How to prepare for perimenopause

Mental Health

Dr Louise Newson is a leading light in the world of menopause education, policy, and support. Believing it’s never too early to be perimenopause savvy, she’s sharing practical information to help everyone have a better experience

No matter what your age or gender, chances are you’ve heard about the menopause. You may have noticed a greater conversation around it of late too, with documentaries such as Channel 4’s Sex, Myths and the Menopause presented by Davina McCall, and The Truth About… the Menopause from the BBC. Both programmes aimed to open a wider conversation and smash the stigma around this inevitable life event for half of the population, discussing commonly related issues, from poor mental health to a decline in libido, and loss of confidence.

However, it’s unlikely that you will have discussed the menopause and the perimenopause when you were learning about the human body, menstruation, sex, contraception, and pregnancy. Proactive management of hormonal wellbeing, how to access help when noticing troublesome symptoms, and what the perimenopause actually is, has sadly been left off the educational agenda for many years.

Thankfully, there has been a shift of late, as Dr Louise Newson is leading the charge on creating a society where we can all be more menopause and perimenopause aware, at every age. As both a GP and one of the UK’s top experts on the menopause, Louise is passionate about making real change around ‘the change’ from within the healthcare and education system, and in a way that’s accessible for everyone who might need advice, support, and signposting.

“The average age for women to reach menopause in the UK is 51”

Louise’s website, menopausedoctor.co.uk, is full of practical information, she’s created the free Balance app to help women track, manage, and share their symptoms with doctors, and her highly acclaimed podcast features interviews with experts covering a range of topics including premature menopause, HRT, skincare, movement, immunity, hair loss, and speaking to your partner about the impact of hormonal changes.

Here she explains what the perimenopause and menopause are, ways to track symptoms, and, importantly, how to get help.

Louise, where shall we start when it comes to the menopause and perimenopause?

A good place to begin is by defining what the menopause is. If you break down the word, meno means our menstrual cycle – our periods – and pause, to stop. So menopause means when our periods stop, but officially we’ve reached menopause when we haven’t had a period for a year. It’s a weird diagnosis, because you can’t make it until a year after it’s happened! However, if someone has their ovaries removed or damaged, then they’ll be classed as having reached the menopause straight away.

d_louise_newson

Dr Louise Newson

With perimenopause, peri means ‘around the time of’, so it’s ‘around the time of the menopause’. During this time, women’s periods might change in nature or frequency. Periods may be regular, but be heavier, lighter, longer, or shorter.

The list of other symptoms associated with perimenopause is as long as your arm, and that’s because oestrogen, the most important hormone, affects every cell and system in our body. If people are experiencing many of the symptoms, and there’s also a change to their periods, it’s likely that they are perimenopausal.

Common symptoms associated with perimenopause and menopause:

  • Period changes
  • Hot flushes
  • Night sweats
  • Fatigue and disturbed sleep
  • Low mood, anxiety, and mood swings
  • ‘Brain fog’
  • Joint aches and pains
  • Worsening migraines
  • Changes to your breasts
  • Skin changes
  • Hair changes

How does someone recognise if they are entering the perimenopause?

You don’t become perimenopausal overnight. You’ll probably get the occasional day of symptoms before your period, when your hormones are at their lowest, then it might be two or three days a month, and it gradually increases from there.

It can be difficult to realise that you’re perimenopausal though, because you might think the physical or mental changes are due to work, relationships, stress, or other life factors. Looking back, I had really bad perimenopausal symptoms that crescendoed five years ago. If I had monitored my symptoms and tracked my period, I’d have realised quite quickly what was going on – but I didn’t. I just thought it was because I was working too hard creating the Menopause Doctor website! Paradoxically, I was writing about all these symptoms I was getting, but I didn’t realise they were mine, because I wasn’t thinking about myself. Like so many women, I was too busy thinking about other people.

At what age should we look out for symptoms of perimenopause?

The average age for women to reach menopause in the UK is 51, and the perimenopause can last around a decade, so the average age would be 41.

However, one in 100 women have an early menopause, meaning they will be perimenopausal in their 30s, and one in 1,000 women under the age of 30 will have early menopause – those women will be perimenopausal in their teens and 20s.

What can people do to support themselves through perimenopause, and in advance of these hormonal changes taking place?

Pre-warned is pre-armed! The issue is that once we’re in the perimenopause we may have symptoms, including brain fog, that make it hard to decipher the information we need. So it’s crucial to gain a greater understanding of what may happen beforehand.

In order to optimise our health prior to and during the perimenopause, we need to eat well, move more, sleep well, and look after our mental health and wellbeing. Although, I have to say that without the right level of hormones once the perimenopause begins, it can become hard to do this. Muscle ache and joint pains, for example, might stop you taking part in exercise you used to love.

What should we do if symptoms are preventing us from living well?

You need to consider how you replace the required hormones, as you can’t produce them on your own. With hormone replacement therapy (HRT), there are different types and different doses, but generally we prescribe body identical HRT.

For the perimenopause, we give lower doses of oestrogen but often of testosterone, too, which can make a real difference to our brain function. It’s just about working out what’s right for you.

It’s important that you get professional help, because if your symptoms are impacting your life, you shouldn’t have to cope on your own.

Listen to the full interview with Dr Louise Newson, including discussions around antidepressants and the menopause, on our podcast, ‘I am. I have’


To connect with a therapist who can support you through the perimenopause or menopause, visit counselling-directory.org.uk

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