We all know that menopause marks the end of a woman’s reproductive life. But did you know that your body goes through different stages within menopause?

Perimenopause is known as the transitional phase that happens before menopause. It’s when our bodies start to wind down reproductive functions before stopping them altogether. Many women who are in perimenopause start to notice changes in their bodies… but they aren’t often aware of what’s really going on.

Although both menopause and perimenopause are part of the same overall transition, they both have different symptoms and treatment options.

So if you’re in your 40s and are noticing erratic periods, changing moods and perhaps the odd night sweat or two, it’s worth exploring the possibility you’re in perimenopause and seeing what your options are.

What happens during perimenopause?

During perimenopause, hormonal changes start to occur, particularly in terms of the level of oestrogen and progesterone circulating around your body.

During perimenopause, oestrogen and progesterone levels are dipping and rising a little out of sync with each other. But during perimenopause, your ovaries are winding down. So you produce less oestrogen. Some months you will ovulate, and some months you will not.

The hormonal fluctuations due to changing oestrogen levels during perimenopause can trigger some symptoms of menopause such as irregular periods and hot sweats, but they come and go erratically.

Perimenopause usually lasts for between 6-8 years before you reach menopause. But each woman is different - for some it may only last a few months, and for others up to 10 years!

When you have gone 12 months without having your period, perimenopause has officially ended and you’re in menopause.

Symptoms of perimenopause

As we get older, our bodies change. Some things you might be experiencing may just be a part of getting older. But some changes may be due to perimenopause.

Many perimenopausal women sometimes experience hot flashes - sudden waves of intense body heat that last 5 minutes or so. They can occur at any time of day or night, making it difficult to sleep. Typically they start in the face or neck, and can get so bad that they leave some women dripping with sweat!

The exact cause of why this happens is not exactly known. But hot flashes are thought to be related to hormonal changes in the brain’s thermoregulatory centre, which is the part of the brain that controls heat production and loss.

Dealing with the symptoms of perimenopause can leave you tired and irritable. Hot flushes, night sweats, and increased anxiety about the changes you’re going through are enough to send your moods haywire.

The hormonal changes in your body can also play a part in influencing your mood, particularly if you are dealing with life stress, are in poor health, or have a history of depression.

Falling oestrogen levels can cause vaginal tissue to become thinner and drier, particularly in late perimenopause. Vaginal dryness can cause irritation, itching, and painful sex.

It’s important to know that if you are experiencing vaginal dryness, there’s no need to suffer in silence. A range of treatments are available including the Mona Lisa Touch that can ease your symptoms and have you feeling like yourself again!

As ovulation becomes more unpredictable, you may experience irregular bleeding. Not only do your periods become less reliable, the heaviness of your flow can change too. This is because there’s less progesterone to regulate the growth of the endometrium, so it becomes thicker and therefore heavier when it’s shed.

You might even skip your period every few months. The less your periods still hang around, the closer you are to menopause.

Throughout perimenopause, your hormone levels rise and fall in unpredictable ways. They can change on a daily or monthly basis and affect not just your energy levels, but also your mental clarity too.

Usually the hormones oestrogen and progesterone maintain a certain ratio in your body. When one decreases it alters this ratio and can leave you feeling tired during the day. Exercising, maintaining a good sleep routine, and meditating can help combat fatigue.

Some women find the scales are creeping up despite maintaining the same diet as they always have. But while weight gain is commonly associated with menopause, it’s not necessarily directly caused by it.

A range of factors associated with ageing can cause your body to hold more weight around your abdomen, hips and thighs. For instance, muscle mass typically diminishes with age, which slows the body’s metabolism and fat burning capability.

As your body ages and also gets used to new hormone levels, your weight may fluctuate and you will need to revamp your diet and exercise program to maintain a healthy weight.

Due to the consistently low levels of oestrogen and progesterone present during menopause, this time of life can lead to thinning hair that breaks more often. So you might see some signs of hair thinning during perimenopause.

Conversely, sometimes you might see some very thin, fuzzy facial hair sprouting up too, particularly on the chin.

The reason why perimenopausal and menopausal women experience hair loss isn’t fully understood, but studies have linked it to changing androgen (testosterone) levels. Reductions in testosterone progresses through perimenopause and menopause have been found to impact androgens and their ability to influence hair follicle health.

Other symptoms of perimenopause may include:

  • Headaches
  • Changes in heartbeat
  • Loss of libido
  • Forgetfulness
  • Muscle aches
  • Fertility issues
  • Dry skin
  • Frequent urination
  • Increased cholesterol levels

How is perimenopause diagnosed?

As perimenopause is a gradual transition, there’s no single test that’s going to give you 100% certainty.

That’s why at Northside Gynaecology, we take multiple factors into consideration including your age, your menstrual history, your lifestyle, as well as the symptoms or changes you’re experiencing.

We may order tests to check various hormone levels. But we don’t always need to do this, if the other signs clearly indicate what is going on.

Treatment for perimenopause symptoms

Fortunately there are a range of things you can do to manage your symptoms of perimenopause. Hormone therapy can help normalise your oestrogen levels so you don’t get floored by sudden spikes that send your body haywire!

Oestrogen therapy comes in many forms including tablets, creams, gels and skin patches. Your gynaecologist will discuss what method would be best for your symptoms and general outlook.

For women who don’t wish to take oestrogen for personal or medical reasons, treatments can vary depending on which symptoms you want to ease.

For instance, prescription vaginal creams can help alleviate dryness or discomfort during sex. The Mona Lisa Touch can help ease vaginal itching, urinary incontinence and laxity (it’s a quick non-invasive procedure that only takes 15 minutes - read more about it here).

Easing symptoms of perimenopause naturally

There are also many ways you can improve your symptoms without medical intervention.

Keeping a fit and healthy lifestyle can enormously influence the severity of symptoms during both perimenopause and menopause.

Eat healthy

  • Cut out fatty and processed foods
  • Eat small portions of lean protein at meal times
  • Fill up on lots of fresh vegetables
  • Eat more whole grains and low-gi food
  • Get plenty of calcium-rich nutrition from yoghurt, fish and cheese
  • Eat plenty of healthy fats from fish, olive oil, nuts and seeds

Get physical!

  • Make 40 mins of exercise part of your daily routine
  • Accumulate 5-10 short bursts of exercise throughout your day
  • Mix up your routine by combining moderately-paced walking with more vigorous exercise (jogging or aerobics)
  • Try weight training at the gym to keep your muscles strong
  • Sign up for a local sport team such as netball or tennis

Practice self-care

  • Meditate and practice mindfulness everyday
  • Reduce your stress levels
  • Indulge in relaxing activities that make you feel good
  • Improve your sleep hygiene habits for better quality rest

Navigating this new time in your life

Perimenopause can be an uncomfortable and perhaps frightening time for women unprepared for the changes that accompany it. As it signals the beginning of the end of your reproductive years, this can bring with it a great deal of emotion.

At Northside Gynaecology, our female-only practitioners are dedicated to giving patients the highest quality service and supportive care. We understand that no two bodies are alike, and we’re dedicated to taking the time to ensure we’ve found the best solution for your needs.

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