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Managing the perimenopause

Most women know that menopause happens at around the age of 50. But, what is not so well known is the phase before the menopause – the perimenopause.

You may be one of the lucky ones – some women don’t experience perimenopausal symptoms at all and this phase can pass by without incident. For others, it can be almost as debilitating as the menopause itself with mood swings, hot flushes and aching muscles affecting their day-to-day.

What is perimenopause?

Most women wouldn’t expect to start the menopause until well into our 40s so it’s easy to blame the symptoms of perimenopause on other things – illness, stress, anxiety or simple changes due to age and maturity. But, the perimenopause can start anytime from the late 30s. The symptoms can come and go for as many as 10 years before the start of menopause proper.

A decline in estrogen marks perimenopause. The estrogen levels will start to fluctuate, causing the menstrual cycle to become more erratic. Eventually, your ovaries will produce so little estrogen that eggs are no longer released. This causes your period to stop, and once you’ve not had a period for a full year, then you are the menopause phase.

What are the symptoms?

The perimenopause may just be the beginning, but, those fluctuating hormones can be the cause of some pretty horrific symptoms, including;

• Hot flushes

• Night sweats

• Sleep problems

• Breast tenderness

• Itchy/crawly/dry skin

• Exhaustion

• Trouble concentrating

• Irregular periods

• Vaginal dryness

• Loss of libido (sex drive)

• Migraines

• More pronounced pre-menstrual tension

• Mood changes, tears and irritability

• Inexplicable weight gain

What changes will I see?

Changes to your period will be the most obvious clue that perimenopause is happening. They’ll become more irregular, lighter or heavier. Ovulation will become more erratic, meaning that some months you will release an egg, sometimes twice, but some months, you won’t release any. You may start experiencing hot flushes and night sweats too triggered by the plunge in oestrogen.

How do I manage the symptoms of perimenopause?

Symptoms can be treated in much the same way as with the menopause, with hormonal therapy or with a combination of complementary therapies, exercise, and good diet choices. It depends on the severity of the symptoms as to what relief you may wish to take.

Oestrogen therapy can help treat perimenopause by stabilising oestrogen levels and reducing symptoms, but there are other ways to relieve the symptoms.

Complementary therapies

Various herbal remedies can help. Herbs such as black cohosh, dong quai and ginseng have traditionally been used during perimenopause, and chaste tree may be useful for some of the symptoms too. However, some of these remedies can be quite potent so it would be wise to seek advice from a trusted practitioner.

Lifestyle choices

Other things you can do to support your body through the changes of perimenopause and reduce the more severe symptoms include plenty of exercise and a good, healthy diet.

Make sure you include plenty of vegetables, good protein and more whole grains to maintain energy and stabilise your blood glucose and weight. Include calcium-rich foods and healthy fats from fish, olive oil, seeds and nuts. Alcohol, sugary snacks and caffeine will trigger hot flushes so avoid these as much as possible.

Regular physical activity can improve your mood and help alleviate some of the more troubling perimenopausal symptoms. Include short bursts of physical activity during the day as well as moderate-paced movement (walking, dancing) with vigorous movement (jogging, aerobics, fast cycling). But remember to unwind too – especially before bed when some gentle yoga, Pilates or a warm bath works wonders in helping you to relax.

The perimenopause is the beginning of the transitional phase that indicates an end to your reproductive years. And, although it may seem daunting and yes, there are certainly some adjustments to be made, it is possible to get through it with as little trauma as possible with the help of some lifestyle changes.