There are at least 34 symptoms associated with the perimenopause, so it’s no wonder us women are confused about the whole thing. Although is unlikely that a woman would experience all of these symptoms, there aren’t many women fortunate enough to go through their perimenopause journey completely unscathed. Today, I’m going to look at 5 of the most common perimenopause symptoms, so that you know what to look out for when you reach that stage of your life.
1. Hot Flushes
And kicking us off is what I think is one of the most common perimenopause symptoms. Even before it became socially acceptable to talk more openly about the menopause, people associated it with sweaty, red-faced, angry, middle aged women. It is the classic perimenopause symptom. But what’s it all about?
Well, during the years leading up to the menopause, a woman’s body goes through many different hormonal changes. Her ovaries begin to work less effectively, and the production of her key reproductive hormones; oestrogen and progesterone, gradually start to decline. We have an area in our brains called the hypothalamus, and this area controls hormone production for such functions as body temperature, mood, hunger etc. So, when our hormone levels start to decrease, the hypothalamus thinks we’re too hot and reacts by dilating blood vessels and increasing blood flow to the surface of the skin in an attempt to cool the body down.
This is what is known as a hot flush. It feels like a sudden wave of intense heat, rushing up through the body and up to the face. A hot flush will last anywhere between 4 and 7 minutes, and can feel incredibly uncomfortable. Not only do you feel as though you’re burning from the inside out, it’s likely you’ll get a red flush to your skin, meaning it can be very difficult to disguise what’s going on. Hot flushes can take you completely by surprise. One minute you’re sat there minding your own business, the next you’re sweating absolute buckets and feeling all kinds of flustered. You may never get them, you may only get them every now and again, you may get them two or three times a week, or if you’re really unlucky you may get them every hour. What is important, is to know how to manage them when you do get them. I’ll do an article about some of the ways you can help with hot flushes soon, however for now, let’s move onto some more common perimenopause symptoms.
2. Irregular Periods
Most people have a misconception of what the menopause is. The menopause itself is literally just one day. It is the day that marks a whole year of no periods. Anything that occurs before this day is known as the perimenopause, and this is the time when those pesky symptoms occur.
In the time leading up to this year of no periods, you will likely notice all kinds of changes to your cycle. Some women suddenly start having heavier, more painful periods, others may have periods that last for two weeks at a time, and some women may have nothing for months then all of a sudden there it is. You may be someone who has always had a regular 28 day cycle, light flow, no PMS, but let me tell you as someone who was that person, perimenopause takes no prisoners. Before starting HRT I was getting two heavy periods a month with spotting in between, and aside from the massive inconvenience, it is utterly exhausting!
If you’ve noticed any changes to your usual cycle, I would recommend using a period app to keep track of the days you bleed. You can then notice any changes more easily, and it may help a little to ascertain when you may have your next period. If you have any concerns, make sure you speak to your GP who will be able to advise you of your options.
3. Brain Fog
Brain fog affects around two thirds of perimenopausal women and for many it can feel as though they are literally losing their minds. Davina McCall talks about how menopausal brain fog had her convinced that she was experiencing early onset dementia, it is that serious. If you’re usually incredibly articulate and pride yourself on your capacity to remember stuff and just generally have your shit together, it can come as a huge shock when suddenly you can’t think of the word, you can’t remember someone’s name, you can’t string a sentence together, or your words get jumbled. It’s probably best described as feeling as though your head has been stuffed with cotton wool, your brain’s still in there, but it’s struggling to work through the fluff. This my friends is brain fog.
The first hormone to decrease during perimenopause is progesterone, and as these levels drop we can experience mood swings, irritability and brain fog. Slightly later on, our oestrogen levels start to deplete and this brings mental confusion, even more mood swings and irritability, fatigue and those lovely hot flushes. Combine the two and it’s no wonder we don’t know whether we’re coming and going. Plus, let’s not forget that the time at which most women go through the perimenopause is also usually a time of great change in their personal lives. Children may be starting to leave home, we may be caring for elderly parents, our relationships may change, and of course there’s all the global factors like covid and climate change to worry about too. It’s a lot to take in, at a time when our brains aren’t exactly functioning at their best.
Exercise, especially exercise done outside, is particularly good for clearing away those cobwebs. As too is a heathy diet of brain friendly foods like, dark chocolate (rejoice!), walnuts, leafy greens, oily fish, and berries. Sleep will also help, but as you can see sleep doesn’t necessarily come easy when you’re a perimenopausal woman. Try using a meditation or brain training app to keep your brain rested and worked out as best you can, and this should hopefully help a little.
4. Vaginal Dryness
Just when you didn’t think things could get any worse, your vagina goes and dries up. And we can blame those depleting levels of oestrogen again, because one of the roles of oestrogen is to keep the vagina lubricated, stretchy and nice and healthy and plump. So, when the oestrogen starts to dry up, so too do our vaginas, I’m afraid!
Low levels of oestrogen causes dryness, thinning of the vaginal walls, and inflammation. What this means, is that not only can sex suddenly be extremely uncomfortable (which certainly doesn’t help with the libido, but we’ll move onto that one in a mo), but you may also experience painful itching and burning down there, and this also makes you more susceptible to UTIs (Urinary Tract Infections).
Women who experience this particular symptom will often feel embarrassed and ashamed about what’s happening to them. Of course, there’s no reason to, as this is all perfectly normal, and happens to many women, however it can make you feel as though you are ‘less of a woman’ and no longer physically desirable. Just like your vagina, you can end up feeling dried up and useless. But fret not because there is help out there, so if you’re experiencing vaginal dryness please talk to your GP about your options. It is also really important to discuss how you’re feeling and explaining what’s happening to your body with your partner, so that they can understand and take things a lot slower in the bedroom department. Sex should be enjoyable, and certainly not painful, which is why communication is key.
5. Night Sweats
Similar to hot flushes, night sweats do exactly as it says on the tin, as in you sweat at night. And talking from personal experience, it is very unpleasant.
You’re fast asleep, in the middle of a realistic dream no doubt (oh yeah, should probably warn, you, one of the less common perimenopause symptoms is vivid dreams!), when all of a sudden you’ve woken up absolutely soaked to the skin with sweat. But this isn’t normal run of the mill sweat, this is proper pungent, stinking sweat. It is full on gross. And not going to lie, the first time it happens, you’re so wet, you think you’ve wet yourself. Which is embarrassing when you share a bed with someone.
It works in exactly the same way as those hot flushes; your body thinks it’s doing you a favour by sending a tidal wave of sweat to cool down your hot body. And I mean temperature hot, not sexy hot, because trust me there ain’t nothing sexy hot about a clammy, wet, stinkfest of a perimenopausal woman!
So yeah, I’ve been there, done that, worn the sweat drenched t-shirt. Again, you might escape them, but it is one of the more common symptoms associated with the perimenopause, so you have been warned.
This is one of the trickier symptoms to spot during the perimenopause, because let’s face it we’ve all got stuff to deal with and so it can be really difficult to pinpoint whether the anxiety is caused by hormonal changes or life events. From personal experience, I went from being an outgoing, confident, motivated, fearless women to someone who was scared to go out, overthinking, catastrophizing, and worried about everything. It literally felt as though the joy and my zest for life had been sucked out of me, to the point that I felt like a completely different person. And let me tell you, it’s scary.
I can remember the exact point when I realised it must be connected to the perimenopause. I was sat at my laptop trying to work, and I felt awful. My stomach was in knots, my hands were shaky, and I felt miserable. But then suddenly, literally I could have clicked my fingers, it went. It was as if someone had taken the dark cloud above my head and blown it away, taking all the negative thoughts and feelings with it. And I felt it immediately. I actually sat there and said out loud, “thank god that’s over”. That was the day I sought help.
Aside from the hormonal changes affecting our moods, there’s also the impact of disrupted sleep due to night sweats, the fact our vaginas and sex drive have dried up, and the not knowing if and when we’re going to get a period. Those factors alone are enough to send our anxiety levels flying. Bouts of anxiety can hit you out of the blue, for no reason, and without warning. As well as the mental side effects it can also play out physically, for example you may experience increased heart rate, palpitations, nausea, shaking, breathlessness, dizziness, and panic attacks. When you understand the reason why this is happening to you, it immediately becomes less scary. Knowing that I wasn’t going mad, and that what I was feeling and experiencing was as a result of the chemical changes going on in my body, filled me with so much relief. And with that relief came the strength to seek advice for a problem that I knew could be helped. Six months of HRT, and my anxiety has pretty much completely subsided. I still have the occasional wobble, but that very much needed top up of hormones has put me on an even keel and for that I will be forever grateful.
7. Loss Of Libido
And finally, the perimenopausal symptom talked about the least, because frankly no one likes to admit they’re not getting as much sex as they used to. But why is it that during the perimenopause a lot of women lose their desire for sex?
It’s those hormone levels again… but this time we’re not just talking about oestrogen and progesterone, there’s also another less well known female hormone that plays a big part in our libido and that’s testosterone. Yep, you’ve all heard of it, and you thought it was something just men had, right? Well, no, us women have it too, and guess what, during the perimenopause our levels of that hormone start to decrease too taking our sex drive with it.
Throw in vaginal dryness, hot flushes, night sweats, anxiety, and a tonne of other symptoms and it’s no wonder we’ve lost the urge to get jiggy. The good news is, it’s not gone for good, in fact many women report coming through the menopause and out the other side with a new lease of sexual life. Plus, there is the option of HRT and other natural alternatives to help spark the fire, so again keep talking to your partner and you will get through this together.
What we’ve learnt
OK, let’s calm down a second, because I don’t know about you lot but I’m sweating just from reading this list of common perimenopause symptoms let alone dealing with the hot flushes. It’s a lot to take on and it does all sound a bit doom and gloom. I’m not going to sit here and tell you going through the perimenopause is a breeze, because it’s not. But, what I hope this article has done, is to educate and share awareness, so that if any of these symptoms happen to you, you’ll at least know what’s going on.
Most importantly, there is help out there. And as awareness is increasing, and stigmas are being broken, there is actually more help out there than there has ever been before. It can help to keep track of your symptoms either by jotting them down on a notepad or in your phone, or you could even download an app to keep track of it for you. Dr Louise Newson, the Menopause Doctor, has a good one called Balance, which not only tracks your period, but also your symptoms, and offers articles with great advice, and helpful resources too. Also, speak to friends of a similar age, chances are they’re going through it too, so be the one that brings it to the table. And finally, most importantly of all, speak to your GP. They are a lot better trained in this area now, and they are obliged to help you with your options, whether that be a form of HRT, or alternative therapies and medicines. Remember, you are not alone.