Understanding perimenopause

Introduction to Perimenopause

Perimenopause marks the period when a woman's body begins its shift towards menopause. During this phase, the ovaries gradually reduce hormone production, leading to irregular menstrual cycles. This transition signifies the winding down of reproductive years.

Duration and Onset

Perimenopause can start anywhere from the mid-30s to the mid-50s. For many, it lasts between four to eight years, though the duration can vary widely. The transition ends with menopause, defined by the absence of menstrual periods for 12 consecutive months.

Distinguishing Perimenopause from Menopause

Perimenopause is a precursor to menopause. While perimenopause involves fluctuating hormone levels and irregular periods, menopause is confirmed when periods have ceased for a full year.

Causes of Perimenopause

As women age, their ovaries produce less estrogen, gradually ceasing egg release and leading towards menopause. This is a natural progression in the reproductive cycle.

Typical Age of Onset

Generally, perimenopause begins about eight to ten years before menopause, usually in the mid-40s. However, it can occur earlier, with premature menopause before age 40 often linked to specific medical conditions or procedures such as a hysterectomy or treatments such as chemotherapy.

Duration of Perimenopause

The average length of perimenopause is around four years, though it can range from a few months to more than four years. Menopause is reached after 12 months without a period.

Hormonal Changes

During perimenopause, oestrogen levels decline, disrupting the balance with progesterone. This hormonal fluctuation leads to various symptoms. By menopause, oestrogen levels are significantly reduced, ending ovulation and menstruation.

Early Symptoms

Irregular periods are typically the first sign of perimenopause. Common symptoms include hot flashes, vaginal dryness, and mood changes. These symptoms can vary widely in onset and duration.

Symptoms arise as the body adjusts to declining oestrogen levels. Common symptoms include:

• Irregular periods

• Hot flashes

• Vaginal dryness

• Urinary urgency and UTIs

• Sleep disturbances

• Mood swings

• Loss of libido

• Heart palpitations

• Sensation of skin crawling

These symptoms can persist for a few months to several years. Regular check-ups are essential to monitor health changes.

Menstrual Changes

Irregular periods are common, with changes in cycle length and bleeding intensity. PMS symptoms may also vary. However, you may also not notice any changes to your cycle at all.

When to Seek Medical Advice

Consult a healthcare provider if you experience heavy bleeding, prolonged periods, spotting, or bleeding after sex and heart palpitations to ensure these are not related to any other medical condition.

Ovulation During Perimenopause

Ovulation can still occur during perimenopause, making pregnancy possible until menopause is confirmed after 12 months without a period. If you are not wishing to fall pregnant its important to ensure you use a contraceptive method that suits you and your partner (ideally not hormonal such as the oral contraceptive pill as these can camouflage perimenopause symptoms).

Diagnosis and Tests

Diagnosing Perimenopause

Many women manage perimenopausal symptoms without formal diagnosis. FSH (Follicle Stimulating Hormone) blood tests can indicate menopause, but fluctuating hormone levels during perimenopause may affect results. However, please seek medical advice if symptoms interfere with daily life.

Management and Treatment

Lifestyle changes can alleviate symptoms:

• Healthy diet

• Regular exercise

• Good sleep hygiene

• Limiting alcohol and caffeine

• Stress management techniques

• Avoiding smoking

• Maintaining a healthy weight

Early Perimenopause

Factors linked to early perimenopause include smoking, family history, cancer treatment, and surgical removal of reproductive organs. For some like me though, there was no identifiable cause...

Health Risks

Post-menopausal women face increased risks of osteoporosis, dementia and heart disease due to lower oestrogen levels. Regular check-ups and a healthy lifestyle are crucial to prevent long term health challenges.

Conclusion

Perimenopause is a natural transition with generally manageable symptoms. Please reach out if you need support, there are many ways nutrition and lifestyle changes can help to navigate this phase smoothly and prepare you for a long and healthy life ahead.

In person and online nutrition consultations may be booked with me at www.hivehealthhub.com.au