Perimenopause: The Start of the Transition

Perimenopause, meaning “around menopause,” is the phase that begins several years before menopause itself. It’s during this time that hormonal fluctuations, particularly in oestrogen and progesterone, begin to occur. These hormones, produced by the ovaries, regulate the menstrual cycle, mood, temperature, and much more. As their levels fluctuate unpredictably, they can trigger a wide range of symptoms.

When Does Perimenopause Start?

Perimenopause usually begins in your 40s but can start as early as your mid-30s. For most women, it lasts 4 to 8 years, but it can stretch up to a decade.

What Happens During Perimenopause?

The hallmark of perimenopause is irregular periods. Cycles may become shorter, longer, lighter, or heavier, and ovulation becomes less predictable. Other symptoms often appear and can worsen as menopause approaches.

Common Symptoms During Perimenopause:

• Irregular periods: Periods may skip months, change in flow, or arrive unpredictably.
• Hot flashes: Sudden waves of heat, often starting in the chest or face, can leave you sweating.
• Mood swings: Irritability, anxiety, or depressive feelings due to hormonal shifts.
• Sleep disturbances: Night sweats and insomnia can disrupt rest.
• Brain fog: Difficulty concentrating, forgetfulness, and mental fatigue.
• Weight gain: Often around the abdomen due to metabolic changes.
• Skin and hair changes: Skin may become drier; hair thinning or shedding is common.

Tips for Managing Perimenopause:

1. Track Your Symptoms: Use an app or journal to monitor changes in your cycle, mood, and physical symptoms.
2. Adjust Your Diet: Incorporate foods rich in phytoestrogens, like soy, flaxseeds, and legumes, to help balance hormones naturally.
3. Exercise Regularly: Strength training and cardio can improve mood, maintain bone density, and combat weight gain.
4. Supplements: Consider magnesium, vitamin D, or adaptogens to help with sleep, energy, and mood.

What Happens During Menopause?

Menopause marks the end of regular menstrual cycles, ovulation, and natural fertility. While the hormonal fluctuations of perimenopause ease, the symptoms triggered by low estrogen levels may persist or even intensify.

Common Symptoms During Menopause:

• Hot flashes and night sweats: Persistent temperature dysregulation.
• Vaginal dryness: Decreased oestrogen leads to thinner, less elastic vaginal tissue, causing discomfort.
• Low libido: Hormonal changes often affect sexual desire.
• Urinary changes: Increased risk of urinary tract infections or incontinence.
• Bone density loss: Estrogen helps maintain strong bones; its decline increases the risk of osteoporosis.
• Heart health concerns: Lower oestrogen may increase cholesterol and heart disease risk.

What Causes Menopause Symptoms?

The primary cause is the decline in oestrogen, which affects nearly every system in the body:

• The brain (mood, memory, temperature regulation)
• The skin and hair (elasticity, hydration, thickness)
• Bones (density and strength)
• Reproductive organs (vaginal tissue, lubrication, elasticity)

Navigating Menopause:

1. Hormone Therapy: Menopause Hormone Therapy (MHT), previously known as HRT, can replace declining hormones to alleviate symptoms like hot flashes and vaginal dryness. Discuss with your doctor to weigh the benefits and risks.
2. Natural Remedies: Supplements such as black cohosh, red clover, or omega-3s may help with symptoms.
3. Moisturizers and Lubricants: Non-hormonal options can relieve vaginal dryness and discomfort during sex.
4. Lifestyle Adjustments: Focus on a heart-healthy diet, weight-bearing exercise, and stress management.

Post-Menopause: Life After the Change

Post-menopause begins the day after your 12-month period-free milestone. At this point, your ovaries produce very little estrogen, and your body adjusts to a new hormonal baseline. For some women, symptoms like hot flashes fade, while others may continue to experience lingering effects.

Long-Term Changes in Post-Menopause:

• Bone Health: Osteoporosis risk increases due to ongoing bone density loss. Calcium and vitamin D become essential.
• Heart Health: Without estrogen’s protective effects, cardiovascular disease risk rises. Regular checkups and lifestyle changes are vital.
• Vaginal and Bladder Changes: Vaginal atrophy can lead to discomfort, and urinary issues may persist.
• Skin and Hair: Thinner skin and hair may require extra care and hydration.

Thriving in Post-Menopause:

• Focus on preventative care, including regular screenings for osteoporosis, cholesterol, and blood pressure.
• Maintain a balanced diet rich in antioxidants, healthy fats, and lean proteins to support overall health.
• Prioritise self-care to embrace this stage of life with confidence and vitality.

Tips for emotional well-being:

Connect with Others: Join support groups or talk with friends who understand what you’re going through.

Practice Mindfulness: Meditation, yoga, or journaling can help manage stress and promote emotional balance.

Seek Professional Help: If feelings of sadness or anxiety persist, don’t hesitate to talk to a mental health professional.

Frequently asked questions about menopause

Can you get pregnant during perimenopause?

Yes, it’s still possible to conceive during perimenopause, so contraception is recommended until menopause is confirmed.

Does every woman experience hot flashes?

No, while they’re common, not all women experience hot flashes.

Is weight gain inevitable during menopause?

Weight gain is common but not unavoidable. A healthy diet and regular exercise can help.

Menopause is a natural and inevitable part of life, but it’s not something you have to endure without support. Understanding the transitions of perimenopause, menopause, and post-menopause empowers you to take control of your health and well-being. Whether you’re managing symptoms, exploring treatments, or simply looking for answers, know that you’re not alone - and this stage of life can be one of strength, growth, and vitality.

For more resources, visit The Bloom for tips, advice, and solutions tailored to your journey.