What Exactly Is Perimenopause & What Are The Symptoms?

Perimenopause means ‘around menopause’ and marks the start of your body’s natural transition into menopause. Also known as the ‘menopausal transition’, this period can also signify the end of your reproductive years, making it harder for you to fall pregnant. 

Perimenopause happens when your hormone levels change, with your levels of oestrogen and progesterone (the main female reproductive hormones) increasing and decreasing rapidly. This can cause a variety of symptoms that can be quite debilitating, largely due to having depleted oestrogen levels.   

Perimenopause typically begins between the ages of 40 to 44. However, women in their 30s can also begin the transition, as can women over 45. Different women will go through perimenopause at different times and various factors can influence the timing.

These can include: 

• A family history of early perimenopause

• Previous surgery on your ovaries

• Smoking

• A menstrual cycle that started before you were 11 years old

• Chemotherapy or pelvic radiation to treat cancer

• Autoimmune diseases such as thyroid disease and rheumatoid arthritis

• The removal of your ovaries and/or uterus (a hysterectomy or oophorectomy) 

One of the more common causes of early perimenopause is primary ovarian insufficiency. This can happen to women at any age and occurs when your ovaries stop producing the right levels of reproductive hormones. 

However, there is sometimes no known cause for starting early perimenopause.

There are a variety of symptoms you can experience, with some more common than others. 

Common symptoms of perimenopause include: 

• Irregular or missed periods

• Heavier periods

• Hot flushes

• Night sweats

• Sleep problems (insomnia)

• Mood changes (irritability, anxiety and depression)

• Decreased libido

• Decreased vaginal lubrication

These symptoms are all typically caused by a decrease in oestrogen and can wreak havoc on your daily life. 

Less common symptoms of perimenopause include: 

• Hair loss or thinning

• Cold flushes

• Changes in vision (scratchy and dry eye)

• Short-term memory problems or difficulty concentrating

• Loss in bone density leading to osteoporosis (a condition which makes your bones weak and more susceptible to breaks/fractures)

• Skin problems (dry skin, acne or blemish breakouts)

The cause of these less common symptoms can be attributed to the hormonal changes you experience. However, other factors such as stress and big life changes can influence how you feel during this period of your life. 

Weight gain is thought to be a symptom of menopause, but there is little to no evidence to suggest this is true. Other factors such as moving less as you age and eating more are thought to be the main cause of weight gain in perimenopause.

How is perimenopause diagnosed?

It’s not always easy to tell if your symptoms are being caused by perimenopause. However, with the right approach, perimenopause can be confirmed (or not) and the right management plan drawn up. 

At OneWelbeck, we take a comprehensive approach to help you understand the cause of your symptoms. We will: 

• Assess your symptoms and medical history

• Perform a physical exam

• Carry out blood tests to check your hormone levels 

If you’re experiencing symptoms of perimenopause, book a consultation with us and we’ll provide you with an accurate diagnosis and a personalised management plan.

Perimenopause lasts around four to seven years on average, but this can vary. Some women may only be in perimenopause for a few months, while others can experience it for more than seven years.

Different factors can influence how long you are perimenopausal, including your age, smoking status, race and ethnicity. 

One study found that black women not only have a longer perimenopause phase than white women, but they also experience early onset perimenopause more frequently. However, with so many influencing factors to consider, these results are not always guaranteed for everyone.

How will I know I am no longer perimenopausal?

The best way to know you are out of perimenopause is by keeping an eye on your menstrual cycle. If you have not had a period for more than 12 months, you are no longer perimenopausal. At this point, you have started the menopause. 

Managing perimenopause symptoms is important as they can have a big impact on your daily life. 

Symptoms such as hot flushes, insomnia and mood changes can all negatively affect your well-being, so finding the right way to manage them is crucial.

Here are some of the best ways you can effectively manage your perimenopause symptoms. 

Lifestyle changes

Making changes to your daily life can be a big help when managing menopause symptoms. 

Eating a well-balanced diet high in the right vitamins and minerals is essential. Calcium is necessary for bone strength so try incorporating foods like cheese, green leafy vegetables and bread made with fortified flour into your diet. As your levels of oestrogen drop, your risk of osteoporosis also increases so eating plenty of calcium could help reduce it. 

Managing stress levels can be helpful when reducing perimenopause symptoms as well. High levels of stress can exacerbate symptoms like insomnia and mood changes, so try to set yourself a regular bedtime and create a relaxing routine to get you in the right mindset for sleep. Techniques like meditation or yoga can also help keep your stress at a healthier level. 

Regular exercise is good for your mind and body, so engaging in physical activity regularly can be effective at managing perimenopause symptoms. 

Going through perimenopause can be challenging, so remember to take good care of yourself and put your needs at the forefront. 

Hormone replacement therapy (HRT) is the most common form of medical treatment when managing perimenopausal symptoms. Although it cannot stop or ‘cure’ perimenopause, it can be effective at alleviating your symptoms. 

HRT contains oestrogen and progesterone to replenish your depleted hormone levels and reduce the severity of the symptoms these hormonal changes cause. While oestrogen-only HRT is available, this is only suitable for women who have had their ovaries or uterus removed. 

HRT is available as tablets, injections, patches and topical gels and comes in different doses. You will usually need to start on a lower dose and work your way up to find what’s right for your body. 

HRT does bring with it some possible side effects, but many women find the benefits greatly outweigh them.  

Benefits of HRT during perimenopause

The main benefit of taking HRT during perimenopause is that it can significantly reduce your symptoms. 

Some of the symptoms it can relieve are: 

• Hot flushes

• Night sweats

• Anxiety and low mood

• Vaginal dryness

• Sleep disturbances

HRT also helps to reduce your risk of osteoporosis as it increases your oestrogen levels. 

Managing your perimenopause symptoms can be tough but with the support of our expert team at OneWelbeck, you can receive personalised advice that meets your needs. 

By speaking with a specialist in perimenopause, you can feel certain that you are receiving the best advice and treatment for your body, helping you find relief from your perimenopause symptoms.

Book a consultation today.