Everything you need to know about perimenopause and menopause
(and wished someone had told me earlier!)
Like a lot of women, I knew a bit about menopause – like I knew it existed, that it was associated with hot flushes, maybe weight gain, moodiness and short temper, and your menstrual cycle stopping. My limited knowledge was mainly from what I had witnessed my mother experiencing. But she never really talked about it openly. I also have an older sister, but I started to experience my perimenopause symptoms way ahead of her, even though I am four and half years younger than her. Many of my girlfriends who may have been perimenopausal certainly weren’t talking about it with me, and probably because they didn’t know either. So what do all women (and men) need to be aware of (and wished I had been told about) to do with perimenopause and menopause…
I wasn’t expecting this…
So when it started to happen to me, I really didn’t have a clue how significantly my perimenopause was going to negatively impact my life for a few years. I wasn’t aware of the range of symptoms that can be indicative of perimenopause and so I struggled for about 4 years before realising what was happening.
For instance, the hot flushes and night sweats utterly exhausted me. The development of severe migraines that disabled me for 24 hours at least once a fortnight were disruptive and I found myself having to cancel things regularly. But I thought I was stressed and maybe a bit burnout at work.
When I did begin to think it may be perimenopause (and to be honest I didn’t even know that word existed) I was expecting to feel a bit tearful, a bit snappy maybe in much the same way I had experienced these emotional changes during my monthly menstrual cycle. I wasn’t expecting to be completely out of control of my emotions. Crying at criticism, at imagined slights, or simply just crying for no obvious reason. Or being angry and sharp, irrationally boiling with rage over really small things. I was just feeling utterly not me, out of control and exhausted.
Surely you’re too young?
That’s the one sentence I heard frequently from everyone – friends, family, and the two different GPs when I asked for help at the age of 43.
Most women experience menopause between age 40 and 58, and the average age at menopause is 51. Many women are surprised when they go through menopause in their forties because they think they’re too young, but it’s not unusual.
Why was I so unprepared? Why hadn’t I been expecting this?
There are over 15 MILLION women just in the UK going through the menopause and by 2025 there will be 1 billion globally.
The fact is that perimenopause and menopause have long been associated with women in their 50’s, and only thinking and talking about hot flashes and missed periods. The reality is symptoms can start much earlier and there are many more that we should be aware of than these obvious two.
No one warned me that these symptoms might be so severe and intense so that I could prepare myself, plan around and discuss openly with those around me so that I could try and minimize the disruption to me, my loved ones, my work, my life.
I do realize and appreciate that every woman’s experience is individual and different.
I know that not everyone has a really bad time.
But from speaking with many friends and the community of women that I work with now in my Menopause-ology community there is still a large lack of clear and helpful information, with some women really struggling, and mostly in silence.
It is important for all of us to be aware and well prepared so that we can move through this transition in a positive, calm and empowered way.
I don’t want you to have to be as confused as I was – so here are my fact checked top pieces of info to support you to have positive, empowered and informed perimenopause and menopause journey.
Stage of Your Menopause Journey
As we move through the different stages of menopause, into our Second Spring, it can be very empowering to think about the changing phases of our lives as women in the same way we experience the changing seasons around us in nature from Summer, Autumn, Winter to Spring.
Three stages to Menopause
Although we use the word “menopause” to describe the whole process, it is actually divided into three different stages:
- Perimenopause
- Menopause
- Post-menopause.
Perimenopause
Perimenopause is the first stage of menopause when hormone levels start to fluctuate and decline. Every system in our body can be affected by these hormonal changes impacting both our physical and mental health.
Most women enter this phase in their mid- 40’s but it can happen earlier or later. On average the perimenopause stage lasts for around 4 years, but it can last for up to 10 years. It really is dependent on the individual. It’s during this time that you are very likely to start experiencing menopausal symptoms.
Menopause
The menopause actually refers to just one day – when you haven’t had a period for 12 months you have officially reached menopause. After this you are post-menopausal but can continue to experience symptoms for years after your final period.
Post-Menopause
Post-menopause is the time after menopause when a woman hasn’t had a period for over a year.
You’re officially in this stage for the rest of your life. At this stage many women feel relieved. Think of all the money we will save on sanitary products?!? And while there are many upsides, some women continue to experience symptoms. How these are managed is unique to your experience.
What happens to our hormones during our menopause transition?
The hormonal shifts we experience in perimenopause can be dramatic to say the least – mine were and significantly affected my day to day mood and emotions.
As we head towards menopause, our hormones start to fluctuate and decline. These hormones regulate so many of our bodily functions, it can have a huge impact on our physical and mental health when they are in flux. So what are these main hormones, what do they do and what happens when they start to decline?
Oestrogen
Oestrogen helps regulate menstruation, the reproductive system, brain function, nerves and bone growth. In menopause, when our ovaries stop producing as much oestrogen, the affects can be significant.
Low oestrogen affects our mood, our nerves, loss of skin elasticity, our joints and hearts. It can affect temperature regulation and cause vaginal and skin dryness.
Progesterone
Plays a key role in the menstrual cycle alongside oestrogen and prepares the lining of the womb for a fertilised egg. Production stops during the menstrual cycle and it declines in perimenopause, eventually stopping after menopause.
Symptoms of low progesterone can include irregular cycles, mood changes, sleep disturbances, anxiety and feelings of depression.
Testosterone
Often seen as the “male hormone” but this plays a key role in the female body too. This hormone is important for our libido, maintaining muscle and bone strength and cognitive function.
Testosterone declines slowly in menopause and can impact mood, cognitive function and libido.
Oxytocin
Also known as the “love hormone”, oxytocin sends messages to the brain controlling key aspects of the reproductive system from child birth to sex drive.
Levels decline in menopause which is linked to reduced libido, vaginal dryness and low mood.
So what can you expect to experience during your menopause transition?
The menopause isn’t all hot flashes and missed periods, there is a whole range of symptoms ranging from physical to psychological. There is no one size fits all with the menopause and every woman will experience it differently.
Symptoms can also come and go, some can be debilitating and severely affect your life while some women will experience only a few mild symptoms.
The important thing is to be aware.
34 common symptoms of perimenopause
Do you know any of the 34 most common symptoms of perimenopause or menopause (and over 60 documented symptoms in total)!! It’s not just about hot flushes?
I didn’t.
So let me take you through a run down of the 34 most common symptoms to be aware of, some of which may take you by surprise. There are also less common symptoms, so here is a run down of the key changes.
Physical symptoms of perimenopause
Hot flashes Irregular periods Night sweats Breast tenderness Decreased libido Vaginal dryness Headaches Burning mouth Change in taste Fatigue Bloating Joint pain Muscle tension and aches Sleep disturbances Weight gain Electric shock sensations Digestive issues Changes in body odour Dizziness Stress incontinence Osteoporosis Heart palpitations Allergies
Skin and hair
Dry skin Adult acne Itchy skin Hair loss Brittle nails
Psychological
Mood swings Anxiety or panic attacks Difficulty concentrating Memory problems Irritability Feeling unhappy or depressed
It is also important to note other ways women may experience menopause.
Premature Ovarian Insufficiency
Menopause is a natural part of every woman’s life, but for a women if you are under 40 years of age then it is referred to as Premature Ovarian Insufficiency (POI). For further information please look at the Daisy Network which was created to provide support to women, along with their families and partners, who have been diagnosed with POI.
Surgical Menopause
If an operation has removed your ovaries or other medical interventions have stopped them working, the onset of menopause and menopausal symptoms can be very sudden compared to a natural menopause. For further information please look at Balance – an evidence-based library of resources.
Menopause-ology community
I truly hope you have found this helpful – these are the things I would have loved to have known earlier. I found the early years of my perimenopause a very confusing, upsetting, and isolating time in my life. Something I don’t want to happen to anyone else. When we are informed and empowered, we can achieve anything! This is exactly the reason why I started Menopause-ology – to be a community that supports other women, provides evidence-based, informed information, tips and techniques to allow all of you to have positive, calm and empowered menopause journeys.
Please share this blog with friends and family, and if you found this blog helpful and want to learn more about your menopausal journey take a look at my blog “Why it is important to think about our menopause as our ‘Second Spring’?” or “Why yoga is so good for us during perimenopause and menopause?”.
Wanting to find emotional balance during your menopause transition in a one-to-one with me – set up a discovery call and let’s have a chat.
Other useful resources
- Balance: Founded by Dr Louise Newson, “a GP and Menopause Specialist who works to increase awareness and knowledge of the perimenopause and menopause, and campaigns for better menopause care for all women”.
- British Menopause Society: Menopause Care Resources Toolkit
- Daisy Network, a charity providing information and support to women with Premature Ovarian Insufficiency, also known as Premature Menopause.
