Ask any woman when she knew she was in the perimenopause and most will tell you they weren’t sure if that’s what it was at first. I, for one, wasn’t sure, got a prescription for HRT but never took it because I didn’t think I needed it. My periods were intermittent but I had no other symptoms that I knew of. Fast forward to a year later, and I was feeling quite low, and then I noticed I flushed hot especially when I was feeling a bit stressed. One day I was overcome by a hot sweat that was like fire raging through my body. Looking at myself in the mirror I realised there were beads of sweat all over my top lip and the hair at the nape of my neck was soaking wet. I remember saying out loud ‘That’s not normal.’
You see, the problem with the symptoms of the perimenopause is that initially they often feel a lot like ‘life overwhelm’. From anxiety, to panic attacks, to heart palpitations, the inability to focus, forgetfulness, brain fog, fatigue, sleeplessness and a terrifyingly short fuse that could blow up if someone leaves a cup out of the dishwasher - these are just a few of the symptoms which could also be an exaggerated version of the generally frazzled, modern midlife woman. The perimenopause (which is often described as the time in which you still have periods) can creep up on us, and as author Maisie Hill says in her book Perimenopause Power, “The ride changes. Subtly at first and then with full force.” Frustratingly there is no textbook description of when it kicks in because the experience is vastly different for us all and some lucky ones sail through it with no problems at all.
According to Dr Louise Newson menopause specialist and author of ‘The Definitive guide to the Perimenopause and Menopause’ ‘As a general rule, the perimenopause begins in the early to mid forties’”(although it can be earlier or later) whilst the average age of the menopause on the UK is 51. Hearing her speak at the launch of her book recently she said,
“Every cell in our body is affected by our changing hormones,” which is why the symptoms can range so dramatically.
The Red Flag
Some women never have a regular menstrual cycle in their life, but for those that do, a major perimenopause flag is when you start oscillating between shorter and longer cycles, if your periods become few and far between or the length of your period changes. This is because hormone levels start to fluctuate wildly and it’s not always a drop in oestrogen (as it is often believed) that’s the culprit. In fact Maisie Hills says that during perimenopause oestrogen levels can remain high whilst progesterone can drop which can cause all manner of symptoms from ‘Shorter cycles to heavy and longer periods, to period pain, pre-menstrual spotting, bloating, headaches and migraines as well as sleep problems, anxiety, depression, acne painful breasts, irritability and ‘ALL THE RAGE.’ Yes, the feeling that you might kill someone for breathing or chewing too loudly is very real.
Check in with yourself
Can we test for the perimenopause? Unfortunately not - oestrogen levels fluctuate from one day to the next, and cycle to cycle so this is not a reliable way of measuring where you’re at. The best way to tell if change is afoot is to keep an eye on yourself. Really check in. Has your period changed? Are you shouting at your partner because they turned over in bed? Are you waking in the night regularly, or do you have PMS type symptoms more often than you used to? Are you feeling abnormally low or anxious? And of course, do you have the dreaded hot sweats? Many people think hot sweats are the biggest indicator of the perimenopause but according to Maisie Hill, these don’t normally kick in until your oestrogen levels start to really drop as you get closer to the menopause. This is a time, says Maisie, “Where you can go from feeling calm and focussed one day then waking up a teary hot mess the next."
Track your cycle
According to Maisie Hill, perimenopausal symptoms – where you still have a cycle - last on average for four years, but they can be as long as 10-15 years. One of her biggest tips is ‘Cycle tracking’ which she believes will give you the greatest understanding of where you are at (you can download a free guide from her website, see below). ’Cycle irregularities along the lines of no period for two months and then two in the space of one month are common during perimenopause.’ The aim of the Cycle Strategy as she calls it is not to just track when your period is due but whether they are shorter, heavier or lighter, how your mood fluctuates throughout the month as well as your energy and behaviour. ‘If you’re always rushing, knackered or barking at anyone who requests something of you, then you need this because it will change your life.’
Be selfish with selfcare
Whether you are suffering from all of the above symptoms or just one, now is the time to really up the selfcare. As Dr Louise Newson said about her own management of the perimenopause, “I got selfish about looking after myself.” Whether you decide to take HRT or not (that is another blog post in itself), many perimenopausal symptoms can be alleviated a bit by focussing on wellness basics. Firstly make sure you are getting enough sleep - scrolling on your phone until 2 am is not going to do your hormone addled brain any good whatsoever. Secondly, make sure you are eating enough fresh food - just as putting the wrong fuel in the car will make it conk out, the wrong food in your system will make you feel ill. This means cutting back on sugar, and processed foods and upping the fruit and veg. Finally, it’s vital you move daily - getting the blood moving around your body is essential for pumping the blood and oxygen to your organs and your brain. Plus it’s vital we do strength bearing exercise to support our muscles which start to wane during menopausal years.
The perimenopause reflects life... Just as we never know what’s around the corner, you won’t quite know what the perimenopause will throw at you, or whether you will sail through it without hitting a storm. At the end of the day the only person who will know what’s happening is you, so check in and take charge.