How to know if you’re starting menopause
Have you felt your body’s natural routine changing? Are you noticing your periods becoming irregular, any bloating, mood swings or hot flushes? You may be experiencing symptoms of perimenopause. Here's our guide on how to recognise the early signs of menopause and how to manage your symptoms.
What is perimenopause?
Perimenopause, menopause, and post-menopause are stages in a woman’s life that reflect the natural decline of ovarian function, where oestrogen production decreases and ovulation stops. This affects the hormones of the menstrual cycle resulting in monthly periods coming to an end and bringing about other associated changes, signalling the end of a woman’s fertility.
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Perimenopause is the first stage of this process, referred to as the ‘menopause transition’. It is a delicate transitional period that usually begins 4-10 years before menopause when the ovaries gradually produce less oestrogen, progesterone and testosterone, and lasts until menopause, the point when the ovaries stop releasing eggs and when a woman has gone without a menstrual period for 12 consecutive months.
During perimenopause, it is normal for many women to experience menopause symptoms and there may also be changes to the menstrual cycle including heavier or lighter periods, and increasing episodes of skipped or missed periods.
Despite the reduction in oestrogen levels, it is still possible to become pregnant during the perimenopause.
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When does perimenopause start and end?
Women can experience perimenopause at different ages. As it is a gradual change in hormones, some women notice signs of transition to menopause in their 40’s while others notice changes in their mid-30’s.
The length of each stage of the perimenopause can vary for each individual.
While the average length of perimenopause is between 3-4 years, some women may only be in this stage for a few months, but it can extend as long as 10 years for others.
Changes in oestrogen levels in perimenopause
During a woman’s fertile life stage, the body produces oestrogen, progesterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
As you approach perimenopause, the ovary’s output of oestrogen, FSH and progesterone fluctuates and leads to a gradual reduction of these hormones. These hormonal changes and declining ovarian function often cause changes to the menstrual cycle and a range of perimenopausal symptoms such as bloating, breast tenderness, hot flushes, night sweats and issues with mood, memory, and concentration.
How do you know you're starting perimenopause?
8 out of 10 women will experience an array of symptoms as they transition to menopause.
Each woman experiences perimenopause differently, while some have few or no symptoms, others will suffer from debilitating symptoms. As hormones shift during the years leading up to menopause, the frequency, intensity, combination, and duration of symptoms vary widely from one to another.
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5 signs and symptoms of perimenopause
If you’ve found yourself asking ‘how do you know if you have started perimenopause?’, here we share signs and symptoms to look out for.
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1. Changes in your menstrual cycle
The early transition of perimenopause is defined by almost regular periods and occasionally skipped cycles; as ovulation becomes more unpredictable, cycles can become more irregular with periods becoming lighter or heavier, and the length of time between periods might be longer or shorter.
There can be phases of skipped or missed cycles that can last over 60 days and then your cycle could run like clockwork once again. This menstrual irregularity lasts until reaching menopause.
2. Worsening of premenstrual syndrome (PMS) symptoms & mood changes
PMS often occurs 1-2 weeks before menstruation and symptoms usually ease after a period arrives. PMS symptoms will vary between individuals and include mood swings, anxiety, irritability, breast tenderness, and bloating.
Some women are more likely to experience heavier PMS symptoms during perimenopause due to the body’s enhanced sensitivity to hormone fluctuation and irregular ovulation. PMS symptoms affect 20% of women during menopause. For women who haven’t had PMS before, they may find the mood changes and physical symptoms difficult to adjust to. You may enjoy our article ‘5 foods to improve your mood’.
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What vitamins support PMS symptoms?
Vitamin E and essential fatty acids have been shown to reduce PMS symptoms including breast tenderness and low mood.
Recommended foods: Almonds, peanuts and sunflower seeds as well as plant oils such as sunflower, soya and olive oil.
Essential fatty acid food sources include omega-3 fatty acids (oily fish such as salmon, mackerel, and sardines), linolenic acid and oleic acid.
If you suffer from PMS, read our blog ‘Nutrition for PMS symptoms’.
3. Hot flushes and night sweats
Hot flushes are one of the most common symptoms of perimenopause. affecting 75% of women going through menopause. Hot flushes are characterised by feelings of intense heat spreading through your chest, face and neck, accompanied by sweating, rapid heartbeat and a flushed appearance. Learn more in our blog: 12 most common symptoms of menopause.
How to stop hot flushes and night sweats
Reducing intake of caffeine, alcohol and spicy food, and regular physical activity has been shown to help manage and reduce the intensity of hot flushes. These stimulants can also aggravate PMS symptoms and interfere with sleep.
Plant oestrogens (phytoestrogens), which are naturally occurring plant compounds that act similarly to human oestrogen, have been shown in studies to relieve perimenopausal symptoms, particularly hot flushes. Foods containing plant oestrogens include linseeds, flaxseeds, oats, chickpeas, and soy-based foods such as tofu, tempeh, miso and edamame.
4. Fatigue, poor sleep and emotional changes
Melatonin, the hormone which regulates sleeping patterns, can be impacted as a result of perimenopausal changes, leading to sleep disturbances and increased fatigue. Fatigue, poor sleep and mood swings affect more than three quarters of women during menopause - learn more here.
Oestrogen and progesterone are powerful hormones that affect all tissues in the body, including the brain. The shifts in hormone levels during perimenopause may lead to mood swings or not sleeping well, causing a variety of emotional changes including lack of motivation, difficulty concentrating, loss of energy and insomnia which can lead to anxiety and depression. Learn more in our research: 'More than 1 in 3 people suffer poor sleep.'
Managing emotional changes during perimenopause can be difficult, but it is possible through diet, nutrients, exercise and breathing. Magnesium is known to reduce anxiety, tiredness and fatigue and supports a healthy nervous system for physical and mental function. You may also be interested in 'Vitamins help to improve sleep' or 'How do I know if I'm deficient in Magnesium.'
5. Weight gain
Fluctuating hormones in perimenopause and the natural ageing process can disrupt your metabolism and impact lean body mass, resulting in women often losing muscle and gaining fat during this phase.
These hormonal changes, along with lifestyle factors may increase the risk of weight gain, particularly around the abdomen area, which has been linked with worsening hot flushes and night sweats.
Tips to help manage weight
Staying active in ways you enjoy such as walking, swimming, cycling and running, and including weight-bearing and muscle-strengthening exercises into your routine may help reduce weight gain, and it is associated with fewer perimenopausal symptoms.
Remember, you can also be more active during your daily routine: try taking the stairs; parking further away from your destination and walking; gardening; or even dancing! Read our nutritionists advice on how to Manage your weight in a healthy way.
How to manage perimenopausal symptoms
A combination of a healthy diet, regular physical activity, and managing stress is associated with fewer perimenopausal symptoms. Limiting consumption of processed foods and drinks, alcohol intake, refined sugars and unhealthy fats is encouraged.
Following a Mediterranean diet may also offset symptoms and has shown to contribute to a healthy heart during perimenopause. Learn more here: Nutrition recommendations for easing menopause symptoms.
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