Unsure about what “perimenopause” is? You’re not alone.
Based on hundreds of comments I receive every day on my page, I answered 10 commonly asked questions about the perimenopause.
From what it means and when it can happen to how you might feel. Here’s everything you need to know about perimenopause…
1. What does perimenopause mean?
The word “peri” comes from the Greek word meaning “about” so it literally means “around your menopause”. The perimenopause is the period of time before menopause, during which your body begins to transition to menopause when your ovaries start to run out of eggs.
This means your levels of estrogen and progesterone, the hormones that regulate the menstrual cycle, begin to fluctuate, which leads to changes in menstrual periods and can cause hot flashes, sleep disturbances, and other symptoms. Although for some women, periods don’t change and stay regular.
2. When does perimenopause begin?
Perimenopauses can begin anywhere between 3 to 7 years before menopause, or in some cases up to a decade prior to menopause.Normal age for menopause, which is when you have gone without a period for 12 consecutive months, is 45 to 55 years old.
This means that most women start experiencing symptoms of perimenopause in their 40s. But for some, symptoms can begin as early as the mid-30s.
Many women don’t realise they are in the perimenopause because menopause symptoms can creep up on them.
They may be subtle, such as feeling a little more anxious, or mood swings can dip lower than usual. Symptoms can come and go and change in intensity.
Symptoms may be also associated with other medical conditions or just put down to ‘aging’ rather than being recognised as being due to the menopause.
3. What does perimenopause feel like?
Perimenopause is commonly associated with hot flashes and night sweats, but it encompasses a wide range of symptoms due to fluctuating hormone levels. Just like with your period, there’s no such thing as normal when it comes to perimenopause.
Here are some of the symptoms associated with perimenopause.
Menstrual changes, such as irregular or altered periods.
Vasomotor symptoms like hot flashes and night sweats are prevalent, and weight gain, especially around the abdomen, becomes more common due to shifts in fat distribution.
Psychological changes, such as depression, anxiety, and mood swings, are also significant, particularly for those with a history of these conditions.
Sleep disturbances, fatigue, and sexual dysfunction, including vaginal dryness and decreased libido, further contribute to the challenges faced during menopause.
Gastrointestinal problems, such as acid reflux and bloating.
Neurological changes like migraines, brain fog, memory problems, dizziness, and tingling sensations in the extremities are frequently reported.
Musculoskeletal pain, including joint and muscle aches, increases the risk of osteoporosis.
Heart palpitations and changes in skin, nails, and hair, such as dryness, brittleness, and hair loss, are also common.
Additional symptoms include dry or itchy eyes, burning sensations in the mouth, taste changes, urinary dysfunction, increased allergies, and body odor.
Remember: this isn’t an exhaustive list of symptoms, not everyone will experience all of them and the severity can vary greatly from person to person.
4. Will perimenopause symptoms go away?
Perimenopause symptoms will typically go away but only once you reach menopause, which marks the permanent end of menstrual periods and fertility. However, the duration and severity of symptoms can vary greatly from person to person, and some people may continue to experience symptoms for several years after menopause.
The menopause itself lasts a day and then you’re postmenopausal for the rest of your life. Symptoms can continue in the postmenopause too, on average for around 5 to 7 years.
During perimenopause, the symptoms can be more fluctuating and less consistent, while during menopause they tend to be more constant and persistent.
5. How long does perimenopause last?
Due to the gradual nature of perimenopause, there’s no definitive number for how long you’ll be perimenopausal for, especially as we all reach menopause at different age. Average age for menopause is 51. So all depends on how early you started experiencing perimenopausal symptoms.
Many women think their perimenopause will only last about a year or so, and then everything will return to normal. The truth is, the course of perimenopause is unpredictable and it can last anywhere from 4 to 14 years.
6. Is there a test for perimenopause?
Hormone testing is rarely necessary or useful to evaluate perimenopause.
This is because the perimenopause is a time of hormonal fluctuations.
It’s often not until or even after periods have stopped, that hormonal changes show reliably on blood tests. The diagnosis of perimenopause is therefore a clinical one based on symptoms in an otherwise healthy woman who has symptoms fitting with menopause, or whose periods have changed.
British Menopause Society states that blood tests are rarely required to diagnose perimenopause or menopause in women aged over 45 and should not be taken.
In women under the age of 45 years, hormonal bloods tests can sometimes be helpful if periods have changed, or to exclude other possible causes for similar symptoms. However, a normal range hormone blood screen does not exclude the symptoms being because of perimenopause, especially if there isn’t another explanation for the symptoms being experienced.
7. Can I become pregnant during perimenopause?
It is possible to get pregnant during perimenopause, although it becomes less likely as you approach menopause as the ovaries produce fewer eggs, and the chances of becoming pregnant decrease.
However, it is important to remember that ovulation can still occur during perimenopause, and pregnancy can occur as long as you’re still having menstrual periods.
8. What is the difference between perimenopause, menopause and postmenopause?
Perimenopause is the transitional phase leading up to menopause.
Menopause is the specific point in time when a woman has gone 12 consecutive months without a menstrual period, signaling the end of reproductive years and typically occurring around age 51. Menopause literally lasts just one day.
The following day you are in postmenopause that extends for the rest of your life.
9. Why doctors often miss the diagnosis of perimenopause?
The challenge is there is no official method of diagnosing perimenopause.
This means that different physicians may diagnose and treat perimenopause differently, based on their training and experience (or lack of...)
Historically, there has been insufficient research and emphasis on women’s health, and this is exemplified in the lack of awareness of perimenopause symptoms, diagnosis, and treatment.
Doctors often miss the diagnosis of perimenopause because the symptoms can resemble other conditions. Additionally, many doctors aren't aware of perimenopause or aren't trained well in menopausal medicine.
Routine screening for perimenopause symptoms is also lacking, so these symptoms can be mistakenly attributed to other issues, leading to delays in proper diagnosis and treatment.
10. Does my lifestyle affect perimenopause?
Lifestyle choices significantly impact the experience of perimenopause, affecting the severity and frequency of symptoms.
A balanced diet rich in nutrients, regular physical activity and adequate hydration support overall health, while good sleep hygiene helps manage sleep disturbances.
Stress reduction techniques and social support can alleviate mood swings and anxiety.
You may want to limit your consumption of added sugars, processed high carb foods, alcohol, caffeine and high sodium foods as well.
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