Perimenopause is the period before menopause. It typically lasts on average of 4 years but can be sometimes twice as long. It can start in your late 30’s but more often later in life. It reflects the transition from the normal ovulation cycle to the last. The function of the ovaries becomes erratic, ovulation is less frequent and oestrogen and progesterone levels fall. Often perimenopause begins with dropping progesterone levels and ends with gradual oestrogen cessation.

Women  experience a range of symptoms due to these hormonal fluctuations. This rollercoaster gives women combinations of different symptoms as the body and brain deals with these hormonal changes. It is estimated that 8 out of 10 women will experience symptoms but only 2 out of 10 will seek medical advice.

The typical symptoms experienced due to fluctuating or falling hormone levels are:

  • hot flushes
  • night sweats
  • mood swings
  • depression, anxiety, stress
  • low energy
  • more frequent migraines or headaches
  • feels clumsy
  • started to have join pains
  • muscle stiffness
  • tearful
  • flat mood
  • reduced self esteem
  • sleep disturbance
  • lack of concentration
  • palpitations
  • dry eyes
  • urinary symptoms
  • vaginal dryness
  • reduced libido
  • bone thinning
  • hair and skin changes (lines, dryness, itching)

Although Hormone Replacement Therapy (HRT) is the most effective treatment it is also important to address life style. Some women are not able to take HRT due to a history of breast cancer or stroke and may prefer alternative routes.

Studies have shown that women with a lower BMI (Body mass index) have less vasomotor symptoms so it is paramount to keep body weight at an ideal level. This is helped by reducing consumption of animal fat, oils, refined grains, sweetened beverages and ultra processed food should be encouraged. It’s best to focus on diets rich in fibre, with rainbow colours of fruit and vegetable, whole grains and soya.

Lifestyle intervention also helps. This includes sleeping well, regular exercise (yoga, walking ,swimming), meditation, appropriate hydration, avoidance of caffeine, alcohol and smoking. Other things to consider are layered clothing, drinking a relaxing chamomile tea or taking short afternoon naps. Also, don’t forget about leisure time. Spend time on doing things you enjoy. Meeting a friend for coffee or pursuing a new hobby is time well invested in improving well being.

Mainstream HRT or Bio Identical Hormones  or Herbal Medicine are always discussed during consultation and individual symptoms and requests are taken into account in order to formulate an individualised management plan.