Perimenopause is a natural phase that marks the transition from a woman’s reproductive years to menopause and post- menopause. While it typically begins in a woman’s late 30s or early 40s, the onset can vary widely. During this phase hormonal fluctuations occur and although menstruation continues, the menstrual cycle may become irregular.
How Long Does Perimenopause Last?
On average, this transitional phase lasts around four years, but the experience varies greatly among individuals.
While the focus of this blog is primarily on perimenopause, it’s essential to discuss the concept of menopause to provide a comprehensive understanding of the female reproductive journey.
What Is Menopause?
Menopause is officially declared when a woman goes without a period for 12 consecutive months, marking the end of reproductive capacity. The ovaries cease egg production and oestrogen, progesterone, and testosterone levels significantly decline. In the UK, this typically occurs around 51 or earlier. In a strict biological sense this phase only lasts for one day.
What Hormones Are Involved During Perimenopause?
Hormones play a crucial role in perimenopause, acting as chemical messengers that direct bodily functions. Several key hormones are involved in this phase, including Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH), Gonadotropin-Releasing Hormone (GnRH), progesterone and oestrogen, each fulfilling distinct roles.
FSH and LH collaborate to control the menstrual cycle and stimulate egg development in the ovaries. As perimenopause progresses oestrogen levels decline, leading to increased FSH and LH levels as the body strives to balance hormonal imbalances. GnRH, produced by the hypothalamus, triggers the pituitary gland to release FSH and LH, thereby regulating these hormones during perimenopause.
Progesterone prepares the uterine lining for potential pregnancy, but its levels decrease during perimenopause, affecting the menstrual cycle and reproductive function.
Oestrogen, primarily produced in the ovaries, regulates various bodily functions such as puberty, menstrual cycles, and bone health. Although oestrogen levels are initially high relative to progesterone in early perimenopause, they decline as perimenopause progresses.
What Are The First Symptoms Of Perimenopause?
Perimenopause symptoms can vary among women, but some common initial signs include:
Night Sweats Around Your Period
Experiencing night sweats specifically around or during the time of menstruation.
Variations In Menstrual Cycle Length And Flow
Unpredictability in the length and flow of the menstrual cycle, ranging from shorter to longer durations and lighter to heavier flows.
Other Classic Signs And Symptoms May Include:
Hot Flushes
Sudden feelings of heat, sweating, and flushing lasting from a few seconds to several minutes.
Mood Swings
Hormonal changes leading to fluctuations in mood, from irritability and sadness to sudden bursts of anger.
Anxiety
Heightened feelings of anxiety without a clear cause.
Brain Fog
Difficulty concentrating, memory lapses, and a general feeling of mental fuzziness.
Skin Changes
Dryness, itchiness, and increased photosensitivity.
Hair Loss
Thinning and loss of hair due to declining oestrogen and progesterone levels.
Metabolic Changes
Influences on carbohydrate metabolism potentially leading to insulin resistance and weight gain, especially around the abdominal area.
How To Manage Perimenopause Symptoms Naturally
If you suspect you’re experiencing perimenopause, journaling symptoms can be immensely beneficial for tracking changes, identifying patterns, and effectively managing this transitional phase. Here’s how to do it effectively:
When documenting symptoms, provide detailed descriptions including type, intensity, duration and any triggers or alleviating factors associated with each symptom. For instance, if experiencing hot flushes, note their frequency, duration, and any factors like stress or certain foods influencing their occurrence.
In addition to tracking symptoms, eat a healthy diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit caffeine and alcohol. Engage in regular physical activity and practice stress-reducing techniques like meditation. Prioritise quality sleep and consider taking supplements like vitamin D3, omega-3 fatty acids and magnesium.
Stay Informed
Staying informed about women’s health issues is crucial for empowering yourself with knowledge about your body and health needs. Keep up to date with recommended screenings, treatments, and lifestyle choices that promote overall wellness. By staying informed, you can take proactive steps to prioritise your health.
While navigating this transition may feel daunting, it’s crucial to remember that you’re not alone and there is a way forward. By embracing a holistic approach to managing perimenopausal symptoms, including prioritising self-care, adopting a balanced diet, and exploring specific functional tests that can help identify the root cause behind your symptoms, you can empower yourself to thrive during this transformative journey.
Reference:
Santoro L (2016). Perimenopause: From Research to Practice. Journal of women’s health
Delamater L.& Santoro N (2018). Management of Perimenopause. Clinic obstet gynecol.
Ilankoon, I. M. P. S., Samarasinghe, K., & Elgán, C. (2021). Menopause is a natural stage of aging: a qualitative study. BMC Women’s Health.
Hao, S., Tan, S., Li, J., Li, W., Li, J., Cai, X., & Hong, Z. (2021). Dietary and Exercise Interventions for Perimenopausal Women: A Health Status Impact Study
The National Institutes of Health (NIH) Office of Dietary Supplements. (2024). Magnesium Fact Sheet for Health Professionals
The National Institutes of Health (NIH) Office of Dietary Supplements. Omega-3 Fatty Acids Fact Sheet for Health Professionals.