Perimenopause can be a really confusing time for women. For a lot of us we don’t even know we are in it. Fifteen years ago, when I first heard the term, I had no idea what it even meant! I had some idea of menopause, but what on earth was perimenopause?

It’s not surprising to find that the term ‘perimenopause’ is quite a recent phenomen. It’s only been used in the last 20 years or so although my research hasn’t revealed exactly when the term came into use.

What does it mean?

Perimenopause means ‘around’ menopause. It comes from the Greek word ‘peri’ meaning around or near, and then ‘menopause’ which comes from the Greek words of ‘mens’ for month and ‘paussis’ for cessation. So perimenopause is the time around your periods ceasing.

How long does it last?

The average time frame for perimenopause is around 4 years but it differs for every woman. It can be as short as 1 year or over 10 years. It very much depends on each individual woman.

When does it start?

Perimenopause can start 7-10 years before you tranisition through menopause and although it’s not proven yet, there does appear to be some indication that if you started your period early (say 11 years old) you may well go through menopause earlier - potentially in your mid 40’s for instance.

Menopause usually occurs somewhere between the ages of 40-58, with the average age for menopause (which is identified as being 12 months without having a period) being 51.4. If you think of a Bell curve, there will be the majority of people quite close to that range on either side, and then some outliers right at the edges.

So, if you were an early starter, you may hit menopause in your mid forties which means you could begin experiencing symptoms as early as your late thirties or early forties.

It can come as quite a shock for women to realise this. We are simply not ready to face this fact at that age!

So how do I know if I’m in perimenopause?

The first signs of being in perimenopause are any of the following:

• irregular periods

• missed periods

• changes in periods - i.e. they can become very heavy (flooding) or become quite light

• hot flushes begin occurring

• night sweats may appear (basically a hot flush at night)

• body odour may become stronger

• head hair may begin falling out

• you suddenly have dry eyes

There are many other signs of perimenopause but these are the main ones that tend to indicate changes are starting to occur within.

A note on exercise

Whilst exercise is really good for us and should continue throughout our life, over exercising whilst in perimenopause isn’t great. If you are doing a lot of intense exercise and your periods have stopped, you may not be in menopause but could be experiencing amenorrhea.

The National Institutes of Health defines Amenorrhea as:

“the absence of menstruation during the reproductive years of a woman's life”

Amenorrhea can be caused by excessive exercise, extreme weight loss, emotional stress or some reproductive disorders. Balancing out these factors can mean that your periods will resume and continue on their normal course, which is really important. Although you might be pleased you don’t have to bother with periods due to amenorrhea, it’s actually not good and can lead to infertility, osteoporosis and cardiovascular disease.

But I don’t want to be in perimenopause! What can I do about it?

Perimenopause and menopause is a completely natural and normal transition. I see it as an important developmental process for women to ready us for the next phase of our lives (see my blog for more on this).

It is not a medical problem to be cured and it’s not the beginning of the end either! It’s simply the marker point of a change in our role in life.

There is a lot we can do to manage the transition, some of which I talk about below. We do sometimes need medical support, usually in the form of HRT, which can be life changing. Each woman needs to manage their transition in a way that works best for them and their circumstances and symptoms. There is no “one size fits all” in the perimenopause journey - we are all different and unique.

Focus on sleep

Everything is harder to deal with when you haven’t had enough sleep. One of the big symptoms for women going through perimenopause is disrupted sleep. Whether that’s unable to get to sleep, unable to stay asleep, or waking way to early, it affects us in the same way.

Ensure that you are exposed to daylight during that day (especially in the morning), so that your circadian rhythm is reset property. Daylight through glass doesn’t count, I’m afraid. So if you go from home, to the car, to the office, back to the car and back home, you haven’t had enough daylight pass through your retina to reset your circadian rhythm. You need to be outside, preferably without sunglasses on for a short period of time, in order to get the benefits of daylight.

And at the other end of the day, make sure you have a wind down routine that tells your body it’s night time. Low lights, quiet or gentle activity, no screens, and a cool dark room all help your body to know it’s night time and to get ready for sleep.

Review your lifestyle

The second thing you can do is to review your lifestyle and see what changes you can make. A lot of menopause symptoms are exacerbated by stress, alcohol, smoking and our fast paced lives.

Reducing your stress can go a long way to reducing your perimenopause symptoms. And the sooner you get on to this the easier your menopause transition will be. Waiting until you are in the thick of it and then trying to reduce your stress won’t be as effective as taking proactive steps now, but it will definitely help at whatever point you reduce the stressors in your life!

Alcohol and smoking are scientifically proven to increase hot flushes and night sweats, so if you are suffering from those (or don’t want to suffer from them) it’s worth making changes to your intake of these now. Swapping to organic wine can help reduce hot flushes as it is lower in sugar content and chemicals, making it easier for your liver to process.

One last thing

The final thing you can do is to change your narrative around the menopause transition. Just like puberty, it is a normal and natural phase that every single woman will go through. Puberty is when our hormones kick in, menopause is when they drop out. In many cultures women are respected and admired as they move through the transition into their wise women and elder years. They are looked up to and revered.

It only seems to be Western society that has cloaked it in shame and tried to pretend the transition doesn’t exist. We have such a focus on young woman, our wonderful wise women have been somewhat ignored.

There are a number of studies that have shown that a negative view of menopause affects the severity of symptoms we experience.

Accepting and looking forward to our wise woman years, as well as making lifestyle changes, will help you to come to terms with this transition with more ease and grace than fighting it every step of the way.

Happy transitioning!

Kàren