What is Perimenopause? Symptoms, Causes and Treatments
The unfortunate truth is that as a woman, once you hit your 40’s, you’re a candidate for perimenopause, characterized by hormonal changes that can dramatically change the way you feel physically and mentally.
40 probably seems pretty young for this kind of thing, but it’s common for menstrual cycle changes to start up around this age.
On top of this, the word ‘perimenopause’ or ‘premenopause’ seems to elude aplenty of women’s awareness.
Once you start experiencing some apparent irregularities in your body, you may find yourself embarking on a research journey. At that point, a potent question to ask might be, “what is perimenopause?“
In this article I’ll give you the heads up on this tricky transitional time, what the symptoms look like, and what you can do about it.
What is perimenopause?
Most women already know about the dreaded menopause, but not all are aware that this process can start ten years before the menopause itself.
The female body is going through a process, and tough as that process can sometimes feel, it’s totally natural for fertility to wane from 40 onwards.
With the decline of ovarian function, hormones begin to shift too, and levels of circulating estrogen will vary.
Perimenopause is the name for the early stages of the menopause; the name is derived from Greek, in which ‘peri’ means ‘near’.
You can think of this period as a time of transition, and while it may last for ten years for some women, for most it only lasts for around three or four.
Maybe you’re wondering how you’ll survive this challenging process…
Well, you will. And you’ll know you have when you reach the end of one year after your final menstrual period.
What are the symptoms of perimenopause?
Perimenopause is characterized by hormonal changes, although symptoms can vary dramatically in terms of both longevity and intensity. Nobody enjoys the symptoms of perimenopause, obviously.
Who would relish night sweats, mood swings and painful periods?
The fact that women get through this time is testament to their innate strength, if anything.
When you know what to look out for, you’re better armed to manage your symptoms and sail through your perimenopause with determination and grace.
Let’s take a look at the most common perimenopause symptoms:
1. Changes in the menstrual cycle
A lot of women start off adult life with irregular and heavy periods. It can feel like a harsh start to womanhood, but they learn to manage it and with time (or hormonal supplementation) things often balance out.
You’ll know you’re hitting the perimenopause when your periods become erratic in later life, or there’s a change to the typical flow.
For example, some women find that their periods come every 21 days instead of the usual 28, and that they have a much heavier flow for the first two days, followed by minimal or non-existent flow for three more.
During such “heavy periods” (medically known as menorrhagia), you may notice an unusual heavy blood flow as well as cramps.
This happens mostly because of an imbalance in the levels of the hormones progesterone and estrogen which thicken the womb lining before shedding it.
The changes will vary from woman to woman, as no two are the same… some will skip periods altogether.
Regardless, big changes to your cycle in these later years of life is a good indication that perimenopause is creeping up on you.
2. Mood swings
Ah… those beloved, perception-altering mood swings!
Isn’t it funny how they have a way of slipping in through the back door and catching you off guard?
You don’t see them coming and they have a nasty habit of making you feel mentally unstable.
Don’t panic just yet though: statistics say that only 10-20% of perimenopausal women experience mood swings. Although it hasn’t been proven, it may be estrogen decline to blame for depressing moods, anxiety and irritability.
3. Night sweats and hot flushes
Hot flushes and night sweats are more commonly experienced during the actual menopause, but it’s possible that you’ll find yourself overheating during the perimenopause too.
It can affect between 35 and 50% of perimenopausal women.
It’s smart to note that some medications can be behind these abhorrent sweaty episodes, so do check on side effects of such medicines before you blame the hormones.
4. Dryness in the vagina
Fortunately, vaginal dryness doesn’t usually happen until the later stages of perimenopause.
Again, you can blame a decline in estrogen levels for this, and it comes in a package with thinning vaginal tissues and loss of libido.
Since it’s not fair for me to pull my punches when it comes to the truth, I’ll admit that this tends to worsen after the menopause, potentially resulting in irritated skin and painful intercourse.
However, it’s not the end of the world: it can be eased with the use of lubricants.
Keep reading if you’re interested in treatment options.
5. Disrupted sleep
Disrupted sleep is another perimenopause symptom that affects up to 40% of women during this time.
Night sweats might be one reason for it, but even in the absence of those, insomnia is a possibility.
Having said that, as people age they sometimes find they sleep less anyway, so this symptom is not guaranteed to be menopausal.
Perimenopause treatment options
Here’s the part that will have you breathing a sigh of relief for sure. There are plenty of options for treating perimenopause symptoms.
Let me enlighten you:
1. Treating menstrual cycle changes
For those of you dealing with irregular or heavy periods, you might want to consider taking a low-dose contraceptive pill, since these can regulate both your hormones and menstrual cycle.
They work by suppressing ovulation and evening out your menstrual flow, which should provide a certain amount of relief.
They can also help with hot flushes and night sweats by bringing them down to a manageable (or if you’re lucky, non-existent) level.
If necessary, you can pop these little lifesavers until the actual menopause hits, depending on a mutual agreement with your Doctor after blood test results.
In terms of alternative options, you might find that CBD oil can help, since it can suppress the hormones causing the hormonal uproar you’re seeking to avoid: namely prolactin and cortisol.
CBD oil is widely used for relief of PMT (pre-menstrual tension) anyway, so this is testament to the benefits it offers.
Like birth control pills, CBD oil may also aid restful sleep.
2. Treating hormonal and mood changes
As mentioned in point 1, a low-dose contraceptive pill may work wonders on regulating your hormones, and consequently your moods.
In severe cases―and usually during the later stages or the actual menopause―your Doctor might suggest Hormone Replacement Therapy (HRT), although it does have side effects so you’ll need to swot up on those before committing.
For the naturally inclined, how about the wonderful plant-based supplement that goes by the name of Chaste Tree Berry (Vitex agnus-castus)?
Perimenopausal women have reported great results in terms of regulated moods and relief from all those other unpleasant PMT symptoms. This is another product thought to bring relief from night sweats and hot flushes, so it may be worth a try.
If this one doesn’t float your boat, you might be interested in powdered Maca Root.
Hailing from the Peruvian Andes, it has long been used to treat reproductive problems such as infertility, lack of sex drive and hormonal imbalances.
3. Treating hot flushes and night sweats
Firstly, the common sense approach says you should lower the temperature in your room and go with thinner bedding.
Don’t drink hot drinks or eat spicy foods late in the day, and wear less (or nothing) in bed.
If those tactics don’t minimize the sweating, you could ask your Doctor for a low-dose estradiol product which comes in pills, topical gels or skin patches.
Since this can be one of the more testing symptoms of the perimenopause, you may feel the need to resort to drugs. Sometimes antidepressants such as Effexor, Prozac or Paxil are prescribed for this purpose too.
Just be careful of potential side effects; as always, read the label and consult your Doctor.
4. Treating vaginal dryness
Although this may not bother you until later in the perimenopause, if and when it hits, you’ll probably want to do something about it.
Again, low-dose contraceptives are a common option, as are topical creams or gels containing estrogen.
You might not need to resort to this though; there are plenty of water-based vaginal lubricants out there that can assist with moisture, acidity and elasticity.
So that’s the question “what is perimenopause?” well and truly wrapped up.
Hopefully it is now clear that despite the challenges perimenopausal symptoms can bring, there is a way around most of them.
Nobody ever said being a woman was easy, and it probably feels like the perimenopause period exists to remind you of that!
Good luck in managing your symptoms, and don’t forget to take a look at other topics in our women’s health section.
Whatever our genders, when it comes to health and wellbeing, we’re all in this together!