Your Perimenopause & Menopause Questions Answered

Most women reach menopause between 45-55 with the average age around 51.

It’s really important to remember that all women’s’ symptoms are going to be unique. Symptoms can be more severe when menopause occurs suddenly or over a shorter period of time.

• Irregular periods
• Heavier or lighter periods
• Vaginal dryness
• Hot Flushes
• Chills
• Night Sweats
• Sleep problems/Insomnia
• Depression and Anxiety
• Headaches
• Mood Swings
• Weight gain and slowed metabolism
• Thinning hair and dry skin
• Loss of breast fullness
• Reduced Libido or Sex Drive
• Reduces Muscle mass
• Stiffness in joints

Some of the well known symptoms of menopause are hot flushes and night sweats although many women might actually notice changes to their mood, sleep and sex drive first. It’s good to be aware of all of the possible menopause symptoms as many women might not associate their dry skin, uncomfortable sex and stiffness in their joints as menopausal symptoms, but they are. This is why it is essential for women to become aware of their bodies and keep notice of any changes that may be occurring.

Many women are completely confused about when menopause starts and if they are perimenopausal. The reality is that no single event determines that you are perimenopausal.

Many women will go through perimenopause which occurs before menopause. Perimenopause is a time when your hormones begin to change in preparation for menopause, and it can happen around mid 40s and last from anywhere from several months to a few years.

Most women develop menopause symptoms about 4 years before their last period and symptoms continue until about four years after their last period.

Some women might even start symptoms a decade before menopause occurs, 1 in 10 women experience menopausal symptoms for 12 years following their last period.

As you can see, menopausal symptoms can be around for a while. This is why it’s so important to learn ways to manage this challenging time.

As you approach your late 30s, your ovaries start making less oestrogen and progesterone, the hormones that regulate menstruation, and your fertility declines.

In your 40s, periods might become longer or shorter, heavier, or lighter, more or less frequent until eventually your ovaries stop releasing eggs and you have no more periods.

Official Menopause occurs when you have gone 12 months without a period.

Other things can bring on menopause such as;

Surgery to remove ovaries can bring on immediate menopause. Your periods will stop and menopausal signs and symptoms begin immediately. They are quite often severe, as hormonal changes occur abruptly rather than gradually over several years.

Cancer therapies such as chemotherapy and radiation can induce menopause, causing symptoms during or shortly after treatment. The halt to menstruation is not always permanent. If radiation is directed at the ovaries, this can also bring on menopausal symptoms.

Primary ovarian insufficiency happens in about 1% of women who experience menopause before the age of 40. Premature menopause may result from the failure of your ovaries to produce normal levels of reproductive hormones.

There isn’t one test that will determine that you are perimenopausal. Official menopause can be diagnosed when it is confirmed you have gone 12 months without a period.

Limited studies have been conducted in this area. A study led by the University of Michigan was undertaken to determine if genetic factors influenced women’s health and menopausal experience.  The study helped created a greater understanding of what genetic factors influence menopausal symptoms and how varying race and ethnicity have an impact.

It determined that Vasomotor symptoms (VMS), specifically hot flushes and night sweats, are influenced by genetic factors, and these genetic influences may differ across racial/ethnic groups.

Genetic factors associated with ages at menopause and first menstruation were also associated with VMS in some, but not all race/ethnic groups.

The takeaway – More studies are needed. Genetic Factors can influence your menopausal symptoms, but this varies depending on race/ethnic groups.

https://journals.lww.com/menopausejournal/Citation/2021/08000/Genetic_variants_predictive_of_reproductive_aging.8.aspx

Everyone will get different and varying menopausal symptoms. Lifestyle changes and medication can vary the severity and frequency of your symptoms. On average perimenopausal symptoms last around 4 years. As you go through official menopause and go into the post menopause phase symptoms will ease.

There are three phases of menopause.

1. Perimenopause
2. Menopause
3. Post Menopause

As you go into post menopause many of your menopausal symptoms will ease. The good news is that your memory will return as brain fog eases.

Early or premature menopause is menopause that occurs before the age of 40.

Early menopause can be induced by some medical treatments such as removal of the ovaries, or radiation and chemotherapy.

About 60% of women who experience early menopause don’t know the cause.

10-30% can be associated with autoimmune conditions such as hypothyroidism, Crohn’s disease, systemic lupus erythematosus or rheumatoid arthritis.

Genetic conditions make up 5-30%. Galactosamia, adrenal hyperplalsia, turners syndrome, Fragile X.

Many women who go through early menopause will experience a longer period of postmenopausal life.  Some of the health risk associated with premature or early menopause are the early onset of osteoporosis, and cardiovascular disease.

Many women who go through early menopause will be recommended to go on menopause hormone therapy (HRT) to help counteract the increased health risks of an extended post menopausal period.

During perimenopause your periods might become irregular, they can become heavier or lighter but you are still having periods.

Menopause is when you haven’t had a period for a full year.

In reality, whether you are in perimenopause or menopause, you will start to notice symptoms.

Perimenopause will start at different ages. Normally it’s sometime in your 40’s, commonly 40-44 but some women will notice changes as early as their mid-30’s.  It is marked my changes in your menstrual cycle.

Perimenopause is known as the transitional menopause period and it ends when you stop having your periods. Menopause is when you have not had a period for 12 months.

The average length of time women experience perimenopause is four years. In saying that some women many be perimenopausal for up to 10 years. As soon as you have gone 12 months without a period you are no longer perimenopausal.

Vasomotor symptoms is the medical terminology for what we commonly refer to as hot flushes or hot flashes and night sweats. They are the menopausal symptoms that most women will seek treatment for.

Hot flushes and night sweats occur due to a form of temperature dysfunction that occurs due to changes in the gonadal hormones. Normally your core body temperature (CBT) remains within a specific range, varying slightly with circadian rhythms.  Physiological processes that conserve and dissipate heat are responsible for maintaining CBT, and this tight regulation is what helps maintain optimal organ function.

Disruption of this tightly controlled temperature circuit results in exaggerated heat-loss responses and presents as VMS (Hot flushes and Night Sweats).

Declining oestrogen levels can impact the bodies’ ability to maintain temperature homeostasis. Currently hormone therapy is used as the primary treatment to help with hot flushes and night sweats.

https://pubmed.ncbi.nlm.nih.gov/18074100/#:~:text=Vasomotor%20symptoms%20(VMS)%2C%20commonly,to%20changes%20in%20gonadal%20hormones.

If you have been prone to hormone-related headaches and migraines prior to menopause then some women will experience more frequent and severe headaches during perimenopause. Some women find ones their periods stop and they go into official menopause their headaches and migraines improve.

A drop in oestrogen can trigger migraines and this can be why some women get headaches/migraines prior to their period.

Changes in hormone levels may influence neurotransmitters in the brain. The reduction in oestrogen can also lead to hot flushes, night sweats and disturbed sleep, which can then lead to anxiety and mood swings.

It’s really important to talk to your GP if you are feeling depressed as there are a variety of options both medical and natural to assist.

26-63% of women will experience sleep disturbance as part of menopause. As our oestrogen decreases it can bring on hot flushes and night sweats which can make getting a good nights sleep challenging.

The decrease in oestrogen also causes bladder problems and can lead to needing to get up throughout the night to go to the toilet. Joint aches and pains are also associated with lower oestrogen.

Tips to get a better night sleep:

• Create a sleep routine (ditch the devices and hour or two before bed and learn to wind down earlier).
• Exercise
• Eat a nutrient rich diet (avoid added sugars, too much caffeine and alcohol)
• Manage Stress

Check out our blog on: How much sleep do you really need?

Yes, unfortunately trouble concentrating and minor memory problems can be a normal part of menopause. Experts don’t actually understand why this happens and currently more research is being done to understand more about it.

What we do know is:

It’s real

It’s hormone related but interestingly women on HRT don’t seem to see an improvement in their memory.

Currently there is no medication that helps brain fog. Studies have shown that even women on HRT still experience Brain Fog.

The good news is that once you’ve gone through menopause your memory will return 😁.

Things that can help manage the brain fog are keeping lists and using a diary along with activities that stimulate your brain.

Vaginal atrophy is a condition in which the lining of the vagina becomes thinner and drier. This condition can lead to vaginal and urinary tract problems. Vaginal atrophy occurs due to the drop in estrogen.

Weight gain during perimenopause is often associated with a reduction in metabolism and changing hormones. The reason women notice more weight on their belly than previously is due to the changes in hormones.

As oestrogen and progesterone increase the male sex hormones play a bigger role. Previously you may have noticed more fat storage on your thighs and butt but now it’s moved to the belly which is what normally occus. The hormonal changes of menopause might make you more likely to gain weight around your abdomen than around your hips and thighs. Although much of the weight gain can be associated with ageing and a slowing metabolism along with lifestyle factors.

Oestrogen has a variety of forms with the strongest being estradiol. Other important, but less powerful oestrogens are estrone and estriol. Most of the oestrogens we have in our bodies are produced by the ovaries, but they can also be formed in other tissues, such as body fat, skin, and muscles.

Oestrogen is essential for the reproductive process.

It also helps regulate:

• The brain and neverous system
• The bones
• The liver
• The urinary tract

Progesterone, the other major female hormone, is necessary for preparing the uterine lining for the fertilized egg.

During official menopause the ovaries will stop the secretion of oestrogen and progesterone.

During perimenopause it is the reduction of oestrogen and progesterone and the constant fluctuations that cause menopausal symptoms.