Menopause and Perimenopause

Menopause marks the end of a woman's menstrual cycles and is diagnosed after going 12 months without a menstrual period. It typically occurs in women in their 40s or 50s, with the average age being 51. 

Perimenopause, often called the menopause transition, is the period during which a woman's body makes the natural transition to menopause, marking the end of the reproductive years. This stage can begin several years before menopause and is characterised by various symptoms due to hormonal changes.

Symptoms of menopause and perimenopause

Common

1. Irregular periods: The length of the menstrual cycle can shorten or lengthen, and you may begin to skip periods.
2. Hot flushes: Sudden feelings of warmth that can occur anywhere in the body but are commonly felt in the face, neck, and chest.
3. Night sweats: Severe hot flashes that happen during sleep, leading to sweating and potentially disrupting sleep.
4. Mood changes: Mood swings, irritability, or increased risk of anxiety and depression.
5. Sleep problems: Trouble falling or staying asleep, often due to night sweats or other discomforts.
6. Vaginal dryness: Decreased oestrogen levels can lead to dry and less elastic vaginal tissues, causing discomfort during intercourse.

Less common

1. Breast tenderness: Pain or tenderness in the breasts, similar to symptoms experienced during the menstrual cycle.
2. Worsening of premenstrual symptoms: More intense symptoms right before your periods, such as bloating, irritability, and mood swings.
3. Decreased libido: A reduction in sexual desire.
4. Urinary problems: Increased frequency of urination or urgency, and a higher risk of urinary tract infections.
5. Thinning hair: Hair may begin to thin and be more prone to breaking.

Managing menopause and perimenopause symptoms

Every woman’s experience of menopause is different and it's important that you talk to a healthcare provider to create a treatment plan that is right for you.

Lifestyle changes:

• Healthy diet: Eating a balanced diet rich in calcium and Vitamin D can support bone health.
• Regular exercise: Physical activity can help manage weight, improve mood, and maintain bone strength.
• Quitting smoking
• Stress management: Taking time for rest and relaxation. Practices like mindfulness, meditation, and other relaxation techniques can help manage mood and anxiety.

Medical treatments:

• Hormone therapy: Menopausal hormone therapy (MHT) is the use of hormone therapy (tablets, patches or cream) to replace the oestrogen that your ovaries no longer make during and after menopause. It can help relieve some of the symptoms of menopause such as hot flashes and vaginal dryness. Different types of MHT have different risks. Your healthcare provider will be able to discuss your individual risk in more detail.
• Vaginal oestrogen: Helps relieve vaginal dryness and urinary symptoms.
• Non-hormonal medications: Some low-dose antidepressants can help manage night sweats and hot flushes. Options like Gabapentin and Clonidine can also help manage symptoms.

When to seek medical advice:

• If symptoms are severely impacting your daily life or causing significant discomfort, it's essential to consult a healthcare provider for appropriate interventions and management.

Conclusion

Perimenopause and subsequent menopause is a transitional phase that can bring various physical and emotional changes. Understanding these symptoms and the available management options can help ease the transition and improve the quality of life. For further information and personalised advice, it's advisable to consult with a healthcare professional.

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