How Do You Know When You Are Perimenopausal?

If you haven't heard of the term 'perimenopause', you're not alone. Perimenopause is the lesser-known stage before menopause when hormone levels fluctuate, and as a result, women experience an array of menopause symptoms while still having periods. To explain further, we're welcoming award-winning menopause experts Health & Her, who are now also available at Superdrug, to our blog to share their expertise.

Period changes during perimenopause are common and can often be quite erratic. Some women experience lighter periods that only last a few days, and others find that their periods are heavier and more frequent. There are three stages of perimenopause*, and your cycle length can be a good indicator to help identify which stage you may be in:

Early perimenopause - at this stage, you may be experiencing no or small changes (less than 7 days) to your cycle length.
Mid perimenopause - your periods become more irregular at this stage, with your cycle length increasing or decreasing by over 7 days.
Late perimenopause - by this stage, you may find that you’re skipping entire cycles, with your cycle length varying by over 60 days.

Research by Health & Her shows that the onset of symptoms during perimenopause can take place, on average, 4-5 years before periods stop (known as menopause). This often marks a very challenging time for women as they may not realise the cause of their sleeping problems, brain fog, mood changes, and other life-impacting symptoms.

In 2019, at Health & Her, we conducted a study that asked 1000 women who had been through perimenopause to tell us more about their experience. The results found that, on average, women first experienced perimenopause symptoms at 46. It took an average of 14 months to associate their symptoms to the early stages of menopause due to conditions such as ageing, stress and depression commonly attributed to being responsible.

To understand more about the benefits that early symptom diagnosis can have for women who are beginning their menopause journey, we’ve spoken to menopause specialist GP, Dr Heidi Kerr, who explains more:

“Increasing awareness to women about the perimenopause is vital as the arrival of many troublesome symptoms unexpectedly in their 40s - not the assumed 50s - can have a dramatic effect on daily life at home, at work and in relationships.

By having a greater understanding of the hormonal changes that are taking place and the impact it can have on their bodies, women will be able to make good decisions about their health at an earlier stage to help alleviate symptoms and improve their ongoing health. This will allow them to reap the benefits as they move forward into their next decade and beyond.

If you’re having severe symptoms and think you’re experiencing perimenopause, speaking to a GP can help. At the Health & Her Clinic we offer tailored advice and treatment options that can support you with a diagnosis.”

Perimenopause Symptoms - What To Expect

Although no perimenopause experience is the same, women transitioning through this natural stage of life often encounter a common combination of physical and psychological symptoms, varying in degree of severity.

In our recent study**, the following were identified as some of the most commonly experienced and severe symptoms of perimenopause:

Period Changes
Hot Flushes & Night Sweats
Stress & Anxiety
Sleeping Problems
Brain Fog & Poor Concentration
Skin & Hair Changes
Mood Changes
Low Energy
Joint & Muscle Aches

Coping With Your Symptoms

Perimenopause can be a life-changing experience that can leave many women feeling isolated, overwhelmed and out of control. To support you through this journey, it can be helpful to consider some of the positive lifestyle choices you can make and the available management options that can help with symptom management.

Nutrition and Supplements

Many nutritionists advise paying close attention to the link between your diet and the menopause experience. A balanced diet rich in fresh vegetables can play a key role in ensuring you maintain optimal health and get all of the essential nutrients you need. Dietary supplements can also be beneficial for providing access to concentrated sources of key nutrients and minerals often depleted from our food due to over-farming and pesticides. Some supplements also contain phytoestrogens, which are plant-based compounds that mimic oestrogen in the body. Symptoms can respond particularly well to phytoestrogens, though they are difficult to incorporate into your diet, which can often make supplements the preferred choice for intake.

Plants, herbs, vitamins and minerals that are traditionally used to support the symptoms associated with perimenopause include:

Sage which is traditionally used to support well-being during menstruation
Wild Yam and Red Clover to help women to cope with hot flushes and night sweats associated with menopause
Ashwagandha to support relaxation in periods of nervous tension and anxiousness
Avena Sativa Oat Extract to help support better sleep, decrease restlessness and cope with menopause-related irritability.
Ginkgo Biloba and Ginseng Panax to help preserve cognitive function and concentration
Zinc and Vitamin C contributes to normal collagen formation and the protection of cell constituents from oxidative damage.
Lavender, Iron, and vitamins B6 and B12 contribute to the reduction of tiredness and fatigue.
Vitamins C and D to support the maintenance of normal muscle and bone function.

Digital Tools and Resources

Digital resources such as the Health & Her Menopause App can help you build positive lifestyle habits that will empower you through your menopause journey.

The Health & Her Menopause App acts as your personal trainer for menopause. It allows you to track symptoms over time with access to an evidence-based toolkit of exercises and activities scheduled into daily goals. This includes Pelvic Floor Exercises for Urinary Changes and Painful Sex, Cognitive Behavioural Therapy (CBT) for Low Mood, Guided Meditation for Sleep, and even timely reminders to take your supplements. It has also been designed for use alongside our Health & Her Perimenopause Supplement and our Health & Her Menopause Supplement for a fully holistic solution that goes beyond the pill and puts you back in control to achieve optimum results.

With personalised health insights into important patterns and triggers, the Health & Her Menopause App enables you to learn more about the symptom management options that work for you, making it the perfect companion to assist you through each stage of your menopause journey.

The Health & Her Menopause App is available to download for free on iOS and Android.

HRT

Hormone replacement therapy (HRT) works by replacing the female hormones that are at lower levels as you approach menopause. Doctors often prescribe HRT to relieve symptoms, and it comes in several forms, including tablets, skin patches, gels, implants, creams or pessaries. To determine if HRT is a good option for you, you should speak to a GP to discuss the risks and benefits.

Speaking to Your GP

If your symptoms are severely affecting your quality of life, consider seeking help from your GP. For many women, this can be a daunting thought, but it's important to feel supported and remember that you're not in this alone. If you feel dissatisfied with the outcome of your appointment with your GP, have further questions, or require additional support in discussing your treatment options, then consider speaking to a specialist GP who is highly experienced in the management of perimenopausal and menopausal health.

At the Health & Her Clinic, we offer online consultations with menopause specialist GPs who are all registered British Menopause Society members. With their specialist knowledge in women’s health, our GP’s are qualified to support you with advice and treatment options tailored to your needs. Examples of this may include if you’re looking for a perimenopause diagnosis, need help in considering if HRT is right for you, or if you’re struggling with your existing HRT or pill. Getting support from an experienced specialist can help a great deal when it comes to getting back to feeling like yourself again, and our doctors take the time to listen, so you never feel rushed.

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Sources:

*Stages of Reproductive Aging Workshop (STRAW) Michael R. Soules, Sherry Sherman, Estella Parrott, Robert Rebar, Nanette Santoro, Wulf Utian, and Nancy Woods. Published Online:7 Jul 2004 https://doi.org/10.1089/152460901753285732

**Research commissioned by Health & Her and carried out by Censuswide. 1001 women. UK. 2019