The Ultimate Guide to Your Perimenopause Symptoms
Ladies! As we all know, there is a lot of focus on menopause itself, but where’s the dedication to perimenopause and the early signs and symptoms that you may experience?
The answer? Right here!
This is a turbulent time with a significant number of changes to our bodies, which can cause you to feel unsettled – to put it lightly.
Knowing as much as you can about perimenopause will allow you to be prepared, to recognize the first signs, and to know what is considered ‘normal.’
Most importantly, knowing how to manage your symptoms at home is HUGE!
No one should be doomed to suffering in silence. So, let’s dive into everything you need to know about perimenopause!
What Exactly is Perimenopause?
Well… Perimenopause is the transitional period where your body makes the shift towards menopause.
Your ovaries are no longer producing as many hormones as they once where, which is why your periods can become more erratic and irregular.
Essentially, it is the period of time where your body is reaching the end of your reproductive years.
When the First Signs Show Themselves and Perimenopause Officially Begins
Everyone is different and every body is different. Meaning, perimenopause can start at different ages for everyone.
Generally, you are likely to embark on your perimenopause journey in your mid-40’s. However, it can begin as early as your mid-30’s.
On the other hand, you might transition into perimenopause as late as your mid-50’s.
Either way it goes for you; perimenopause typically starts 8 to 10 years before you reach menopause.
** If by chance you reach menopause before 40, it’s classed as premature menopause. This can happen because of various medical conditions or surgery. However, if no medical intervention or condition has contributed toward reaching menopause before 40, this is called primary ovarian insufficiency. **
When Perimenopause Ends
To put it simply, perimenopause ends when you have officially reached menopause. Which has official started once you haven’t had a period (or spotting) for 12 consecutive months.
Why Does Perimenopause Happen?
Perimenopause happens due to changes to your hormones, causing their levels to fluctuate, frequently going up and down. These hormone changes are what is responsible for all the fun symptoms that us ladies get in this stage of life.
For example: Our progesterone and estrogen (the main sex hormone), which are both produced by our ovaries, adrenal glands, and fat tissue and are super important for or our reproductive system, start to decline.
As they start declining, they become imbalanced and cause all kinds of unwanted symptoms… This is not a fun time for women.
These symptoms consist of:
Irregular periods
Lighter or heavier bleeding
Sleep disturbances
Mood swings and anxiety
Hot flashes
Low libido
Vaginal dryness
Night sweats
Brain fog
What Perimenopause Feels Like
As common as it can be, it is super important to note that perimenopause should never feel like you’re dying.
Perimenopause feels different for everyone.
Some women will experience a wide range of symptoms while others can go through the entire transitional period with very few symptoms and may not feel too different at all.
There is no “right” way to feel during perimenopause.
There is such a range of perimenopause symptoms, from physical ones to emotional and mental ones. That some women feel like they’re going crazy, while others will feel totally fine.
No one’s journey, in any stage of life, is identical to another persons, including during perimenopause. That’s why everyone’s first signs are unique to each individual.
How is Perimenopause Diagnosed?
Perimenopause is a long transition, that is unique to each individual, there isn’t a test to “diagnose” you with being perimenopausal.
Your health care professional will most likely to lab work to check your hormone levels, however, due to the age range that perimenopause starts for each individual, as well as the fact that hormonal imbalances can happen for many other reasons, there is a number of factors in play for them to make a formal perimenopause diagnoses such as:
Your age
History of your menstrual cycle
The symptoms you’re experiencing
Family menstrual health history
What is the Difference Between Perimenopause and Menopause And How do I Know When I’m no longer Perimenopausal?
Perimenopause is the period of time leading up to menopause which is the end of perimenopause when a woman has been period free for 12 consecutive months.
Perimenopause literally means “around menopause.” This is when you will be experiencing the majority of the symptoms that are linked to menopause, but your periods have not yet stopped, however they are typically irregular.
Menopause is official when you have had no periods (or spotting) for 12 consecutive months. That’s why it’s so important to track your periods. Also, after you reach menopause, your symptoms finally start to subside!!
Signs of Perimenopause
So, what are the first signs of perimenopause?
Before we get into this is it very important to remember that perimenopause is unique for every woman. No women will have the exact same experience with every symptom, some will experience all of the symptoms, and some will have very few, mild symptoms.
Let’s take a look at the most common symptoms of perimenopause.
1. Irregular Periods
Because your hormones are continuously fluctuating, your periods during perimenopause might feel very different to what you’re used to.
This will vary from women to women in terms of how periods differ.
Perimenopausal menstruation could mean a heavier or lighter flow, changes in color, closer together or further apart than normal, or you could even experience cramping and nausea without the presence of a period.
2. Night Sweats
Night sweats are one of the most common and first side effects of perimenopause.
Sometimes, night sweats can become so severe that your clothing and bedding is soaked through, and your sleep is disturbed. Naturally, your body sweats so that your body can cool down. Your body does this as a safety and comfort technique.
However, with night sweats, that comfort disappears.
You might feel an intense and sudden wave of heat spread over your body. This could then be followed by your skin reddening, sweating and a faster heart rate. If you’re sleeping, this can wake you up and disrupt your sleep, often leading to exhaustion, with so many women tying a link between perimenopause and fatigue.
3. Fatigue
Sleep disturbance is a super common perimenopause symptom. It involves:
Finding it tricky to fall asleep
Waking up sporadically throughout the night
Waking up exceptionally early
A combination of all of these
It’s not difficult to see why so many women experience perimenopause and fatigue at the same time.
Sleep problems can hinder your mental and emotional health and cause your physical symptoms to feel more extreme.
You can mainly thank the falling levels of estrogen, progesterone and testosterone for being unable to get a full night’s sleep.
With such drastic changes and fluctuations in hormone levels, it is unsurprising that physical symptoms – particularly sleep disturbance – happens so frequently.
While the link between perimenopause and fatigue is undeniable, it’s not inescapable.
4. Insomnia
Insomnia and perimenopause are, unfortunately, highly related.
There are two main types of insomnia:
1. Chronic insomnia Defined when you’re struggling to sleep for 3 days per week for at least 3 months.
2. Short-term insomnia This is diagnosed when you’ve been struggling to sleep for three months.
But how common is insomnia in perimenopause?
Up to 60% of women in perimenopause experience some type of insomnia, which is why there’s a lot of focus on insomnia and perimenopause.
Remember, there is a difference between sleep disturbance and insomnia. If you are finding it challenging to fall asleep or stay asleep during perimenopause, do not suffer in silence. While insomnia and perimenopause are strongly linked, it’s not something you have to put up with.
5. Anxiety
Anxiety can creep up at any point in your life, but it becomes super common going into perimenopause.
As your estrogen levels fluctuate, you could be left with feeling more overwhelmed and anxious than usual, connecting the dots between perimenopause and anxiety.
Perimenopausal anxiety symptoms can include:
Feeling irritable, more restless, panicky and more nervous
Finding it challenging to relax
Worrying about the smaller things
A lack of focus and struggling to remember things
Feeling tense
Sweating more
Sleep disturbance
Panic attacks - can bring along with them dizziness, pain in your chest, rapid heart rate, and a deep sense of fear.
Perimenopause and anxiety both come with their separate challenges. When experienced together, some women find it extremely tricky to cope with.
6. Bladder Issues
Due to the shame that can come with bladder weakness, it is one of the least talked about symptoms, however it is actually exceptionally common as women transition through perimenopause to menopause.
That being said, it is a natural part of a woman’s life, therefore it is super important that we start talking more about it!
In fact, bladder issues are one of the key reasons why perimenopause and anxiety and perimenopause and fatigue are connected (amongst others.)
While some women believe that urinary incontinence is just part of aging, it is not always the case. And it is not something that you are doomed to live with. There are ways to prevent and treat it (which we’ll get to shortly).
Weakening bladders tend to start in perimenopause as your estrogen levels begin to fall. Estrogen plays a key role in making your urethral and vaginal tissues thin out, and as women age, our pelvic floors start to relax. In combination, this can cause urinary incontinence.
Hello, perimenopause anxiety!
7. A Decrease in Fertility
As you edge closer to menopause itself, you are ovulating less frequently. That’s why periods during perimenopause can be so erratic and irregular.
And when you do ovulate, you may release a “lower quality” egg. Or the hormones used for ovulation may not be able to support a pregnancy efficiently.
Due to this, it is less common to fall pregnant during perimenopause.
That said, it absolutely can happen. So, if you don’t want to conceive during perimenopause, it’s best to make sure you use a form of protection.
Pregnancy is completely possible until you’ve reached menopause.
8. Sex
Perimenopause can alter your sex life, libido and sensations.
For some women, their libido increases. However, for many, sex drive decreases. This is often due to vaginal dryness and irritation, which can cause sex to feel uncomfortable and in extreme cases, painful.
Unfortunately, a loss of libido can add pressure, often contributing to the tie between perimenopause and anxiety. However, there are certainly things you can do to improve your sex drive during perimenopause, which we will talk about shortly.
9. Hot Flashes
Hot flashes are one the most common symptoms of perimenopause. Your GP will likely refer to hot flashes as “vasomotor symptoms” or “VMS.”
Hot flashes feel like an intense wave of heat spreading through your face, neck and chest accompanied by redness. You may sweat excessively, feel your heart rate increase, experience panic and anxiety and feel cold afterwards.
Sometimes, hot flashes can be the result of perimenopause and anxiety. Other times, the hot flashes are triggered by anxiety. It can be a vicious cycle. However, you can experience hot flashes without anxiety.
10. Cholesterol Levels
Cholesterol is found in every cell of our bodies. It’s made by our bodies, or we can absorb it from our diet. We need cholesterol so that our body can make the hormones: estrogen, progesterone, and Vitamin D. It is needed to help repair our cell membranes. Not to mention, cholesterol also works to create bile acids in your liver, aiding with fat absorption when digesting our food. So, as you can see, some cholesterol is good.
But what about the bad cholesterol?
Bad cholesterol is made up of LDL cholesterol and triglycerides.
When you have high levels of LDL cholesterol in your bloodstream, you might notice inflammation and plaques may form in your arteries. When this happens, it could lead to something called atherosclerosis – where your arteries harden. This is a huge root cause of heart attacks and strokes.
The risk of heart disease increases in perimenopause. So, it’s important to be aware of cholesterol levels at this time. A lot of perimenopausal women don’t check their cholesterol levels frequently and quite commonly are unaware of rising levels prior to menopause.
This is a big reason why so many women take perimenopause vitamins and perimenopause supplements.
11. Weight Gain
Studies have proven that women’s body compositions change through perimenopause.
Fat mass increases as does waist circumference, plus there is a decrease in muscle mass.
It’s common for fat to gather around the abdomen, which is where the term “meno belly” can come to fruition.
Estrogen is a huge player in the world of energy metabolism. As your estrogen levels fluctuate, the way your body works to metabolize fat changes.
It is important to note that genetics also play a role in weight gain during perimenopause, as well as lifestyle factors and diet.
12. Itchy Skin and Spots
Spots can creep up in perimenopause for the same reason it makes an appearance in puberty. (Who invited her either time?!)
The changes and fluctuations in hormone levels have a direct impact on our skin’s natural defences, which can trigger acne or other skin conditions.
Skin changes can begin during perimenopause and last throughout menopause itself and beyond.
Additionally in perimenopause itchy skin is super common.
There is a huge shift in the oils we produce which can lead to dehydrated skin, which results in dryness and itchiness.
How to Manage Perimenopause Symptoms
Repeat after me: Perimenopause should not feel like dying.
There are ways to manage your perimenopause symptoms at home. So, let’s break it down symptom by symptom.
Managing Your Perimenopausal Periods
Periods: regardless of when they take place, kind of suck.
Before perimenopause, we get used to them, learning first-hand how to manage our periods. But when perimenopause comes and our periods start to differ, it is like we have to learn all over again.
If you’re noticing your periods during perimenopause are more uncomfortable, you can:
Engage in light exercise to help with bloating and reduce cramps
Speak with your health care professional about pain relief
Use meditation to help with stress, pain and/or mood changes
Use a hot water bottle, applying it to your stomach or back to help with muscle pain and cramps
Make sure your diet is rich, varied, nutritious and healthy.
Swap caffeinated tea and coffee for peppermint tea. This helps to relieve cramps, diarrhea and nausea.
How to manage night sweats
Remember to always speak with your health care professional if your perimenopausal night sweats are too difficult to cope with.
No one should suffer in silence.
There are also some ways you can manage night sweats at home:
Bring a glass of cool water to bed with you. Sip on it throughout the night.
Invest in temperature control cooling bedding
Wear pajamas that are loose on your skin, lightweight and made either of cotton or linen
Make sure you exercise daily.
Swap your duvet for a lighter blanket
Go to bed as stress-free as possible. Meditate, journal, deep breathing, or a bubble bath!
Keep your fan on, or sleep with your windows open
Stay clear of night sweat triggers like booze, spicy foods, caffeine or cigarettes before bed
Do not exercise directly before bed. Give yourself enough time to unwind.
How to Manage Your Fatigue
Sleep disturbance is such a common perimenopause symptom, and it can be extremely damaging to your physical, emotional and mental health.
If a lack of sleep is severely impacting you, please make an appointment with your health care professional
Different ways to treat at home are:
Make sure you’re exercising daily
Keep your room
Create complete darkness
Create a relaxation routine
An hour phone-free every night
Eat last at least 2 hours before bed
How to Manage Your Anxiety
Anxiety can be triggered at any point in life, but during perimenopause it can increase.
With so much change going on inside your body, anxiety can trigger hot flashes and night sweats, weight gain, vaginal dryness, sleep disturbance and even impact your periods.
Do not suffer in silence with perimenopausal anxiety. Speak with your health care professional if your symptoms can’t be managed with these natural methods:
Prioratize your sleep
Routine exercise does help with perimenopause anxiety
Mindfulness-based stress reduction (MBSR)
Quit (or cut down) on alcohol and caffeine
How to Manage those Dreaded Bladder Issues
Thanks, falling estrogen levels, you strike again at being the absolute worst!
But here’s the good thing, there are a bunch of techniques you can implement to avoid perimenopausal bladder problems:
Don’t go for a pee just in case
Don’t push when you pee
If you absolutely have to, suppress the urge to pee – this is only if you need to pee but there is no where for you to pee at the time, you can do this by:
Distracting yourself
Breathing exercises
Be still (either sitting or standing)
Perform 5 – 10 Kegels to calm your bladder
How to Manage Low Sex Drive and Vaginal Dryness
If you are finding your libido has fallen, know that you’re not alone. Many women report a change to their sex drive and, while some women experience a higher sex drive, most do report a lower one.
To help increase libido, you can try:
Getting routine exercise
Avoid caffeine and alcohol
Quit smoking if you’re a smoker
Avoid products that irritate the vagina - scented soaps and bath products.
Ensure you’re following a balanced and nutrient-dense diet
Manage your weight to boost wellbeing and confidence
Do pelvic floor exercises
Take time to become aroused – engage in more foreplay to raise moisture levels and avoid painful sex
Take the pressure off of the orgasm - commit to pleasure with or without an orgasm
How to Manage Your Hot Flashes
Hot flashes are among the most common symptoms, they can vary in severity, and some can be entirely debilitating.
However, there are ways that you can manage hot flashes yourself so you can remain cool, flash-free and collected:
Keep a journal of your hot flashes – What you were eating, drinking, and doing, and time of day when they were triggered
Dress in light layers - even in the colder months:
Sleep in light layers:
Carry a cooling spray with you:
Lukewarm showers and baths rather than hot:
Lowering Your Cholesterol
You can lower your cholesterol levels during perimenopause to keep your heart healthy by dedicating yourself to making some lifestyle changes, particularly by focusing on your diet:
How to Manage The Weight Gain
Weight gain is super common, but you are not doomed to gain weight.
You can, absolutely, lose the added weight.
Focus on nutrition – with a healthy and diverse diet full of fresh produce and whole foods
Stay hydrated
Avoid processed foods
Get in enjoyable physical activity – focusing on aerobic and strength-based
Prioritize sleep – 7 to 9 hours a nigh
how to Manage You Itchy Skin and Spots
Skin changes are often a hard pill to swallow and can be frustrating. However, there are ways you can manage perimenopause itchy skin and spots yourself:
Wash your face daily - Use a mild soap that won’t dehydrate your skin.
Moisturize your face with facial cream, avoiding harsh products
Don’t scrub too hard when exfoliating
Use a cleanser that contains salicylic acid - to help clear clogged pores
Don’t pick or pop spots
Avoid sun beds and use sunscreen whenever you’re outside
When to See a Health Care Professional
Remember that your health care professional is there to help you through this transition. You shouldn’t suffer in silence. If any of your perimenopause symptoms become too much for you to handle, book an appointment to assess a suitable support strategy.
In terms of your periods - there are red flags that indicate when you need to see you health care professional. While changes to your periods are natural and expected, keep an eye out for any of the following and make sure you see your healthcare professional should any arise:
You are experiencing exceptionally heavy bleeding or you’re bleeding for a long time
You haven’t had a period for a year and then you start bleeding
You’re bleeding after sex
You have PCOS (polycystic ovarian syndrome)
Perimenopause in a Nutshell
Perimenopause is a transition phase that is different for everyone. With a duration of symptoms, that are unique to each woman.
That’s why there’s no set list of first signs of perimenopause.
What you must remember is that perimenopause should never feel unbearable.
With so many women Googling “perimenopause is making me crazy,” it’s clear that the taboo still exists.
The most important thing is to talk about your experience with the people you trust. Having support is one of the most crucial ways to get through this time.
One of the best ways to cope with perimenopause is to be prepared, knowing as much as you can and the indicators for when you need to see your health care professional.
Remember that perimenopause doesn’t last forever. And there are ways to lighten the load throughout this transitional period.
Don’t underestimate the power you have to reshape your experience of perimenopause!
Getting Support
One of the best things that you can do for yourself is getting all the the support from family, friends, and professionals that specialize in woman’s health.
Being a Registered Holistic Nutritionist that is specialized in woman’s hormone health, my program Hormone Health for Females of all Ages is the perfect place for you! This program is individualized and tailored to fit YOU specific needs and lifestyle to fit you and what you ned in the best way possible.
To learn more about it and how we can work together, click the link above to check out the program, book a 30-minute FREE Discovery Call here, or message me directly on Instagram!
I look forward to connecting with you soon!!