and benefits of different treatment options and help you make informed decisions about your care.

In addition to medical treatments, your doctor may also be able to offer referrals to other healthcare specialists or resources, such as mental health professionals or support groups, to help you manage the emotional and psychological impacts of perimenopause.

By working closely with your doctor and healthcare team, you can ensure that you have the support and guidance you need to navigate perimenopause with confidence and ease.

Do I still need pap smears and mammograms after going through perimenopause?

Even if you are menopausal or postmenopausal, you should continue to have Pap or HPV tests every three years until the age of 65. Screening may be discontinued at age 65 (or 70) if women have had at least three normal Pap tests in a row and no abnormal Pap tests in the previous 10 years.

You should continue to have mammograms after menopause because the risk of breast cancer increases as we age (in fact, research has shown that most breast cancers are found in women over 50).

In conclusion

Navigating perimenopause can be daunting, but gaining knowledge about what to expect can alleviate anxiety and provide a sense of control. By understanding the most common symptoms and changes that can be made to alleviate them, we can take charge of our health and well-being. Remember, every woman’s experience is unique and seeking support from a doctor or a mental health professional is always an option. With self-care and appropriate lifestyle choices, we can confidently face the challenges of perimenopause with resilience and grace. As the saying goes, “knowledge is power,” and when it comes to perimenopause, it’s essential to stay informed and empowered.

Let me know if there are any other questions you may have that you think I should add to this post.

Disclaimer: As with all my health posts, I want to point out that I am not a doctor and while I endeavour and absolutely always aim to write factual posts to help women with information about perimenopause, all medical advice should be obtained from a registered doctor.

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