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What is Perimenopause?

Here at WUKA we always aim to bring you up to date and accurate advice and information. Knowledge is power, and learning as much as you can about your own body- and your own menstrual cycle- is one of the most empowering things you can do. 

We spoke to Dr. Haleema Sheikh, a specialist in integrative women’s health and biodentical hormone balancing for the Marion Gluck Clinic, for advice on perimenopause signs and symptoms. The Marion Gluck clinic is the UK’s leading medical clinic, which pioneered the use of biodentical hormones to treat menopause, perimenopause and other hormone related issues. Headed up by Dr. Marion Gluck herself, the clinic uses her method of biogenetical treatment to rebalance hormones to improve wellbeing, quality of life and to slow down ageing. 

What is perimenopause?

Perimenopause refers to the transition time leading up to the menopause. There are lots of physical changes that take place during this time, as the body begins to prepare for the end of fertility and the menstrual cycle ends. 

And because we’re all different, we all experience perimenopause differently, just as we all experience different menstrual cycles. So there really is no ‘one size fits all’ explanation of what happens, when and why. Most people will have a unique experience of perimenopause.

What causes perimenopause?

As we age, the hormones that control fertility and the menstrual cycle begin to slow down, and eventually the ovaries will stop producing oestrogen. This means that ovulation ends, and the menstrual cycle ends too. This is a natural process, another step in life’s journey and one which many people still don’t really understand too much about.

The imbalance of hormones during this time causes a range of menopause symptoms that can be experienced to varying degrees, and again this is totally normal. Most will start to transition through perimenopause between the ages of 45 and 55, although some might go through it sooner.

What is Perimenopause?

What are the first signs of perimenopause?

One of the first signs of perimenopause is a change in the menstrual cycle, with periods becoming irregular. Sometimes a missed period is a very obvious sign, but there can also be many other reasons why this happens, and not just perimenopause. Because of this, it can be quite confusing at first, and you’d be forgiven for wondering whether the changes you’re experiencing are down to menopause or something else. If you track your cycle, you’re more likely to know when something isn’t right, but even then it can be difficult to know at first. 

Dr. Sheikh told us,

“Menopause is usually associated with other symptoms of hot flushes/ night sweats/ brain fog/ vaginal dryness and is considered normal any time from 40 years.

Occasionally it occurs less than 40 years and this is considered to be an early menopause/ premature ovarian failure. Blood tests looking for elevated follicle stimulating hormone (FSH) from the pituitary indicating that the ovary has retired can confirm the diagnosis when repeated at least 6 weeks apart.”

Changes to your menstrual cycle

Some people find that their once regular cycle becomes more erratic, and this is due to the fluctuating levels of oestrogen as production begins to naturally slow down. Some months you might miss a period, and other months you might find that your flow is more heavy than usual. These changes are normal, and you might notice notice other signs at this time too, as outlined above by Dr. Sheikh.

What are the symptoms of perimenopause?

Dr. Sheikh explains that the main symptoms of perimenopause can be put down to the “significant decline in the orchestra of ovarian hormones- oestrogen. progesterone and testosterone,” and goes on to separate the most common symptoms into two categories:

What is Perimenopause?

Physical symptoms of perimenopause

  • hot flushes (sometimes followed by chills)
  • night sweats
  • fatigue
  • sleep disturbance
  • muscular aches
  • dry eyes/skin condition
  • vaginal dryness/urinary symptoms

Emotional symptoms of perimenopause

  • irritability, anxiety and/or mood disturbance
  • poor concentration/ brain fog
  • loss of libido

How to ease the transition to menopause

The list of symptoms associated with perimenopause might look daunting, but remember that many people only experience a few of them, and some less intensely than others too.

If you find that your periods become erratic and irregular, and you experience very heavy bleeding, use our Heavy Flow period pants to keep you leak-free and comfortable. Lots of women experience menopause night flooding too, which our Super heavy flow period pants are ideal for. These pants can hold up to 60ml blood, which is the equivalent of 12 tampons.

What is perimenopause?

There are also lifestyle changes that you can implement to help ease the symptoms too. Dr. Sheikh advises: 

“Our hormonal health is often a reflection of our lifestyle and so focussing on how we eat, move, sleep and relax can help to reduce the severity of disruptive symptoms during the transition. 

 

In terms of nutrition, it is important to focus on adequate amounts of protein, omega-3 fatty acids, probiotic-rich foods, such as fermented foods, fibrous foods such as vegetables, fruit, and whole grains. 

 

Ensure regular physical activity in the form of strength training and high intensity training which can be very helpful in maintaining cognitive health and muscle mass which maintains metabolic health and buffers the reducing hormones.

Actively managing stress and prioritising relaxation can improve perimenopausal women’s ability to cope with stress and improve overall psychological well-being. Some examples of stress management are meditation, breathing techniques, yoga, and visualisations.

 

Prioritising good sleep hygiene such as avoiding screens at night and establishing a consistent and relaxing bedtime routine can help to induce a night of more restful sleep and allow us to cope with our busy lives at this time of life. 

 

There are also a variety of herbs and adaptogenic botanicals which can help balance reproductive hormones and support the adrenal hormones on which we will be more reliant as the ovaries decline. These include ashwagandha, rhodiola, sage, shatavari and red clover.

 

For some women starting body identical or bioidentical HRT in perimenopause can be very helpful in managing symptoms of hot flushes, sleep disturbance, brain fog and a general feeling of not being yourself. There is good evidence that starting HRT in perimenopause can be protective in many ways.”

What is perimenopause?When to see a doctor

It’s important to know that it’s ok to seek help from your doctor if you find that perimenopause symptoms are impacting on your life and wellbeing. There is nothing wrong in asking for help, and no shame in seeking medical treatment as you transition through these changes. 

Dr. Sheikh points out that while a focus on lifestyle is essential, there are also other treatments that could help.

“Hormone replacement therapy can certainly help alleviate symptoms associated with the loss of ovarian reproductive hormones at menopause, and help women feel like themselves and function optimally. HRT will work better with a good foundational lifestyle, and this is an important message to share. 

 

Bioidentical hormone prescribing allows for a more personalised approach to check hormone levels and ensure a balanced prescription is issued for each woman and may include testosterone when needed which helps with libido/metabolism/motivation and DHEA an adrenal hormone which support vitality and resilience.

 

Some women will prefer not to take HRT, or it may not be appropriate because of their medical/family history and there are many supplements and botanicals that can help alleviate symptoms. The botanicals that are helpful in perimenopause can also be used after menopause. Hops and soy isoflavones which contain phyto- estrogens can also help alleviate troublesome symptoms from lack of oestrogen. 

 

Magnesium support, vitamin D and omega 3 fish oils supplementation can also improve general wellbeing.”

 

Related posts:

Menopause Night Flooding

When is Your Period Officially Over?

Perimenopause Symptoms

FAQs

What is the typical age for perimenopause?

According to the NHS, perimenopause usually begins between the ages of 45 and 55, but some people might experience symptoms earlier. Speak to your GP if you’re under the age of 40 and you think you might be going through perimenopause. 

What does perimenopause feel like?

There are many symptoms associated with perimenopause, and not everyone will experience them all. One of the first signs is usually changes to your menstrual cycle, accompanied by one of the main symptoms:

  • hot flushes (sometimes followed by chills)
  • night sweats
  • fatigue
  • sleep disturbance
  • muscular aches
  • dry eyes/skin condition

There are also emotional symptoms that can occur, such as irritability, anxiety and/or mood disturbances, poor concentration/ brain fog, loss of libido

When does menopause start?

Dr. Sheikh told us,

”Menopause is a retrospective diagnosis when a woman has not had a period for a year which indicates that the ovaries have reached the end of their functional lifespan.”

With this in mind, if you do experience bleeding or spotting post- menopause, this should always be investigated. Make an appointment to see your doctor so you find out what’s going on.


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