From tracking your symptoms to embracing exercise and addressing any pelvic floor issues, this Women’s Health With Evolve column looks at how you can make your perimenopause journey more positive
Have you experienced a hot flush, a panic attack, insomnia or a change in menstrual flow and been unable to pinpoint the exact cause? These symptoms—and many others—can be early signs of perimenopause.
While the perimenopause is most likely to start in a woman’s 40s, for some it can begin as early as her 30s, or even earlier in the case of a surgical menopause (a total or radical hysterectomy where the ovaries are removed). And this transitional time can last anywhere from two to 12 years.
Recognising this important life stage early presents you with greater opportunities to invest in your health, build a strong foundation and manage any troublesome symptoms. Here are five tips to help you navigate perimenopause and make it a positive and empowering journey.
1. Knowledge is power
Menopause marks the one year anniversary of your last menstrual period, whereas perimenopause is the time period prior to this when you’ll have cycles, but start to experience menopausal symptoms. It is characterised by incremental changes in female hormones, namely oestrogen and progesterone. For some women these changes can be very subtle, but for others this period can be significant and have a huge impact on quality of life. Due to the hormonal shift a wide range of symptoms can appear and they can evolve and change in subsequent years.
Typically, in the early stages of perimenopause, oestrogen levels are relatively high compared to progesterone and this can cause heavier periods and also shorter menstrual cycles. Symptoms such as breast tenderness, headaches, night sweats, insomnia, anxiety and hot flashes can dominate. Towards the later stages of perimenopause, as women approach menopause, oestrogen declines and periods will become less frequent and unpredictable. Different symptoms may start to occur such as bladder urgency and frequency, painful sex, and joint and muscle pain.
Management of these symptoms can be as simple as addressing lifestyle factors such as sleep, nutrition and stress management. Further treatment may include topical oestrogen or menopausal hormone therapy, which is best known as hormone replacement therapy (HRT). While, historically, HRT has courted controversy, doing your own research, talking to your GP and finding what works for you is the most important message. Everyone's experience of this transition will be unique, however, understanding the process will enable you to be proactive and reach out for help when necessary.
2. Track your period and symptoms
The best way to recognise the signs of perimenopause is to track your period and work out what is “normal” for you so you can then identify changes in your period or accompanying symptoms, their severity and impact on your daily life. Your period can change over the years, and as you get older typically your cycle gets shorter and increasingly irregular. Cycle tracking should include information such as length, flow and symptoms including pain, cramping, mood, sleep and gastrointestinal changes. There are plenty of apps that can assist with tracking, including Clue, Eve, Flo and Spot On. If you have further concerns about your menstrual cycle, seeking medical support is recommended.