Menopause, and particularly perimenopause, is a confusing time. There are many more symptoms of the menopause transition that don’t get the same attention as hot flushes/flashes. And when women juggle work, home and caring responsibilities simultaneously as menopause, their symptoms can often be overlooked. So it can be difficult to work out exactly when you are in the perimenopause phase of your life.
This blog aims to give you guidance on how to work out if you are in perimenopause.
Just a word about the word women. Not all women have ovaries. And not all people with ovaries identify as women. However, everyone who has ovaries will experience menopause. You may notice that I interchange the word woman/women with “person” to be more inclusive.
Menopause is the book end to our reproductive years and is the term that you can use when you are exactly 1 year free of your periods. Perimenopause is the time (7 – 10 years before this).
I invite you to think about perimenopause as you think about puberty. I think it is fair to say puberty was a probably a few decades ago for you now. But as you continue to read, you will remember more about this time.
Puberty – the hokey pokey dance of entering adulthood
Your transition from childhood to adulthood – puberty – did not happen overnight. You might have experienced physical symptoms first, e.g., a quick breast or hip growth or the start of your menstrual cycle. For me, it was like I woke up and my hips had turned into rudders that stuck out from my body and banged on things, as I acclimatised to my changed shape.
Or perhaps what you noticed first was emotional changes. Where you were once happy to go with the flow; your parents or even some of your friends became annoying, or it seemed they didn’t understand you. Life turned from black and white to many shades of grey, and you started questioning where you fit into it all. Or if you fit at all.
Puberty is also the time when we become interested in sex and can experience our first sexual experiences, either with ourselves or with others.
Puberty is much like the hokey pokey dance. Some days you put your whole body into adulthood, and other days your whole body was out, as you reverted to childlike behaviours. On other days, parts of you were adult-like, and others weren’t. Finally, your whole self was in. And the realisation that adulting was a lot harder than it looked from the outside!
However, during this hokey pokey dance through puberty, you went to classes at your middle or high school, where a teacher carefully explained the changes you might experience – both physical and emotional. You might have been given books. Or had talks about the birds and the bees from your parents. You learned that all these changes resulted from changed hormones, which in effect, held your body to ransom and forced these changes upon you. Whether you wanted them or not.
The education you received (whether it was the base line of the state education system or to much more via people you trusted) during this time, supported your transition. It helped remove the fear and confusion.
Symptoms of Menopause
Unfortunately, unlike your transition through puberty, there are no classes that everyone takes to learn about the menopause transition. Our workplaces are not designed to support symptoms like hot flushes/flashes or changes in cognition. Not because they don’t care, but because there is not the same societal support as there is for the puberty transition.
There are 34 official symptoms of menopause. These can be roughly divided into five categories:
- Vasomotor – the region in the brain that regulates blood pressure and heart rate. E.g.: hot flushes, itchy skin, night sweats, headaches, irregular heartbeat and even changes in body odour
- Vaginal – dryness, vulvovaginal atrophy (which can affect prolapse and continence) and decreased libido
- Muscular and skeletal – joint pain, muscle tension and aches, stress incontinence and osteoporosis
- Insomnia and sleep disturbances – which can impact on weight gain
- Mood – including difficulty concentrating, fatigue, memory lapses, dizzy spells, irritability, depression, anxiety and panic disorder
Thankfully, most people going through menopause do not experience all these symptoms.
What will be my menopause experience?
The British Medical Journal stated in June 2022 that more than 75% of those experiencing menopause report symptoms and that over 25% describe their symptoms as severe.
In plain speak, around 1/3 of those transitioning through menopause will feel some changes but will not be subject to significant symptoms and will seem to sail through easily.
About 1/3 of people will experience some symptoms; although they are annoying, they will not affect their overall function.
And the last 1/3 of people transitioning through menopause will experience symptoms that will significantly impact on their ability to function.
It is the last third that are good candidates for Menopausal Hormonal Treatment (MHT).
Just a word about the word Menopause Hormonal Treatment (MHT). You may be more familiar with the term – Hormone Replacement Treatment (HRT). However, there is a move away from this term as your body does not need hormones to be replaced. Menopause is a natural process that reduces sex hormones, like oestrogen and progesterone, to stop reproduction abilities.
HRT is a term from medicine that historically viewed menopause as a disease or a disorder rather than the natural ageing process.
There is significant research regarding the genetic disposition of menopausal symptoms. This means that if you know how your mother, or if you are lucky, your grandmother experienced their menopause transition – this might be insightful to you.
However, we also must consider that your mother or grandmother probably could not talk openly about their experiences at the time. And culturally, an inclusive language around menopause had not evolved.
Please note that most studies have focused on hot flashes/ flashes as the primary symptom studied (ignoring the other 33). However, this research also concluded that white women were more susceptible to hot flushes/ flashes. This might also help explain why this is the symptom everyone is most familiar with.
Research from 2022 has concluded that women of colour reach menopause earlier and experience more intense symptoms compared with white women.
But how do I know when I am in perimenopause?
There are 3 ways to ascertain if you are in the perimenopause phase of your life.
- Do the maths. The average age of menopause – (when you are one year free of your periods) is 52. Perimenopause symptoms can start between 7 – 10 years before this. 52 – 10 equals 42.
- Ask your mum, aunts or older sisters. What age were they when they went through menopause? What were their symptoms?
- Make a note of any changes you are experiencing.
Testing hormones is not the answer.
Unfortunately, no accurate hormone testing kit can predict if you are Officially Perimenopausal. Your hormones will change during the transition, as the drop in oestrogen and progesterone is part of the natural way your reproductive system shuts up shop. However, these hormones can change from day to day and from hour to hour. Therefore, you would need to invest in trice – daily hormone tests over several months to draw a clear conclusion.
And if we return to our puberty memories, we did not do hormone testing to know that we were transitioning into adulthood. We knew that it happened for most people from around the age of 12 and took around 7 – 10 years to conclude. Our hokey pokey hormones took a while to settle down Along with our psychological acceptance of closing the door to our childhood.
A final word on menopause
Menopause is a natural and normal phase every person with ovaries undergoes. This transition for you may have few symptoms, or it may have debilitating symptoms. If your menopause symptoms make it difficult for you to work, live and enjoy your life. Then it is well worth seeing a menopause specialist and seeing if MHT is suitable for you. This is where your notes on the variety and severity of your symptoms will be handy. Alongside any genetic information, you can share.
The perimenopause years can also be framed as the gateway to the next third of your life. Your reproductive abilities may have finished, but your life is far from over. However, the decisions you make and behaviours you put into place health-wise during this time will significantly impact how you age.
If you want to learn more about menopause, I highly recommend these 2 masterclasses:
“I thoroughly enjoyed Mish’s menopause presentation. It was informative, educational, practical, creative, and darn right hilarious without losing the seriousness and importance of the topic being covered. Mish is such a pro with a world of experience and knowledge and gift of communication. I highly recommend doing this presentation if you work with women from their 30’s onwards – you’ll learn so much to add to your wheelhouse with your clients.”
As a flash sale we are doing a 2 for 1 deal on these 2 Masterclasses – get both Perimenopause – Training women age 37+ and Menopause in a BUNDLE for just $35!
CLICK THE IMAGE ABOVE TO GET THE COURSE OR CLICK HERE.
If you enjoyed this blog…. you might also enjoy these ones.
Just click on the image below!