Perimenopause – the life-phase nobody tells you about.
There are lots of words beginning with ‘p’ when it comes to the amazing things women’s bodies go through - periods, puberty, pregnancies. Most of us have heard of all these and have a fairly good idea of what they mean.
But there’s another important ‘p-word’ when it comes to women’s unique biology that hasn’t had so much attention… Perimenopause.
So what is it?
Firstly, it’s not the same thing as menopause.
Menopause is your last ever period. It’s when you stop being fertile and you can’t get pregnant anymore. Your ovaries are two magic little glands snuggled down in your pelvis that make eggs and hormones (estrogen, progesterone and testosterone). They are what causes your womb to bleed (have a period) every month. Eventually, your ovaries retire (this is menopause). They stop making eggs and hormones and so your periods also stop. This usually happens around the age of 51. But your last period can occur anytime between the age of 45-55, and we still consider that ok.
But before your ovaries officially retire - they hand-in their notice. And this ‘notice-period’ varies hugely between different women. It can be two years long - or ten years long! When a person hands their notice in for their job- they usually start slacking off - and it’s the same with our ovaries.
This notice-period is called perimenopause. So it’s the phase that comes before menopause. It’s a bit like puberty in reverse - our ovaries are slowing down instead of starting up. It can sometimes begin in your mid to late 30’s; although for most women it starts in their 40s.
So in perimenopause, the ovaries haven’t stopped working completely yet; but they are winding down and starting to struggle. They don’t always pop out an egg every month (ovulate). And they don’t always make enough hormones to tell the womb to bleed (menstruate/have a period). Or sometimes, they wake-up again suddenly and pump out too many hormones.. So, strange things can start happening to your periods in perimenopause. They might get a lot heavier. Or longer. Or the complete opposite can happen and they get lighter and shorter. The timing can go to pot too - so you might get less periods with long gaps between them. Or you might get extra periods and have two in a month instead of just one.
So Perimenopause can be messy.
It can also be sneaky. Because for some women, their periods don’t change at all. Still regular, still the same flow. So no clues that anything is changing.
But having normal periods doesn’t mean a woman can’t be in Perimenopause. The ovaries may still be managing to make enough hormones to tell your womb to bleed. But that doesn’t mean they are making enough for all their other jobs.
Because your ovaries are multitaskers. They don’t just make periods and pregnancies happen. They are very busy bossy glands!
The hormones they produce go everywhere in our body and brain. They talk to our bones, muscles, nerve cells, skin, immune system, blood vessels - even our eyelids have receptors for these hormones on them. This is why there are so many possible symptoms when our hormone levels start to fluctuate and change. Women can get fatigue, anxiety, insomnia, itchy skin, dry eyes, palpitations, dizziness, loss of sex drive, hot flushes, muscle and joint aches, vaginal dryness… to name but a few! And sometimes these symptoms can be really severe and women worry they have some horrible disease - or that they are losing their minds.
But just like we don’t all have exactly the same periods or pregnancies - we don’t all have the same perimenopause either. Some women breeze through the whole phase and barely notice a thing. We are all different.
We are all unique.
So whatever your version of perimenopause looks like - the important thing is to know it’s coming - and be ready for it. Track your cycles so you can spot subtle changes. Look after your body with good food, plenty of exercise, decent sleep and good stress-relief. This will all help you enter this phase of your life fit and ready for it ❤
And if you end up with a messy, sneaky or stressful perimenopause package - you don’t need to suffer in silence. Talk about it. Read about it. Seek help/support from your doctor if you need to. Because this life-phase may throw you off balance - but you’ll soon find your feet again, so you (and your ovaries) can enjoy a long and happy retirement.
Words by Dr. Linda Dear