Perimenopause - What Every Woman Needs To Know
Perimenopause demystified
Ever heard the phrase, “you don’t know what you don’t know”? That, for me, sums up perimenopause. If you’re reading this, you feel like you’re battling with a body that’s no longer yielding to your will, and you’re anywhere within a 10-year radius of menopause, you might just be dealing with the mind f%%k of symptoms that are part and parcel of perimenopause.
Take me, for example. After finally learning how to harness my hormones in my 30s, I was trucking along, feeling triumphant and secure in the knowledge that by the time I hit the age of menopause, I’d have it all figured out and escape the worst of it.
I admit, I had to question that when, a couple of years ago, I started experiencing some unusual symptoms. Subtle enough for me not to catch it – I mean, who would ever think that itchy ears (I’m talking the itchiest ears) would turn out to be a symptom of perimenopause? Who knew!?
Honestly, I had just put it down to the COVID vaccines until Dr Carrie Jones started talking about itchy ears this year and explained the whole mechanism of action behind it and hormonal changes in perimenopause!
Next up came the anxiety – it took a hold over my mind last summer. I thought I was just unhinged by the heat of Thailand, taking a month off work, and the lack of structure to my days, but this was different. I felt on edge for some part of every day, and it didn’t feel good.
By the time we got back home and old familiar routines were reinstated, the anxiety lifted... right about the time my cycle started to change.
Now, one thing I could always count on was a 28-day cycle – but my perfect record changed from one day to the next. First I skipped a cycle (I was neither stressed nor pregnant), the next one came shy of 28 days, and the next one went 34 days long.
And just as I got my cycle back on track (regular and predictable), I started to react to foods, products, door handles, and got an unrelenting outbreak of eczema on my hands. It took months of exploration and effort to get a handle on it – nearly 9 months’ worth! I brought in the big guns in the end because I couldn’t see the wood for the trees anymore… and I should never have tried to.
Things are calm right now. I’m doubling down on what I need to do to keep things that way, and that’s as much as I can do with the knowledge and awareness I have right now.
If you’re not sure what to expect, the truth is nothing is off the table when your hormones are whack! That’s why I wanted to share my experience and what I’ve learned personally and through my work with women as a holistic hormone health practitioner.
If you’re still with me, let’s talk perimenopause.
What is perimenopause?
Perimenopause is the transitional phase before menopause, where a woman’s reproductive hormones (oestradiol and progesterone) fluctuate as the ovaries begin to slow down. This has a systemic, body-wide effect – where no body system is off-limits – setting the stage for a range of symptoms that might leave you wondering, “What in the name of God is going on with my body?”
Here’s the kicker – this phase can start as early as your late 30s and can last anywhere from 2 to 10 years. It ends with menopause – officially diagnosed when you've gone 12 consecutive months without a period.
The key hormonal changes that typically characterise perimenopause are:
Oestrogen levels fluctuating dramatically - usually staying higher for longer periods of time before decreasing
Decreased progesterone levels, shortened luteal phase, and more frequent anovulatory cycles (where ovulation doesn’t happen)
Messed up hormonal feedback loops
In early perimenopause, oestrogen is increasing while progesterone is decreasing
In late perimenopause, both oestrogen and progesterone are low
But what do these hormonal changes actually look like to most women?
Signs and symptoms of perimenopause
Common signs and symptoms include, but are not limited to:
Unpredictable periods (more frequent, heavier, or cycles that are further apart)
Hot flushes
Mood swings (feeling mad, bad, or sad)
PMS, skin breakouts, or rashes
Cyclical headaches or migraines
Brain fog and memory issues
Daytime fatigue
Anxiety, panic attacks, or depression
Changes in libido
Sleep disruptions and night sweats
Itchy, restless legs (especially at night)
Joint and muscle pain
Higher blood fats (cholesterol, blood fats…)
Thinning hair
Tinnitus
Bladder issues (urinary incontinence)
Haemorrhoids or varicose veins
It’s no wonder women often say they feel like Dr Jekyll and Mr Hyde in their own body, given the long list of possible symptoms.
As the most common symptoms are hot flushes, sleep disturbances, mood swings, and changes in libido, let’s take a closer look at them.
Hot Flashes
Around 80% of women in *early* perimenopause will experience hot flushes.
Although a hot flush only lasts up to 5 minutes, it can happen at any time, day or night (hello, night sweats!) – they couldn’t give a damn whether you’re in a meeting, on a dinner date, or attending a school concert - how inconvenient!
The unpredictability can be nerve-wracking. If you start experiencing them, wear loose, layered clothing; plunge your face into a basin of ice-cold water; sit by an open window, consider herbs (get proper advice from a trained provider), breathe, and trust that it will pass!
Changes in Sleep Patterns
As if we women don’t have enough to handle with the perimenopause, most of us can’t even get a good night’s sleep either.
With such dramatic changes going on inside our bodies, it’s not hugely suprising - but is hugely frustrating! Most women in perimenopause report difficulty falling asleep, staying asleep, and waking much earlier than usual.
Lack of sleep compounds the hormonal changes going on inside, making everything feel even more challenging than it already feels.
Double down on good sleep hygiene practices: ditch the screens before bed, practise relaxation techniques, take a walk, plan out your next day, sleep in a dark room, and try a few drops of White Chestnut (a Bach Flower Remedy) if circulating thoughts prevent you from drifting off.
Mood Swings
Ah, mood swings.
Most of us have felt that irrational rage, irritability and sadness that signals a period is just around the corner… but in perimenopause, it can feel 10 times worse than usual.
As oestrogen levels fluctuate between abnormal highs and lows and progesterone levels start to plummet, unpredictable hormones during perimenopause can also affect neurotransmitters like serotonin, dopamine, and oxytocin driving symptoms like anxiety and depression.
If you're feeling unusually emotional, anxious, or depressed, you don’t need to go it alone. Speak to your healthcare provider about free and available resources and support.
Sex Drive & Fertility Problems
During the later stages of perimenopause, sexual arousal and desire may change. Low oestrogen (and testosterone) can cause libido to quite literally tank overnight, vaginal dryness sets in and sex can become more painful and less enjoyable.
Losing your libido can feel difficult to wrap your head around, but lower libido, vaginal dryness and fertility issues are all common occurrences during perimenopause - and you’re not to blame!
If you’re trying to conceive, perimenopause may make it more challenging - but not impossible. As cycles and ovulation become less predictable, you might find it more difficult to predict your fertility levels throughout the month but pregnancy is still possible and can be supported with the right combination of complementary therapies.
When to seek help…
Our healthcare system is designed to diagnose and treat acute problems, which explains why so many women feel unsupported medically or fobbed off by antidepressants or sleeping pills for perimenopausal symptoms when they reach out for help from their Dr.
The interplay between your hormones and body deserves exploration. You deserve a broader understanding of what’s happening with your body.
What if you’re not actually going crazy?
What if you don’t need the pills after all?
What if it’s just your hormones?
If you want to explore your perimenopausal health from a root-cause perspective or holistic support for your symptoms, check out my services page and feel free to book a call if you want to discuss your options further. Together, we’ll figure out the best plan to ease your symptoms and help you feel more like yourself again.
