Perimenopause: 5 questions answered

What is perimenopause?

Menopause is a singular point in time, twelve months after your last period.  Once you’ve passed this milestone you are post-menopausal. The period of time leading up to menopause is perimenopause, the transition between your fertile years and menopause. 

It can be a challenging time for lots of women, as they find themselves on a hormonal rollercoaster leading to all kinds of unpleasant symptoms.  That’s not to say everyone suffers through perimenopause, you may breeze through it!  Until recently, this time in a woman’s life has been a taboo subject and many women have little understanding of what to expect.  Knowing the signs and symptoms can help you better understand your experience, manage your symptoms, and get the support you need.

When does it happen?

The average age of menopause in the UK is 52, with perimenopause lasting anywhere from a few months to ten years before that!  Most women enter perimenopause between their mid-30s and late-40s and can expect to reach menopause between the ages of 45-55.  Menopause before age 45 is considered ‘early’ and prior to the age of 40 it’s considered ‘premature’.  If this applies to you, you should speak to your GP for advice.

Why does it happen?

Perimenopause is a period of huge hormone fluctuations.  During the pre-perimenopause fertile years, there is a fine balance between a woman’s two key sex hormones; oestrogen and progesterone.  During perimenopause women no longer ovulate every month.  This leads to a decline in the amount of progesterone produced and a relative imbalance between progesterone and oestrogen.  This means many women experience periods of oestrogen-dominance (relative to progesterone) during perimenopause.  Over time oestrogen levels gradually drop off and even out at a much lower level.  Perimenopausal symptoms are the result of erratic hormone patterns.

What are the symptoms?

Where to start?!   Whilst many of you be aware of stereotypical symptoms such as hot flushes and night sweats, there are many more that are not commonly known and can create a lot of concern amongst women.

So here goes…all the following can be the result of perimenopausal hormonal changes:

  • Hot flushes
  • Dry skin
  • Depression
  • Anxiety
  • Irregular periods
  • Joint pain
  • Headaches/migraine
  • Mood swings
  • Poor memory and brain fog (you’re not going mad!)
  • Breast pain
  • Weight gain
  • Fatigue
  • Night sweats
  • Insomnia
  • Brittle nails
  • Weak hair
  • Palpitations
  • Heavier periods
  • Bladder weakness
  • Loss of libido
  • Nausea
  • Spotty skin
  • Dizziness
  • Tinnitus
  • Irritability
  • Lighter periods
  • Vaginal dryness
  • Abdominal fat

What can I do to prepare and/or manage my symptoms?

The good news is there is lots you can do to support your hormone health before, during and after perimenopause.  Diet and lifestyle change can really help, here are my top three focus areas for perimenopausal women.

Focus on blood sugar balance

Fluctuating blood sugar levels can have a negative impact on other hormones such as insulin, cortisol.  This in turn can contribute to hot flushes, anxiety, brain fog and weight gain.  Managing blood sugar levels is also really important for achieving consistent energy levels and good sleep.  What this means in reality is:

  • Eating balanced meals which contain protein, healthy fats and complex carbohydrates (think vegetables and wholegrains rather than processed foods like white pasta and bread).
  • Avoid highly processed foods and sugary snacks
  • Cut down and/or eliminate alcohol.  Alcohol is high in sugar which can lead to swings in blood sugar levels, but also disrupts sleep and places more of a burden on your liver (see below).

Support detoxification

Old hormones are processed in the liver and excreted via the faeces.  Therefore it’s essential that we have a well-functioning liver and regular bowel movements to get rid of hormonal waste.  Oestrogen in particular can cause issues if it’s not excreted in a timely manner.  It can be reabsorbed into the body and fuel the oestrogen-progesterone imbalance that contributes to perimenopausal symptoms.  Here are a few ways you can show your liver some love:

  • Include high quality lean protein in your diet.  It’s essential for effective detoxification
  • Eat a rainbow of vegetables and fruit to provide anti-oxidants and fibre
  • Include cruciferous vegetables such as broccoli, cauliflower, kale, cabbage, watercress and rocket in your diet
  • Reduce your exposure to toxins in food, personal care and household products

Resistance training

Resistance training using exercise bands, body weight or weights becomes more important as we age.  I recommend it to all perimenopausal women for several reasons:

  • Protects against osteoporosis which becomes more of a risk as your oestrogen levels decline
  • Builds lean muscle which in turn increases your metabolism and promotes weight loss
  • Reduces insulin resistance, so supporting healthy blood sugar levels and protecting against type 2 diabetes
  • It makes you feel good!

Finally, don’t discount hormone replacement therapy (HRT), which has come on leaps and bounds in recent years.  It can make the world of difference for many women and is always worth a conversation with your GP if you feel you need extra support. 

Want to know more?

Perimenopause is a huge topic, of which I’ve barely scratched the surface in this article!  Hormonal and digestive health of women aged 40+ is an area of particular interest for me and I’ll be running a series of workshops and courses on all-things perimenopause throughout 2022.  Sign up to my mailing list to make sure you’re kept up to date.  You’ll also receive copy of my quiz “Why am I so tired ALL THE TIME?!”

For anyone interested in 1:1 support, you can book a free 30 minute discovery call

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