When a woman in her forties says she sleeps badly, feels irritable and her cycle has gone off track, the usual response is that she is stressed. Sometimes she is. But very often the cause is perimenopause, a transition that is still talked about far too little.
What perimenopause is
Perimenopause is the period before menopause when the ovaries gradually reduce hormone production. Oestrogen levels do not fall smoothly but rise and drop, and those fluctuations cause most of the symptoms. It usually begins in the forties, sometimes in the late thirties, and lasts several years. Menopause has arrived when you have had no period for twelve months in a row.
Signs that are easy to miss
- cycles become shorter, longer or unpredictable, with heavier or lighter bleeding than before
- waking at 3 a.m. and struggling to fall back asleep
- hot flushes and night sweats, sometimes very mild
- irritability, anxiety or low mood without a clear reason
- forgetfulness and brain fog
- stronger PMS, tender breasts and more frequent headaches
- vaginal dryness and lower libido
- joint pain
Why it matters to recognise it
When we blame everything on stress, we often put up with symptoms for years, even though many of them can be eased. Hormonal changes also affect bone and heart health, so this is a good time for preventive check-ups.
What helps
- Keep a diary. Track your cycle and symptoms for two or three months. Your doctor will get a much clearer picture.
- Talk to a gynaecologist about options. Hormone therapy is safe and effective for many women, and there are non-hormonal options too. The decision depends on your health and family history.
- Train for strength. Resistance exercise supports bones, muscles, mood and sleep.
- Watch alcohol and caffeine. For many women they worsen hot flushes and insomnia, especially later in the day.
- Ask for a second opinion. If you feel it is not just stress, you have every right to look into it further.
Perimenopause is not the end of anything. It is a transition, and it is easier to move through when you know what is happening.
This article is for information only and does not replace an examination and advice from a doctor.