There are three main stages when it comes to hormone changes. Perimenopause, menopause and post menopause. There are certain symptoms which tend to be more typical for each particular phase and some symptoms which can be present in all three.
In this article, we’ll look at the average age to expect perimenopause, signs of perimenopause, one of the most telling signs perimenopause is ending and the transition into menopausal symptoms. Let’s get straight into it.
What is perimenopause?
Perimenopause is the period that leads up to menopause. Perimenopause can be a time of wildly fluctuating hormones.
A woman technically still ovulating and has periods although they become less regular. She is still able to have a baby, though it will be much harder than when her hormones had a regular monthly ebb and flow. A follicle stimulating hormone test can help to determine when a woman is in perimenopause but is not necessary.
Why does perimenopause start?
Perimenopause starts because a woman's body coming to the end of it's reproductive years. The ovaries oestrogen production starts to decline and releasing eggs is no longer a guaranteed monthly occurrence.
When does perimenopause start?
For most women, perimenopause starts in a woman's 40's ( the average age is 46) and typically lasts about six years until menopause around the age of 52. Menopause before the age of 40 is called Premature Menopause or Premature Ovarian Insufficiency. 1% of women experience this. Early perimenopause means a woman's hormone levels unstable in her 30's.
Perimenopause affect on physical and mental health
Early perimenopausal symptoms can vary from woman to woman due to fluctuating hormone levels. Common symptoms of lower progesterone and oestrogen levels include irregular menstrual cycles, hot flashes, night sweats, debilitating headaches ( menstrual migraines), weight gain, vaginal dryness, mood swings and mood changes. Hormonal fluctuations can also make getting a good night's sleep more difficult. Memory lapses and fatigue are also common.
Irregular periods are one of the giveaway signs perimenopause is ending.
Irregular periods and coping with heavy bleeding
Irregular periods includes heavier and prolonged menstrual cycles, lighter periods, late periods, spotting and missed periods.
According to the NHS, a menstrual flow is classed as heavy if you need to change a tampon every one to two hours, if it lasts for more than a week, or if it interferes with your daily life. A light period is one in which you lose less than 30ml of blood.
If you’re struggling with heavy periods, your doctor may be able to prescribe tranexamic acid – a medicine that helps your blood to clot. Prescription anti-inflammatories and anti-inflammatory painkillers such as mefenamic acid and naproxen can also help. The Mirena coil is often prescribed to manage heavy bleeding for women in perimenopause.
Late Perimenopause Symptoms
As a woman gets nearer to menopause symptoms can change. Thanks to more stable oestrogen levels symptoms like headaches and mood swings tend to improve as menopause approaches. Other symptoms can become more severe.
Hot flashes and night sweats
Common late perimenopause symptoms for some women are an increase in hot flashes and night sweats. The good news is that not all perimenopause symptoms get worse with time. In fact, some symptoms, like headaches and mood swings, tend to improve as menopause approaches. This is all thanks to lower, but more stable oestrogen levels.
More painful periods can start
The painful periods perimenopause can bring with it are due to prostaglandins. Prostaglandins are lipids with hormone-like properties and are made by can increase the chances of cramps, and make them worse. The uterus releases more of this hormone as perimenopause progresses. So, you might notice more painful periods, particularly in the latter stages of perimenopause as you get closer to menopause.
When does perimenopause end?
What are the signs perimenopause is ending? As perimenopause draws to a close menstrual periods can become more spaced. It's common not to bleed for two months then bleed. Another sign perimenopause is ending is the mergence of other symptoms.
Menopause officially begins when you have not had a menstrual period, or any spotting, for a full 12 months. The last period in perimenopause tend to be difficult to recognise due to irregularity of periods. The exact month you reach menopause can be a little hit and miss! sometimes your medical history can give you a good indication on what to expect.
The menopause transition
Women enter menopause in their 50's. The average age is 52. The menopausal transition is when hormonal fluctuations in perimenopause give way to a more steady decline. You no longer have a menstrual cycle. Early menopause is when your last menstrual period is before the age of 45.
Common Menopause Symptoms
Women who have entered menopause may continue to experience frequent hot flashes and night sweats due to the hypothalamus ( your brain thermostat) getting lower estrogen levels . Low sexual desire, vaginal atrophy, increased anxiety, memory and concentration lapses and disrupted sleep are still common challenges.
Late menopause symptoms
As menopause continues a woman is likely to experience more physical symptoms such as much drier skin, thinning hair, frequent urinary tract infections, weaker bones and vaginal dryness. The slow decline of hormones mean women tend to have a more stable mood.
Health risks associated with menopause
Women lose some of the protection of oestrogen when they have reached menopause because they have less of it. Oestrogen helps to manage cholesterol levels has a protective relationship with blood vessels and arteries keeping them flexible and free from fatty plaque.
- Weight gain affects around 50% of menopausal women. Being overweight is one of the risk factors associated with heart disease, type 2 diabetes and stroke.
- Cholesterol levels can increase after menopause which means the risk of a heart attack or stroke increases
- Blood pressure can increase - which can increase your risk of cardiovascular disease
- Bones can become weaker - 50% of women over the age of 50 will break a bone due to osteoporosis.
There is significant evidence Hormone Replacement Therapy reduces your risk of cardiovascular disease and osteoporosis.
A healthy lifestyle can help to manage symptoms
Diet and exercise are really powerful allies who it comes to how you fare in the menopause years. Regular exercise can help to control weight, strengthen bones, manage stress levels and support sleep.
Both weight bearing exercises and aerobic exercises are recommended for women over 40. Weight bearing exercises will help to counteract the loss of muscle mass associated with age which can contribute to a slower metabolism.
Aerobic exercise like brisk walking and swimming will help your heart to work harder and keep it healthier. A strong heart is much more efficient at pumping blood and oxygen around your body. The NHS recommends we do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week.
Nutrition and diet can help your body to adapt better to your lower hormonal status by increasing vitamins and minerals to support energy, protein to help to build muscle, burn calories and control weight. Adaptogens and herbal remedies can support your brain while cutting back on alcohol and coffee can help to keep hot flashes and anxiety symptoms to a minimum.
The Bottom Line
A change in your menstrual cycle is one of the signs perimenopause is ending. Heavy, painful, or irregular periods are common before entering menopause. Some symptoms like hot flashes, anxiety, sleep disruption and brain fog can persist throughout perimenopause and menopause tho mood changes tend to become more stable.
HRT, diet and exercise can all have significant benefits when it comes to managing the symptoms and health risks associated perimenopause and menopause.
FAQ
Can perimenopause cause painful periods?
In the perimenopause phase hormone levels fluctuate and can also surge. If Oestrogen levels rise, the uterus releases more prostaglandin, which can increase cramping and make pain worse.
What are perimenopause periods like?
It’s common for your periods to change during perimenopause. Some women find their cycle gets shorter, while for others it increases by a few days. Some women experience much heavier periods and clotting or find their periods are lighter than usual with a less intense flow. You might even skip periods altogether, particularly towards the end of perimenopause.
