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Gustav Restau - Independent Lifeplus Associate


Menopause, or perimenopause?

Reading Time: 5 minutes

When people talk of going through the menopause, what they are often actually talking about, is the perimenopause. Menopause is the end result – the time when your menstrual cycle stops, you no longer experience periods and you are no longer fertile. The process of reaching this point – the perimenopause – can take years.

Have you entered the perimenopause and not realised?

The key indicator of the menopause is, understandably, that your periods stop. This doesn’t happen overnight, and while we are all different, there’s often a gradual slowing down indicated through a change in your cycle. Your periods may become erratic and arrive late, or even early. You may miss periods altogether, perhaps for a few months, only to then have them arrive again. You may also notice them becoming lighter than usual. It could go entirely the other way too, and fluctuating hormone levels could actually see you having heavier, or more frequent periods for months, or years, before they stop altogether. As these changes can be both gradual and erratic, it’s not uncommon for women to start the early stages of perimenopause and not realise.

Managing the physical and mental symptoms of perimenopause

Some people are lucky and experience few perimenopausal symptoms at all. They might also find them to be perfectly manageable. Others can have a much more difficult time. As with many things though, knowing what to expect is half the battle when it comes to managing and doing the best you can for your physiological health. The best known perimenopausal symptoms are some of the most common and include irregular periods, hot flushes, night sweats, bloating and anxiety or a general low mood.

Mood swings

Mood swings, sadness and feelings of anxiety or depression are caused by hormonal changes. You might find yourself feeling more irritable, anxious, depressed or tearful than usual and while this is of course unpleasant, it’s perfectly normal. Emotions can be given a boost by increasing your bodies serotonin levels, and there are ways to do this naturally.

Vitamin D has been shown in studies to control serotonin synthesis1 so try to get some short, safe bursts of sun exposure as this can help your body produce Vitamin D. You can also increase Vitamin D through your diet – foods such as cereals and orange juice are often fortified with it. The same studies also showed the omega-3 fatty acids to be helpful with managing low moods. You can boost these by eating oily fish like mackerel and salmon as well as cheese and egg yolks.

There is help out there if you need it, and if you feel that your symptoms are beyond your control it’s important to let people know that. You can try talking to friends and family or might consider a support group. If you still feel unable to cope, don’t be embarrassed about speaking to a medical professional. Your symptoms are not unusual and you should be taken seriously.

Bloating

Hormones have a lot to answer for! As well as affecting our mental wellbeing, there are also physical effects that occur as they fluctuate. One of the more common ones around the time of the menopause is water retention, which can cause swollen and puffy ankles, hands and feet. This water retention is often accompanied by gas bloating. The good news is that both of these symptoms can be helped by maintaining a healthy diet. Try to reduce the amount of salt and fizzy drinks you consume, as both of these have a tendency to make you bloated. Slowing down your eating in general helps prevent too much air entering your system, so try to take your time and chew your food more thoroughly. Eating smaller meals can also help as it doesn’t put such a stress on your digestive system.

Hot flushes

Your body’s ability to regulate temperature can also be affected by changes in your hormone levels, leading to the dreaded hot flushes. These can happen at any time during the day or night, often without warning, but there are some things that can trigger them too.2 Avoiding spicy foods, caffeine and alcohol can help, as well as avoiding things that would naturally make you hotter, such as wearing too many layers of hot clothing and having the heating turned on too high. If you’re a smoker, stopping smoking can also help.

To manage hot flushes, try to sit near open windows with fresh air rather than in warm corners or by radiators. Wear loose layers of clothing and make your bed with layers too – sheets and blankets can be better than a thick duvet. If you feel like you might be about to experience a hot flush, spritz your face with cool water or place a cold flannel on the back of your neck. Sipping cold drinks and sucking on ice cubes can also help.

Will the perimenopause ever end?

It might feel like it won’t, but it will. This transition period is exactly that, a transition. It won’t last forever and every passing day is a step closer to reaching full menopause. As this can take years though, it’s understandable that some of the signs it is coming to an end might be missed. The biggest sign – as with entering puberty and starting your periods, is that they stop. To be truly considered post-menopausal, a year will have elapsed since your last period. At this point you can safely say you have been through the menopause.

A note about the andropause

Menopause fundamentally occurs due to a decline in sex hormones and while this is notable in women when their periods start slowing down, men don’t have this same indicator. Men also experience a decrease in sex hormones as they age, and may experience what is known as the andropause. This brings with it symptoms including:

• Loss of libido
• Mood swings and irritability
• Reduced muscle mass and ability to exercise
• Tiredness but difficulty sleeping
• Poor concentration
• General lack of energy
• Redistribution of body fat, with common developments being a larger belly or greater fat retention around the breast tissue.

If men are increasingly experiencing these symptoms as they age, it’s possible they have entered the andropause.

Life after the menopause

Some people are lucky and may not experience particularly troublesome symptoms while approaching the menopause. For others, it can affect their lives on a daily basis. It might be assumed that for these people, leaving perimenopause and entering the full menopause would come as a relief. It may well do, but it also might bring to the surface some unexpected emotions. While they can seem a huge inconvenience, experiencing periods is something that will have become a natural part of life and the mental effects of this no longer occurring can take you by surprise. You might start questioning whether you are actually ready to enter this next stage. Did you have children? Did you have as many children as you wanted? Knowing those years have passed can make you question whether you would do things differently if you had your time again.

However you are feeling, you are not alone. Try to remind yourself that you are simply entering a new stage. Yes, you may no longer be able to have children yourself, but this doesn’t mean that any maternal desires you might have can’t find other outlets. There are still plenty of opportunities for you to express your nurturing side. You’ve got many years ahead of you to form relationships based around support and wisdom. Whether you are a mother or not, you can still take on a mothering role long after the menopause.

Another bonus to having gone through the menopause is that, while it might simply be circumstantial, you might find a new confidence you didn’t previously know you had. As people age you can’t fail to notice that they tend to say what they think more. Whether this is simply coincidence, or a result of more balanced hormones making you less self-conscious, it can be truly liberating to say yes to things you want to do and no to things you don’t.

There are a few health factors to be aware of post-menopause, but these are nothing to worry about. Cholesterol and blood pressure might go up, and your risk of developing osteoporosis can also be greater. This can be managed by ensuring you have a good diet and are getting enough calcium to keep your bones strong though. Likewise, a healthy diet and regular exercise have been shown in studies to be able to prevent some of the weight gain that can be associated with the menopause.3 As long as you are aware of what to expect and are willing to follow a healthy lifestyle – which we should really all be doing at any age anyway – then life after the menopause really doesn’t have to be all the different to life before it.

  1. https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.14-268342 []
  2. https://www.nhs.uk/conditions/menopause/hot-flushes/ []
  3. https://link.springer.com/article/10.1207/S15324796ABM2603_06 []