Perimenopause affects the majority of women – but although awareness is slowly increasing around the effects of menopause and meaningful ways to help manage and reduce symptoms, few people have an understanding of a lesser-known stage of the transitional period that precedes it.

What is perimenopause?

Perimenopause means ‘around menopause’ – the term used to describe the transitional period between a woman’s fertile years and menopause. It’s often misunderstood or overlooked, but this phase can last for between two and four years, and brings with it many of the symptoms we know and characterize as menopausal.

The onset of perimenopause differs for individual women and depends on a variety of factors. Most women begin to experience signs and symptoms in their 40s, but some begin to see changes as early as their mid-30s.

Symptoms of perimenopause

Changes in estrogen levels give rise to a collection of symptoms which may be mild or more intense depending on your individual health and the stage of perimenopause you are experiencing.

Everyone’s experience of perimenopause is unique. Women tend to have different symptoms in varying severities – some will experience all, others won’t experience any, with many varying in intensity in between. Symptoms may be subtle or severe, or barely noticeable.

Some of the most commonly reported symptoms of perimenopause include:

*Irregular periods: As ovulation slows, periods may become less frequent. You may skip one or more periods at once. If there is a persistent change of more than 7 days in the length of your cycle, you are likely in the early stages of perimenopause.

*Mood swings: Irritability, anxiety and depression are not uncommon during perimenopause. Much like symptoms of PMS, mood changes can be unpredictable with no external cause.

*Hot flashes: Hot flashes are one of the most unpleasant symptoms of perimenopause and menopause. Intensity, length and frequency may vary, but often hot flashes occur at night, disrupting sleep.

*Sleep disturbance: Sleep quality can reduce during perimenopause, as it becomes harder to fall asleep and stay asleep throughout the night. Symptoms such as hot flashes can further impact upon sleep.

*Vaginal/bladder issues: Lower estrogen levels can lead to loss of elasticity and lubrication in vaginal tissues, causing pain and discomfort. Decrease muscle tone can also contribute to urinary incontinence.

*Sexual dysfunction: Lowering or loss of libido is common during perimenopause, affecting desire and sexual arousal.

You may experience the onset of several symptoms all together, or a gradual increase. If you are experiencing any of the above symptoms and suspect you may be starting perimenopause, speak to your MD for a diagnosis. Early intervention and support are often key to make this transitional phase smoother and more comfortable.

How will I know when menopause has started?

Many women who believe they are experiencing menopause may actually be in the perimenopausal phase. Being able to identify perimenopause and put treatment plans in place to help you navigate this period is essential, not only to ensuring that you can help yourself to feel better right now, but also to help manage symptoms of the menopause at a later stage.

Specialists say that after 12 months without a period perimenopause ends, and a woman has officially reached menopause.

Holistic support during perimenopause

Although perimenopause is a normal and natural transitional period in every woman’s life, you shouldn’t have to suffer with severe symptoms without support. Clinical approaches (such as Hormone Replacement Therapy) are available and are

well-suited to some women, however if you’re looking for a more holistic approach, there are several methods that can collectively help to ease symptoms alongside or instead of pharmaceutical support.

*Herbal helpers

A selection of healing herbs have been used for thousands of years to support women as they go through perimenopause. Although medical studies are still preliminary, initial findings and anecdotal evidence demonstrate that many of these herbs are highly effective in reducing perimenopause symptoms. These include maca, red clover, dong quai and evening primrose.

*Stay active

It’s common during perimenopause to gain weight, especially excess body fat around the middle. This is due to a variety of factors, including lifestyle, age and fluctuating hormones.

But maintaining a healthy weight can help to mitigate the severity of menopausal symptoms – so as well as eating healthily (more on this below), staying as active as possible is key. Activities to try include resistance or weights training, cardio and HIIT, all of which can help to manage weight and support better hormone balance. In studies, women who lost 10% of their body weight over a year were more likely to experience fewer hot flashes and night sweats, or eliminate them entirely.

*Healthy diet

Eating plenty of fruits and vegetables is key during perimenopause, to ensure your vitamin and nutrient levels are high. Focusing on foods rich in vitamin D and calcium can also help with loss of bone density, whilst increasing consumption of phytoestrogens (found in soy, flaxseeds and sesame seeds) has also been shown to help balance hormone levels, as well as upping your intake of lean protein and drinking plenty of water.

There are a few things to limit though – avoiding trigger foods such as coffee, alcohol and sugary or spicy foods can reduce the incidence of hot flashes, as well as reducing processed and refined foods high in sugars and fats.

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