Am I in Perimenopause? The Low Down on Symptoms
It's a question we get asked a lot:
Am I In Perimenopause?
There's a lot of talk about menopause but not much about perimenopause (peri). Peri is the lead up to menopause when the ovaries start to wind down. Menopause is a point in time marked by a year without a period.
It can really vary in length for women, anything from 2-12 years and on average is between 4-6 years. The average age to reach menopause is 51 years of age.
It’s generally considered you have reached menopause when you haven’t had a menstrual cycle for 12 months and your Follicle-Stimulating Hormone (FSH) blood level is elevated to 30 mIU/mL or higher.
There is no hormone/blood test to tell you are in peri as your hormone levels can vary so much day to day. Most women notice when they start to have irregular cycles and start to question what is going on. It happens to most women in their 40s. There are 4 different stages within the perimenopause transition see the diagram below.
The Four Phases of Perimenopause
Early Perimenopause Symptoms
In the very early stages you can start to feel a shift beginning to happen. Things just feel different as hormones start to fluctuate, your cycle can still be regular or it could be shortened to 21-26 days. Professor Jerilynn Prior says that a midlife woman with a regular cycle with three of the nine symptoms below is likely to be in peri:
- New-onset heavy and/or longer flow
- Shorter menstrual cycle (25 days or less)
- New sore, swollen or lumpy breasts
- New mid-sleep waking
- Increased menstrual cramps
- Onset of night sweats, in particular premenstrually
- New or markedly increased migraine headaches
- New or increased premenstrual mood swings
- Weight gain without changes in exercise or eating.
It’s important to remember that in the different stages of peri with the winding down of the ovaries the hormone levels are different too.
In the beginning there is low progesterone paired with high fluctuating oestrogen and as you start to reach menopause you start to have low oestrogen levels. So symptoms will change along with the hormonal changes. Some months you will ovulate and some you won’t. So you might experience symptoms one cycle and not the next.
It can be a rollercoaster ride and so different to your fertile years of familiar monthly cycle.
Common Perimenopause Symptoms
Below is a list of common perimenopausal symptoms. You may experience one or several of the following:
- Hot flushes
- Night sweats
- Irregular periods
- Problems with falling asleep, staying asleep and sleep quality
- Breast tenderness
- Itchy/crawly/dry skin
- Trouble concentrating
- Vaginal dryness
- Loss of libido
- More intense PMS
- Mood changes - anxiety, depression, rage
Weight gain, despite no changes to diet or exercise, due to the metabolism slowing down or insulin resistance.
Approximately 25% of women who experience natural menopause will have severe symptoms. The other 75% are likely to have mild or possibly no symptoms.
Whilst some of these symptoms can impact on the quality of your life, it can really help to remember that perimenopause is temporary. You will emerge on the other side.
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NOTE: If/when you have suspicions that you might be in perimenopause, it would be a great time to have a full medical with a qualified healthcare professional to help diagnose that you are in perimenopause by reviewing your medical history, menstrual history, and your symptoms. Also to make sure that it is perimenopause and not any underlying health conditions.