Many of you might have thought you were too young for perimenopause. Though you might by now be starting to recognize some symptoms. Let’s clarify what perimenopause is, and explain about it being the most symptomatic phase of menopause. You are actually only menopausal for one day! Once you have experienced 12 continuous months of no bleeding and you then go into your postmenopausal years. Perimenopause is the lead-up to menopause and could be the start of some uncomfortable symptoms like brain fog or hot flushing.

There are many symptoms
Every woman experiences their own unique menopausal journey, with over 34 different symptoms of menopause that women can potentially suffer from. There are several different ways that your body can start to show the first signs of menopause. This is all down to declining hormones, in particular estrogen. Though textbooks may tell you there are 34, there are indeed many more which some women may not recognize as typical menopause symptoms. For example; itchy crawly skin, vision changes (perhaps requiring glasses), or feeling terrified of driving at night!

Don’t bury your head in the sand
Many women unfortunately still associate the word menopause with little grey-haired ladies. This couldn’t be further from the truth. As a result, they tend to ignore many of the first signs of the perimenopause that are going on, not wanting to think that they might actually be at that stage of their lives.

At what age can you start seeing the first signs of menopause?
The average age of menopause is 51 years, but from experience, many women’s estrogen levels will start to decline in their early to mid-forties, with the first signs of menopause symptoms becoming more pronounced around the age of 51. To be honest it is such an individual health issue that trying to put a specific date on it is nigh on impossible. At either end of the spectrum, there is a percentage of women who experience early menopause called premature ovarian insufficiency (POI) or premature menopause. A percentage of women have a relatively late menopause, so after the age of 56 yrs and then there are women who are plunged into quite an intense menopause following surgery or after chemotherapy or radiotherapy.

It is very important if you are showing signs of premature menopause to go and see your GP. If there are no contraindications to you taking hormone replacement therapy (HRT) it is advisable for it to be prescribed, it helps enormously with all your symptoms and helps to prevent long-term symptoms developing by protecting bone and cardiovascular health. POI is more common than people realize – an excellent website for prematurely menopausal women is the Daisy Network. A small number of women, around 1:10,000 women are under 20. And don’t be surprised that for those under 30 the ratio is around 1:1,000. Then you will see about 1:100 women are under 40.

Common first signs of menopause
The most common first signs of menopause have to be hot flushes and or night sweats. Three out of four women will experience them at some point and for many, it is a continuous battle with heat and cold. Some women just experience a faint glow, whereas others look like they’ve just walked off a squash court! They are incredibly annoying, embarrassing, and debilitating. Some women find their hot flushes/flashes are completely random, others find they are triggered by certain drinks, food, or situations. The most common culprits are caffeine and alcohol, particularly red wine. We know, all the good things in life! Then there’s spicy food or for some, it’s just having a hot drink or moving into a hot environment. Ironing can even bring them on, (marvelous excuse to get someone else to do it!), or for some, it’s being in a stressful situation.

The best ways to tackle your hot flushes

• You must make sure you stay well hydrated and eat a healthy balanced diet, take a look at all the bright colors on your plate (if you don’t have any and its all beige then make some changes).
• Find an exercise or form of movement that suits you. Perhaps look at yoga or pilates, but even a 15-minute brisk walk really helps. Try to fit this into your day. Make the time to build it into your routine. It will help reduce the intensity and frequency of flushes.
• Keep a food and flush diary to find out your triggers. This is very simple and there are some great apps you can download to manage your eating habits better. For many it is caffeine that kick starts a hot flush for example.
• Practice and find out about positive mindfulness, and learn simple cognitive-behavioral techniques. This doesn’t cure the hot flush/flash but can help reduce their intensity, and possibly the frequency of them too.
• If your symptoms are really affecting your quality of life then you might want to consider Hormone Replacement Therapy (HRT). Or at the very least you will need to sit down with your Doctor and discuss what options are open to you.
• If you are experiencing insomnia, possibly brought about by night sweats, make sure you stay well hydrated. You can also try diaphragmatic breathing, a CBT technique, to help to keep calm. You must ‘switch’ your brain off, and away from the night sweat.

Physical Symptoms
One of the most common first signs of menopause are changes to your menstrual cycle. Perhaps missing that first period, which can send some women dashing off to their local pharmacy for a pregnancy test! Having heavy periods, or any change to your usual bleeding pattern is very common.

Heavy periods can be extremely debilitating. You won’t be wearing your favorite pair of white jeans for a while! The number of sanitary products required can become ridiculous. Joking apart, experiencing heavy periods is awful, and completely affects the quality of your life. The sooner you address the problem the better. It is incredible how many women are borderline anemic, so it’s a good idea to get your iron levels checked.

This affects not only energy levels but contributes to insomnia, resilience to ill health, the list goes on. There are medications that can be prescribed by your doctor to reduce the flow of blood. They will also help with those awful tummy cramps. You may want to consider using tranexamic acid. There are other alternatives like having a Mirena coil fitted, this has the benefit of providing contraception as well. Always ask your GP/Doctor what options are available, so that you can make an educated decision. It’s your body!

It’s important to always get any unexplained bleeding checked out by your GP/Doctor, and if they are concerned they can then refer you to see a gynecologist.

Psychological Symptoms
A lot of women will start experiencing these symptoms without even realizing they are actually the first signs of menopause. Their hormonal journey through life is once again off on its merry way! That brief ‘honeymoon’ period comes to an end when for a short spell of time reproductive hormones have hopefully calmed down and plateaued out a bit. (I do however realize for some hormones are a lifelong battle.)

The extra pressures at this time of our lives don’t help either. A common term heard is the ‘sandwich generation’. If you have kids you are sandwiched between their demands and the increasing demands of elderly parents. This results in not much time to think about yourself. So, it can take a while to realize that you are experiencing irritability, anger, lack of concentration, memory loss, low mood swings (sound familiar?) It’s not only down to the grunting, equally hormonal teenagers driving you nuts, but is contributed to by your own hormones starting to fluctuate up and down like yo yos!

Psychological symptoms can be some of the most debilitating symptoms out there, with many women hiding how they feel, especially within the workplace.

Common symptoms experienced
Anxiety & depression, or low mood swings are two common symptoms experienced during menopause. You may even experience a lack of concentration that could lead to problems at work. Anger & Irritability are also symptoms, so it is essential to learn how to manage your anger. Another symptom might be crying for no reason, and we have all been there! All these alongside poor memory, forgetfulness, even panic attacks, and heart palpitations are very common.

All these symptoms are incredibly common as the first signs of menopause but many women panic, don’t realize that in many cases what they are experiencing is due to their hormones, and wrongly assume they are losing their marbles! We have heard this many times ‘I thought I was getting early onset dementia’. On one hand, we can joke amongst ourselves, and if you are lucky you have good friends that will soon put you right. But some women sadly try and hide how they are feeling, which can make matters worse. The more you talk about how you feel, the better and you will soon realize how common these symptoms are.

What we can do to help ourselves

• Have a really good look at your lifestyle choices. If you have a healthy diet, engage in exercise, and give yourself smidgens of time for some rest and relaxation (R&R) your body will cope a lot better with any symptom.
• Look at how much caffeine and alcohol you have in your diet. Try and minimize your intake. It’s a fact that both of these affect not only how you feel, but contribute to insomnia, weight gain, joint aches.
• Get a food and flush diary on the go… no cheating! The healthier the foods you consume the more your body will thank you. If you desperately want to fast, do a natural one. Have all your meals by 5.30 pm then don’t eat again until the following morning at 7.30am – this is easily the best way to incorporate a fast into your life without denying your body essential energy and nutrition throughout the day.
• Exercise – engaging in some form of exercise regularly helps with all symptoms and also helps to prevent long-term symptoms from developing by looking after your bone and heart health. You don’t have to go and join a gym, just 10 mins of High-intensity exercise (HIIT) is a good place to start. Set yourself realistic goals to make it sustainable, even just skipping for 10 mins can make a difference.
• R&R – if you can incorporate into your busy lifestyle small amounts of time for yourself throughout the week your body and mind will thank you.

 By Dee Murray