10 questions answered on perimenopause
Unsure on what “perimenopause” is? You’re not alone. We’ve scoured the internet and answered 10 commonly asked questions about the perimenopause. From what it means and when it can happen to how you might feel. Here’s everything you need to know about perimenopause…
1. What does perimenopausal mean?
Word nerds, this one's for you, “peri” comes from the Greek word meaning “about” so it literally means “around your menopause”. The perimenopause is the period of time before menopause during which your body begins to transition to menopause.
A time of transition, your levels of oestrogen and progesterone, the hormones that regulate the menstrual cycle, begin to fluctuate, which leads to changes in menstrual periods and can cause hot flashes, sleep disturbances, and other symptoms. Ultimately, this is your body preparing to enter menopause and is a natural progression in your reproductive cycle.
2. What does perimenopause feel like?
Much like its vague “around your menopause” meaning, perimenopause symptoms can vary greatly from person to person and can range from mild to severe. Just like with your period, there’s no such thing as normal when it comes to the perimenopause, but here’s some of the most common perimenopause symptoms:
- Irregular periods: As your ovaries begin to produce less oestrogen and progesterone, your menstrual cycle becomes less regular, with periods becoming shorter or longer, heavier or lighter, or more or less frequent.
- Hot flashes: You may experience sudden feelings of intense heat, often accompanied by sweating and a rapid heartbeat.
- Sleep disturbances: Many experience difficulty falling asleep or staying asleep during perimenopause.
- Mood swings: Fluctuations in hormone levels can cause mood swings, including irritability, anxiety, and depression.
- Vaginal dryness: As oestrogen levels decrease, the vaginal walls may become thinner and less lubricated, causing dryness, itching, and discomfort during sex.
- Headaches: Due to the fluctuation of hormones, some people may experience headaches or migraines during perimenopause.
- Fatigue: As the body adapts to the hormonal changes, some people may feel more tired than usual.
Remember: this isn’t an exhaustive list of symptoms, not everyone will experience all of them and the severity can vary greatly from person to person. Symptoms can also be caused by other factors such as stress, diet, exercise or sleep habits.
3. Will perimenopause symptoms go away?
Perimenopause symptoms will typically go away but only once you reach menopause, which marks the permanent end of menstrual periods and fertility. However, the duration and severity of symptoms can vary greatly from person to person, and some people may continue to experience symptoms for several years after menopause.
During perimenopause, the symptoms can be more fluctuating and less consistent, while during menopause they tend to be more constant and persistent. After menopause, the symptoms such as hot flashes, night sweats, vaginal dryness and sleep disturbances tend to decrease or disappear completely, but some people may continue to experience other symptoms such as mood swings, headaches and fatigue.
4. What age does perimenopause start?
Everyone will experience perimenopause at different ages but it tends to start 8-10 years before you reach menopause. The age at which perimenopause starts can vary greatly from person to person, depending on factors such as genetics and overall health. Some people may begin to experience perimenopausal symptoms in their late 20s or early 30s, while others may not experience them until their late 40s.
5. How long does perimenopause last?
Due to the gradual nature of perimenopause, there’s no definitive number for how long you’ll be perimenopausal for, especially as we all experience different symptoms at different levels of severity. On average, the perimenopause lasts between 4-8 years.
6. Does perimenopause start suddenly?
Perimenopause is a gradual process and usually does not start suddenly. Your ovaries produce less oestrogen & progesterone gradually and your menstrual cycle will become less ‘regular’ over time, this process can take several years.
Some people start experiencing perimenopausal symptoms early on, with symptoms such as irregular periods or hot flashes, whilst others don’t experience any symptoms until much later into their perimenopausal period. Some may notice a gradual onset of symptoms over several months or years and others may experience a more sudden onset. Your perimenopause experience will be just as unique as you.
7. What are the last stages of perimenopause?
During the last stages of perimenopause, your body may start to show that this transition is ending. As with the rest of the perimenopause, symptoms may increase in severity and frequency or others may begin to become less intense. Here’s some signs that the perimenopause is ending:
- The time in between periods will increase until they stop altogether. If you’re noticing there’s around 60 days or more between periods, you’re probably approaching the end of your perimenopause.
- Fewer and farther between headaches or migraines. Now your fluctuating hormones are starting to settle down, you should find any headaches begin to ease.
- More hot flashes. As oestrogen plays a role in body temperature control, the lowered hormone levels can cause your brain thermostat to malfunction.
- Struggling to sleep. A well known menopause symptom, you may find it tough to get a good night’s sleep.
- Feeling in a better mood. Although your hormones will be low, they’ll be more consistent allowing your mood to improve as there’s no wild hormonal fluctuation to deal with.
8. What’s not “normal” during perimenopause?
You know we believe there’s no such thing as “normal” when it comes to our menstrual health, but it’s good to keep an eye out for things which may require a medical evaluation:
- Heavy or prolonged bleeding: During perimenopause, it's normal for periods to become shorter or longer, heavier or lighter, or more or less frequent. However, if you experience heavy or prolonged bleeding, or if you're experiencing bleeding between periods, it's important to see a doctor or gynaecologist as it may be a sign of a more serious condition such as fibroids, endometriosis, or cancer.
- Severe pain or cramping: Some people may experience mild to moderate cramping or pain during perimenopause, but if the pain is severe or debilitating, get it checked out.
- Bladder or bowel problems: In some cases, perimenopause can cause urinary tract or bowel problems, such as incontinence, frequent urination, or diarrhoea. If you experience these symptoms, it's important to see a doctor as it may be a sign of a more serious condition such as an infection or a growth.
- Severe depression or anxiety: Perimenopause can cause mood swings, but if you experience severe depression or anxiety that interferes with your daily life, it's important to see your healthcare professional as it may be a sign of a more serious condition.
- Persistent and severe headaches: Some people may experience headaches or migraines during perimenopause, but if the headaches are severe, persistent, or accompanied by other symptoms such as vision changes, it's important to get it checked out.
- Unusual lumps or bumps: If you notice any unusual lumps or bumps on your body, it's important to see your healthcare professional as it may be a sign of a more serious condition such as cancer.
Remember that it's always important to consult with your doctor or gynaecologist if you have any concerns about your symptoms during perimenopause or if you spot anything that’s out of the ordinary for you.
9. Is there a test for perimenopause?
There is no definitive test for perimenopause, but there are several tests and diagnostic tools that healthcare professionals can use to help determine if a person is experiencing perimenopause. These include:
- Follicle-stimulating hormone (FSH) test: This test measures the level of FSH in the blood. FSH is a hormone that stimulates the ovaries to produce eggs. As the ovaries begin to produce less oestrogen and progesterone during perimenopause, the body produces more FSH in an attempt to stimulate the ovaries to produce more hormones. Elevated levels of FSH can be an indicator of perimenopause.
- Estradiol test: This test measures the level of estradiol, a form of oestrogen, in the blood. During perimenopause, the ovaries produce less estradiol, and levels of estradiol in the blood decline.
- Luteinizing hormone (LH) test: This test measures the level of LH in the blood. LH is a hormone that regulates the menstrual cycle. During perimenopause, the level of LH in the blood increases.
- Thyroid-stimulating hormone (TSH) test: This test measures the level of TSH in the blood. TSH is a hormone that regulates the thyroid. During perimenopause, the level of TSH in the blood can increase or decrease, which can cause symptoms such as weight changes, fatigue, and mood swings.
- Pelvic exam: A pelvic exam can be performed to check the size and shape of the ovaries, uterus, and cervix. During perimenopause, the ovaries may become smaller and less firm to the touch.
It's important to note that these tests are not diagnostic of perimenopause but rather give an indication of the hormonal changes that occur during perimenopause. The diagnosis of perimenopause is typically made based on a combination of symptoms and test results, as well as your menstrual history. It's always important to consult with your doctor or gynaecologist if you have any concerns about your symptoms during perimenopause.
10. Can I become pregnant during perimenopause?
It is possible to get pregnant during perimenopause, although it becomes less likely as you approach menopause. Perimenopause marks the transition period before menopause, and during this time, your menstrual cycle becomes less regular and as the ovaries produce fewer eggs, the chances of becoming pregnant decrease.
However, it is important to remember that ovulation can still occur during perimenopause, and pregnancy can occur as long as you’re still having menstrual periods. If you’re not looking to conceive, it’s important to use contraception during perimenopause.
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