Reviewed by

Uwe Porters - Midwife & Menstrual Health Expert


Let’s Talk About Perimenopause

Reviewed by

Uwe Porters - Midwife & Menstrual Health Expert

Menopause is a totally natural and normal process and yet, we really don’t talk about it that much! It’s a massive taboo and that needs to change. The reality is that half the human population is going to experience menopause so we might as well discuss it!

In this post, we’re going to discuss perimenopause – the time when your body is preparing for menopause. We’ll tell you what it is, what to expect and some things you can do. Let’s get all the details out into the open, shall we? We think it could help provide huge relief to any of you suffering in silence.

Brace yourself. It’s a long post.

What is the perimenopause?

Perimenopause literally means “around menopause.” It’s the time in your life when your body starts preparing for menopause which is the end of your reproductive years. It’s also sometimes known as the “menopausal transition,” and it usually begins a few years before you actually start menopause.

During perimenopause, your estrogen levels rise and fall unevenly. During perimenopause, your ovaries are producing less estrogen as they prepare to stop releasing eggs entirely. However, you can also experience periods of high estrogen. As a result, your menstrual cycles may lengthen or shorten, and you could have a cycle where you don’t actually release an egg (ovulate) at all. There are some physical symptoms (which we’ll cover in a minute) but for some women, it’s quite an emotional journey too because it signals that the time is coming where you literally lose the ability to get pregnant. (It’s important to note that you can still get pregnant during perimenopause but the chances decrease - more on that later).

What age does it start?

It’s different for everyone, but it usually starts sometime in your 40s. Sometimes, it can start in your late 30s as well. This phase lasts up until the time when your ovaries stop releasing eggs. The average length of perimenopause is about four years, but this time frame varies a lot from person to person. For some women, it might only be a few months and for others, it could continue for 10 years!

You know perimenopause is over when you’ve gone a full year without having your period. 12 months after your last period is when you have officially reached menopause. In the years leading up to this point, women experience many changes in their monthly cycles including other symptoms like hot flashes. This phase is called the menopausal transition or perimenopause.

What’s the difference between perimenopause and menopause?

As you might have already guessed, perimenopause includes the years leading up to menopause. Technically, menopause is not official until you’ve gone 12 months without a period.

What are the symptoms?

There’s not a lot of glamour with perimenopause, is there?! But understanding your body can help make this transition a lot easier. Here are a few of the most common symptoms:

Irregular periods

The most common symptom of perimenopause is an irregular period. Basically, since puberty, your body has been producing estrogen. But in perimenopause, your estrogen levels start to drop so your body needs to adjust. One of the first symptoms you might notice is changes to your period. Things like irregular periods, skipping periods or periods that are heavier or lighter than normal can all be symptoms of perimenopause.

Hot flashes

You’ve probably heard about hot flashes, but you might not be expecting to experience this lovely symptom in the perimenopause stage. But they do appear for many women long before menopause.

Hot flashes range in severity. They can be like a brief feeling of warmth or feeling like you are being consumed by fire from the inside out! There’s no real warning that you’ll have one either so they can sneak up at really awkward times like when you’re delivering a presentation at work or having sex with your partner. They can also be quite dramatic causing redness in your face and upper body, sweating, chills and in some severe cases, disorientation or confusion.

They can come on quickly and catch you off guard. Most last one to five minutes. You might have a few over the course of a week. Or if you’re one of the unlucky ones, you might get 10 or more, sometimes during the night. Hot flashes at night are sometimes called night sweats and some women report waking up completely drenched in sweat. It can be distressing, embarrassing and a major inconvenience!

It's not exactly clear what causes hot flashes, but the root cause is changes in hormones. There’s also not much you can do when they happen, other than ride them out as best you can. We’ll tell you some lifestyle changes that can help with perimenopause symptoms below.

Vaginal dryness

Falling estrogen levels can cause vaginal tissue to become thinner and dryer. We’re sorry to report that it starts in perimenopause and often gets worse after menopause. The main symptoms are itching, irritation and pain during sex which can – understandably - impact your sex drive. The Guud news is there are lots of ways to treat vaginal dryness. Using a lubricant is a great way to help. You can also talk to your partner about spending a bit more time on foreplay too!

Vaginal dryness can also be related to hormone changes and your diet.

Also read how your cervical mucus changes throughout your cycle

Sleep problems

If it’s not those pesky night sweats keeping you awake, the insomnia might. Close to half of perimenopausal women report sleep problems. There are many reasons, but broadly, it’s all down to hormone changes. Sleep cycles also change as we age. If you find yourself wide awake at 3 am staring at the ceiling, you’re not alone.

Mood swings

Mood swings are, of course, a common PMS symptom, but they can also occur during perimenopause. The most common symptoms are things like anxiety, depression and irritability. If you have a lot of life stress, your overall health is poor, or you have a history of depression, you’re a lot more likely to experience mood swings during perimenopause.

Other symptoms

We’ve covered the most common symptoms above, but you may also experience some of the following:

  • A need to wee more often
  • A change in your cholesterol levels
  • Bone thinning
  • Memory problems or trouble concentrating

What Lifestyle Changes Can Help With Perimenopause

That was a pretty grim list of symptoms wasn’t it? But it’s not all bad news. There are some simple lifestyle changes that can help alleviate or eliminate symptoms of perimenopause.

Eat a healthy dieet

We know, we know. We talk about this all the time. But the reality is, food really can be your medicine. This means eating a balance of good fats, complex carbs and proteins, proteins and more proteins (we can’t say it enough!). As you age, your body requires roughly 50% more protein than a younger adult to preserve muscle mass, strength to maintain a good quality of life. Having sufficient protein also helps to increase your immune functions and reduce recovery time from illness. If you don’t think you’re getting enough protein from your food, consider getting a plant-based protein powder to add to smoothies or yoghurt in the morning.

In general, try to add lots of fruits and veggies to your meals, and try to eat every few hours to keep your blood sugar in check.

Avoid sugar and refined carbs like pastries and white bread and remember you can always add a supplement to help with your overall health. Omega-3 is a good option. It’s packed with DHA which helps you maintain a healthy heart and brain – good for your mood and your mind!

Be thoughtful about phytoestrogens

As you now know, oestrogen decreases during menopause. This is because your ovaries stop producing oestrogen. Foods rich in phytoestrogens are also often recommended to women heading towards menopause. You find this in food like edamame, flaxseed, tofu, soy or soy drinks and lentils.

Phytoestrogens are compounds that occur naturally in plants and if you eat them, they can mimic the action of oestrogen in the body. Phytoestrogens can be very useful in their pure form, always in moderation.

Also, during the (peri)menopause, always beware of processed phytoestrogen products such as processed soy in the form of soy oil or soy lecithin, because during this phase oestrogen levels can fluctuate very sharply, with sudden drops or violent spikes, which can actually worsen symptoms.

Consider a supplement

As you get older, your body needs more vitamins and minerals, especially B vitamins, folic acid, omega-3 and magnesium. You probably don’t think about this all that much, but it’s possible you’re not getting enough of these essential nutrients through food alone. That’s why adding a supplement to your diet can be a guud idea.

We have an entire guide on which vitamins and minerals can help support your body as you transition to menopause here. Check it out.

Reduce stress

We know it’s not always possible, but if your mood is already all over the place thanks to changing hormone levels, try to eliminate as much unnecessary stress from your life as you can. Stress is also linked to hot flashes and low sex drive too. Lowering stress doesn’t need to be difficult. Exercise. Get adequate sleep. Spend time in nature or with friends that give you energy and make you laugh. Practice some deep breathing or meditation. And here’s an easy one: say no more often! We routinely take on too much and over commit. It’s OK to say no sometimes!

Move your body

Find some kind of exercise you like and make it a regular part of your routine. Many women say they gain some weight during perimenopause and menopause especially around their tummies. This is common because in an effort to prolong your fertility as long as possible, your body tries to hold on to whatever estrogen you have left and estrogen is often stored in body fat.

It’s important to think about maintaining or building muscle mass before and during perimenopause. You have probably heard the old adage “use it or lose it,” right? There’s truth here. In this case, the “it” refers to your lean muscle mass which naturally declines as you age.

So pick something. Anything. No need to run a marathon. Walk. Jog. Swim. Do Yoga. Cycle, dance, go to a step class, chase your children around. Whatever it is, it will help you physically and mentally as well.

Add more proteins

When you're in perimenopause, it's not just the passage of time that can affect your muscle mass and skin health. It's also the decline in estrogen. That's why it's a smart move to up your protein game during this phase. Try to include some protein in every meal – it's like a safeguard for your muscles and can potentially help you fend off unwanted weight gain. Researchers from the University of Sydney's Charles Perkins Centre even suggest that making slight tweaks to the balance of what you eat during this transition can go a long way in preventing weight gain and preserving lean tissue. So, go ahead and make protein your friend during perimenopause.

A few other suggestions...

Broadly, a healthy lifestyle of good food and exercise will do wonders but here are a few other suggestions to help alleviate the symptoms of perimenopause:

  • If you smoke, please try to quit
  • Get adequate sleep each night. Stick to a consistent schedule and avoid screens before bedtime
  • Keep your bedroom cool. Lower the temperature or invest in a cooling mat. It can do wonders if you’re struggling with hot flashes
  • Limit your alcohol consumption. We won’t tell you to give it up altogether, but please drink sensibly
  • Try acupuncture. If you’re into alternative treatments, some studies have shown that acupuncture can help alleviate perimenopause symptoms like hot flashes

Can I still get pregnant if I am perimenopausal?

Listen up ladies. This is important. The answer is YES! It’s not likely, but it is possible. So just because you’re entering this stage of your life, don’t go getting complacent in the birth control department. Despite the fact that your fertility is declining, you can still get pregnant. So, if you don’t want a baby at this stage in your life, use some form of birth control until you have officially reached menopause (you have gone 12 months without having your period).

Still have questions? Let us know. We can help point you in the right direction.