Just like puberty, menopause (and perimenopause) is an experience that will affect every woman with ovaries if they live long enough, so if you fall into that category (and even if you don’t!), it’s worth arming yourself with some facts on what to expect.
Historically, menopause has been a subject shrouded in mystery, confusion and, worst of all, silence. But with around 13 million women currently going through it in the UK, it’s something we should definitely be talking about.
What is perimenopause
First thing’s first: what actually is perimenopause? Many medical practitioners define the transition into menopause as occurring once you’ve experienced 12 continuous months without a period. So think of perimenopause as the runway to that phase. It can last up to 10 years, so it can be a pretty long runway for some people.
“While the average age that women experience menopause is 51, many experience symptoms years before that, from their early 40s, as oestrogen levels fluctuate and decline and ovaries start to slow down,” says Dr Katie Armstrong, menopause specialist and founder of Clinic51. “This variable start point means that it can be hard to make the link between how you are feeling and perimenopause.”
Be on the lookout for the symptoms
No two women will have the same perimenopause, and knowing what to look out for could save you a lot of worry when symptoms do appear.
“One of the biggest misconceptions is that you’ll know when you’re approaching menopause because you’ll get one of the famous ‘hot flushes’,” says Katie. “In reality, symptoms are incredibly wide-ranging.”
Be aware you might experience anxiety, brain fog, altered sense of smell, sleep issues, brittle nails, itchy skin, headaches, tinnitus, difficulty breathing, fatigue, mood swings, dry eyes, aches and pains, erratic periods, loss of libido, sore or dry vulva and/or vagina, oral health issues, dizziness and palpitations.
Because the symptoms are many and varied, they can catch women unawares, often resulting in multiple, fruitless trips to the GP. If you’re in your 40s and 50s, any of these symptoms should alert you to a possible transition into perimenopause or menopause.
A note of caution from Katie: “Beware of getting your information from social media! There is some great advice out there, and some not so great. Try to be critical of your source. I’ve listed some good resources in the ‘menopause library’ section at Clini51.”
Prioritise a health check
The food we eat, the quality of our sleep, our exercise and emotional health are all fundamental to living a good life. As people transition through perimenopause and into menopause, their needs in these areas are likely to change. And because they are all so closely interlinked, this is the moment to take a holistic approach and ensure your routines are supporting you across the board.
“It’s the time for a mini health audit,” says Emma Bardwell, one of the UK’s leading menopause nutritionists. “We need to feel strong and resilient now and well into the future, which means making sure our markers are all optimal. I get my clients to test their iron, folate, thyroid, cholesterol and vitamin D and B12, as well as HbA1c (which measures glucose levels). Then we work on getting them to be the best they can be.”
A diet that supports strong bones and muscles, as well as your body’s anti-inflammatory response and gut health, is essential. Focus on plant-based foods high in fibre, calcium and protein, and include oily fish and fermented foods. For more on tweaking your diet, read our journal articles Finding Strength in Menopause and 5 Tips for Good Gut Health.
It won’t surprise you to hear that fluctuating levels of oestrogen, progesterone and testosterone in perimenopause will impact your metabolism, strength and energy levels too. For tips on maintaining your movement, read 3 Ways Menopause Impacts Your Workouts.
Know that help is out there
You might think you have to keep your head down and simply tough out this phase of life. But, just like puberty, it’s a transition that could go on for several years with shifts and changes within that time, so seek support and help when you need it.
Even if you don’t need the professional help of a GP, specialist or nutritionist, it’s a time to lean on your own self-care routine as well as your network.
“For many, the change that their body goes through gives them the incentive they need to focus on their health, after what might have been years of looking after others,” says Katie. “One of the biggest boosts is spending time with supportive family and friends who know what you’re going through – this is definitely a good time to foster that community.”
Emma adds: “If no one close to you seems to understand what’s happening, there are lots of online forums, menopause cafes and support networks out there. Find ways to offload, vent and have a laugh.”