Many women face depleted energy levels, gnawing anxiety, subtle brain fog, or diminished sex drive as we approach our forties. Juggling the many responsibilities of young children, ageing parents, increasing responsibility at work, we can think we need to try a bit harder, get up earlier or spend our well-earned cash on expensive supplements. We may have even ventured to the doctors to hear our blood tests are normal and tempted to settle for less.
But have you considered that you could be at the start of your perimenopause? Menopause, not discussed in those earlier years, is often thought of as something for the next decade! So it may surprise you that this hormonal transition period, something called the perimenopause, can start up to 10 years before we finally finish our period and enter menopause. It may also be news that perimenopause, marked by the fluctuation and decline in our sex hormones, affects more than our periods. Our hormones affect all parts of our health and wellbeing.
Oestrogen, for example, affects nearly every part of our body – skin, hair, brain function, weight distribution and energy production. When levels of this hormone rise and fall, we can feel it in our mood and energy levels, struggle with vaginal dryness, develop urine infection, palpattions and hot sweats.
Progesterone is one of the most calming of the three hormones that are declining in our bodies over perimenopause. It’s also the first to go into decline. As we adapt to the lower levels that are available in our system, we can have difficulty with sleep, feelings of anxiousness and a hard time remembering things.
Testosterone, usually thought of as a ‘male hormone’ is also produced in our ovaries. When we enter perimenopause this hormone begins to decline too. Testosterone plays a role in our libido, brain health and mood regulation. It also has a hand in keeping our muscles and joints strong and healthy. As it declines we need to become more mindful of exercise and maintaining muscle mass.
The parts of our body that react most strongly to changing hormone levels are unique to each individual. Some women are lucky not to have any symptoms at all, aside from periods ending. However, 80% of women will experience several perimenopausal symptoms, and for 25% of these women, the symptoms are severe.
Sadly there is no test to say you are in perimenopause or a test to rule it out. The key is your story and working with an up to date, sympathetic doctor to help you establish what your body needs to support it in this time.
The solutions to navigating the perimenopause well are unique to each women. While for some of us, the conventional use of hormone replacement (HRT) is a lifeline, this treatment is safe for most women, and it is never too early to start and confers many benefits. I want to stress that it isn’t something that you take after the menopause when your periods have finished, it can be used right in those early times when you’re just getting the brain fog and the anxiety.
However, it is clear from medical research that we can all improve the experience through our daily choice in what and when we eat and how we sleep, rest, move, manage stress and connect with ourselves, others and purpose. These lifestyle choices tap into the body’s innate ability to heal, bring balance, and foster resilience.
Perimenopause is a transitional stage of our lives. Every woman will go through this, and many of us may find it is a turbulent and challenging era. I believe the key to navigating this transition is to learn about what to expect, spot the early signs, prepare yourself by improving your lifestyle, and reach out for help when needed.
To find out more about your questions, consider looking at the work of Dr Sally at www.doctorsallywomens.health. You will find answers to the many questions asked about perimenopause on her website, a free e-book and the opportunity to participate in video-based courses.