All about... the perimenopause :: Menopause symptoms

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What is the perimenopause?

There is no set age when perimenopausal symptoms occur, although generally it’s thought they can begin as early as 10 years before your periods stop. This means that for many women, the perimenopause is likely to start around their mid to late-40s (although for some, it can happen when they are in their mid-30s or earlier).

What causes the perimenopause?

As you start the journey towards the menopause, your body’s production of the hormones oestrogen and progesterone will rise and fall in an unpredictable way. A lot of the changes you may experience are a result of falling oestrogen – the main female sex hormone. This fall in oestrogen production causes the ovaries to stop producing an egg each month – but can also cause other symptoms.

What are the symptoms?

Symptoms connected to the menopause are common – many of us know about hot flushes and mood swings – but these can also be typical signs of a perimenopause. You may experience some of the following:

● Irregular periods: Falling levels in sex hormones oestrogen and progesterone can affect your periods. Your cycle may become shorter, longer or irregular – and you may notice the blood flow becoming heavier or lighter. Some women can find they have a month without bleeding, only for it to start again the following month – or for the bleeding to continue for much longer, or be much heavier, than it normally would.
● Hot flushes: Many women experience hot flushes during the perimenopause – which are likely to be caused by hormonal level changes affecting the temperature-control in the brain. The length and intensity of hot flushes vary from woman to woman.
● Sleep problems: Sleep disruption is also common – waking during the night can often be caused by hot flushes, but some women may find their sleep pattern becomes erratic even if they don’t have hot flushes.
● Vaginal changes: As your hormone levels alter, this can cause changes to the elasticity and lubrication of vaginal tissues which can cause sex to be uncomfortable. Lower oestrogen levels can also make you more vulnerable to urinary tract or vaginal infections such as cystitis.
● Mood swings, anxiety and depression: Some women find their mood is more alterable and there can be an increased risk of depression. This can also be caused by other perimenopausal factors such as tiredness due to changes in your sleep pattern.

Should I see my GP?

Everyone experiences a differing range of symptoms, but if the changes in your body are causing you concern or are affecting the way you live and work, you should definitely see your GP. This is also a good time to have a general health overview with your doctor as well as maintaining a good balanced diet that is rich in vitamins and minerals.

Are there any complicating factors?

The perimenopause is a natural part of the ageing process, but studies indicate that some factors may cause an earlier onset. These include:

● Smoking
● Family history
● Medical treatment – some cancer treatments such as chemotherapy or radiation therapy can bring on perimenopausal symptoms.

What are the more unusual signs of the perimenopause?

Hormone changes can also be linked to other more unusual symptoms which may not usually be attributed to the perimenopause. These include:

● Itchy skin
● Muscle pain and aching joints
● Heart palpitations
● Dizzy spells
● Headaches
● Poor memory and brain fog

If you are suffering from a range of symptoms, make sure you tell your GP about them all – whether you think they are related to the perimenopause or not. This will help your GP to see your health as a whole – rather than a number of different individual ailments.

What to ask your doctor

Not everyone will need to ask the same questions, but here are some suggestions of things you may want the answer to.

● Are these the signs of the perimenopause?
● How long will these symptoms last?
● Should I see a specialist?
● Do I need treatment for my symptoms?
● Can I still get pregnant?
● Could my symptoms be caused by any other health condition?
● Am I at risk of osteoporosis or other health problems?
● What vitamins and minerals should I take?
● I leak urine when I sneeze or cough – what can I do?
● How can I increase my sex drive?