What is the perimenopause?

Most people know what the menopause is. We can (just about) recall that biology lesson from many years ago, when the teacher briefly mentioned how a woman’s periods end in her 50s, drawing her reproductive years to a close. And that was it. Apparently. 

Fast forward to our 40s and still having periods, women can be hit by an unexpected myriad of symptoms, ranging from mood swings and insomnia to memory loss and aching joints, and are left wondering what on earth is happening. Rarely are women aware of the cause of these symptoms, or that they are connected, and so begins a journey of discussions with friends, snatched lunchtime Google searches and often fruitless GP visits. 

When women say they are going through the menopause, what they are actually referring to is the perimenopause period – “peri” being Latin for “before”. As the body prepares for the menopause, levels of progesterone and oestrogen begin to fluctuate and the previously regular pattern of hormone peaks and troughs of a woman’s cycle become erratic and more extreme before they eventually reduce to an almost flatline in postmenopause. If puberty is the steep climb towards the top of the hormone rollercoaster track, then the perimenopause is the long, downward slope with a multitude of turns, twists and hairpin bends. The menopause is when the carriage comes to an abrupt halt! 

Most women enter their perimenopause in their early 40s and this will often last about 10 years before they reach their menopause – defined as twelve months with no periods. During this decade, women can experience a multitude of different symptoms caused by their progesterone levels gradually decreasing (although not in a linear fashion) and this then causes the effect of oestrogen levels to rise and fall more dramatically. I often think of these two hormones like shampoo and conditioner – they are both necessary, complementing the effect of one another but they do very different jobs. After decades of relatively steady hormone levels, the interplay between these two hormones can begin to cause difficult and overwhelming symptoms for many women. There is usually little correlation between previous hormonal patterns and perimenopause symptoms and although some women do sail through this time, the majority of women will experience symptoms at some stage. 

HRT can be very effective in balancing the fluctuations of these hormones by delivering regular doses of oestrogen, progesterone and sometimes testosterone. There are many different forms and combinations which you can discuss with your doctor but it certainly isn’t a magic bullet in helping to control all the effects of this period of transition. The perimenopause can affect other hormones in our body, such as serotonin, which affect our mood and ability to remember things. We can also experience changes in our requirements for certain nutrients such as iron and our ability to absorb these minerals can reduce. Weight gain is a common concern for perimenopausal women as our hormones affect where we store body fat. 

So whilst I would love to say to my clients “do this and that and you’ll be feeling much better by next week”, it’s just not that simple. Each woman is unique and her hormone journey is too. There are many things that women can do to support their health and wellbeing during this time, with or without HRT. Please get in touch if you’d like more information on how Verto Nutrition can help you. 

Summary:

The perimenopause usually starts in a woman’s early 40s and last around 10 years. It is a period of transition as progesterone levels move from a steady pattern and begin to fluctuate strongly altering the effect of oestrogen.  

The menopause is defined as 12 months with no periods and the average age of a woman to experience this is 51 years. Hormone concentrations drop to a low but continuous level . 

The postmenopausal period begins after that time, when the body produces minimal oestrogen and progesterone going forward.