Symptoms of perimenopause – the precursor to menopause – can appear up to 15 years in advance. For World Perimenopause Day, London GP Dr. Deyo Famuboni describes ten perimenopause symptoms to look out for
You have lived your life in line with your monthly routine with no apparent changes in your body in the past five to ten years. Then suddenly your period comes and your first thought is, “Am I pregnant?”
You know this is very unlikely because you have an effective contraceptive. You’re doing a pregnancy test and it’s negative. Your period will eventually show up. So what’s up?
Lifestyle intervention can help significantly with perimenopause
You may be in perimenopause, the natural transition period women go through before menopause. This is a natural step in a woman’s body to permanent infertility.
The average age for menopause in the UK is around 52 years, but perimenopause can start at different ages and most women notice changes sometimes in their early 40s and occasionally in their mid 30s.
This is due to changes in female hormones, mainly estrogen, that rise and fall unevenly.
In general, perimenopause shouldn’t be a cause for concern. Lifestyle intervention can help significantly with perimenopausal symptoms.
This includes regular exercise and a diet high in phytoestrogens. These are natural plant-based estrogens found in foods like soybeans, dark leafy greens, and cruciferous vegetables like broccoli.
However, if it affects your quality of life and wellbeing, see your doctor. Other tests may be done depending on your symptoms. Various medical therapies, including hormone replacement and non-hormonal options, are available by prescription.
10 signs you may be in perimenopause
# 1 Irregular periods
The hormonal changes affect your ovaries, which release an egg, and this, in turn, can make your period longer, shorter, or miss for a few months. These could be signs of early or late perimenopause.
Missing periods of three months or more, and very heavy periods, especially if accompanied by feelings of tiredness or shortness of breath, will need to be checked by your doctor, especially if you are under 40 years of age.
# 2 hot flashes
Suddenly hot and sweaty? This is common during perimenopause and can vary in duration and intensity during the day and night – this often contributes to insomnia and sleep disorders.
This happens due to the hormonal fluctuations and it can be different for every woman. It can take anywhere from two to 15 years.
Wearing breathable clothing, such as cotton, and staying hydrated can help alleviate symptoms.
Avoiding other causes of hot flashes such as obesity, alcohol, excess caffeine, spicy foods, monosodium glutamate (a spice common in processed foods), and some medications can also help relieve symptoms.
# 3 mood disorders
This can often occur with mood swings, irritability, agitation, or fear. A change in your usual temperament can be a sign of perimenopause as your hormones skyrocket and drop. A lack of good quality sleep can also contribute.
Regular exercise and a healthy diet to make sure your blood sugar levels stay stable can help.
# 4 Vaginal dryness
The hormonal changes cause the vaginal wall to reduce its fluid production and also its elasticity. Some women generally find it uncomfortable, others only notice it during sexual intercourse.
The time it takes to get aroused also increases with age. Using vaginal lubricants can alleviate this.
# 5 Urinary disorders
In general, our anatomy makes women prone to urinary infections. This can happen for the first time during perimenopause or an increase in frequency. You may notice urinary frequency and pain.
This warrants a review by a doctor. A decreased ability to hold urine can also occur. This is because the elasticity and tone decrease.
Ways to prevent this from happening include urinating after intercourse, using lubricants, and doing regular pelvic floor exercises.
# 6 Loss of libido
There are various causes for this and the mood swings, lack of sleep and shortened arousal times can certainly contribute to it. However, many women have no problem with this.
# 7 Problems conceiving
Ovulation decreases and this leads to fertility problems. It can take up to a year for you to conceive naturally. However, if you are in your late 30s or early 40s and are struggling to get pregnant, it pays to see a doctor earlier.
Contraception up to 12 months after your last period is advisable if you do not want to become pregnant.
# 8 General pain
When estrogen decreases, the body cannot replace bones as efficiently. Ligaments and cartilage are also affected. Research also suggests that the hormonal changes are linked to the development of osteoarthritis.
Pain can also be a sign that your bones are becoming thin due to osteoporosis. Getting enough calcium and vitamin D, as well as exercise to strengthen your bones and muscles, can help prevent this from happening.
Several studies have looked at the use of Glucosamine for pain and although individual women have reported improvement in their symptoms, the evidence for its use is limited.
# 9 weight changes
Several factors contribute to this. These include slowdowns in our metabolism and our ability to build muscle, as well as increased stress from lack of sleep and worries about other signs mentioned above.
Stress can add weight as increased levels of the stress hormone cortisol can lead to mid-weight gain. Therefore, an improvement in the underlying cause is needed.
Regular exercise and a healthy diet, with special attention to the nutrient-to-calorie ratio, can help prevent weight gain. This is because you burn fewer calories as you get older.
Sudden weight gain warrants a visit to the doctor.
# 10 chest pain
When the level of estrogen drops, the levels of cholesterol and sugar in the body rise. The heart and blood vessels also become stiffer. This puts you at risk of heart disease as it contributes to the blockage of blood vessels.
Discomfort on the left side in the chest, especially when exerting, urgently requires medical attention.
Dr. Deyo Famuboni is a London based family doctor with over 10 years of medical experience.
After graduating from the University of Edinburgh, she trained in a variety of medical specialties, including obstetrics and gynecology.
She has worked abroad for some time as well as in the NHS and the private sector in the UK.
She is a member and clinical advisor to the Royal College of General Practitioners and a diplomat for the Royal College of Obstetrics and Gynecology, the Royal College of Pediatricians, and the Faculty of Sexual and Reproductive Health.
She also has a keen interest in nutrition and health, and blogs at Doctordeyo.com
Follow Dr. Deyo on Instagram.
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