Perimenopause

What is perimenopause?

Perimenopause is the stage of life leading up to your last menstrual period, which is known as menopause. During this stage you may experience some of the symptoms of menopause.

For most females, menopause will occur between 45 to 55 years of age.

Perimenopause lasts 4 to 6 years, on average. However, for some people it can last up to 10 years before menopause, and for others only a year.

Perimenopause ends 1 year after your last period. The next stage is known as postmenopause.

What happens during perimenopause?

Perimenopause takes place because most of the time, the ovaries don’t just stop working suddenly. They gradually slow down over time as they begin to run out of eggs. This affects the level of hormones in your body, such as oestrogen and progesterone. Changes in hormone levels can cause changes in your periods as well as other symptoms.

Some people don’t experience this gradual process because their ovaries stop working suddenly, for example because of surgery or cancer treatment.

What will happen to my periods during perimenopause?

A common feature of perimenopause is irregular periods. Your periods may come less often, or sometimes even more often. They may be longer or shorter than usual for you and your bleeding may be lighter or heavier than usual. Some months you might not get a period. It can change from month to month.

Even though changes in your periods are normal in perimenopause, you should see your doctor if:

• your bleeding is very heavy or continues for a long time
• you experience bleeding after not having your period for a year
• you have polycystic ovarian syndrome (PCOS)
• you are obese

What other symptoms will I experience?

Most females will experience symptoms of menopause, although 1 in 5 won’t have any symptoms at all. Around 1 in every 5 females will have symptoms severe enough to affect their daily activities.

Symptoms of perimenopause may include:

• hot flushes
• mood swings
• low libido (sex drive)
• headaches
• disturbed sleep
• sore breasts
• weight gain
• vaginal dryness
• tiredness and difficulty with concentration and memory
• itchy or dry skin
• sore muscles and joints

What can I do to relieve my symptoms?

You might find the symptoms ease if you:

• eat a healthy diet
• get some regular exercise
• get enough sleep
• quit smoking
• reduce stress where possible
• lose weight, if you are overweight

Hot flushes may be relieved by:

• cutting back on tea, coffee and other drinks with caffeine
• avoiding alcohol and spicy foods
• eating foods that contain phytoestrogens, such as tofu, whole grains, beans and lentils
• using fans or air conditioning
• cool drinks
• dressing in layers, so that you can take off some clothing when you feel hot

If you suffer from vaginal dryness, you can use lubricants for relief.

Are there any medicines I should take?

You can still become pregnant before you reach postmenopause. It’s important to use contraception during perimenopause if you don’t want to be pregnant.

There are several medicines that can relieve symptoms of perimenopause. Some contain hormones to replace your body’s natural hormones. Speak to your doctor to find out which option is most appropriate for you.

Can I take herbal medicines?

Many people take herbal medicines for symptoms of perimenopause. There is a large variation in the types and amounts of herbs in these products. Some of these products are effective but some are not.

It’s best to get advice from a health professional with training in herbal medicine use.

Do I need any tests?

Most people don’t need a test to check if they are in perimenopause. You are likely to be perimenopausal if your periods have stopped or become irregular and if you have symptoms of perimenopause.

A blood test can check the levels of two hormones, FSH and oestradiol. As you approach menopause, FSH levels rise and oestradiol levels drop. However, these hormone levels can vary a lot from day to day, so they are not a reliable test of perimenopause.

These tests are only used when the diagnosis is not clear, for example if you’re under age 45 and your periods have stopped.

Will I gain weight?

On average, females gain half a kilo per year between 45 and 55 years of age.

Menopause doesn’t cause weight gain, however it causes a change in where your body stores fat, which may start to build up around your waist. This can increase your risk of high blood pressure, heart disease, diabetes and other health conditions.

Healthy eating and exercise can lower your risk.