The Different Faces Of Perimenopause

Our bodies are changing all the time. And this couldn’t be truer than for us as women. But we don’t need to tell you that. First comes menstruation in adolescence. Our bodies shapeshift and then we endure decades of premenstrual syndrome (PMS) and monthly hormonal fluctuations. No wonder we have mood swings. Here are the 10 symptom categories you need to know about perimenopause.

Ok, let’s be honest, it takes quite some years to figure out the pattern of what is going on, and how we’re actually feeling as our monthly cycles move through its phases. For those of us who bear children, we again, go through a huge physiological shift, from morning sickness all the way through to the matracene (the physical, psychological and emotional process of becoming a mother). And give it a few more years still, and just before the menopause comes knocking, our bodies go through another profound, yet almost entirely under acknowledged shift: enter the perimenopause. And why should you care about it? Because we think there has been enough grinning and bearing. 

We’re here to dispel the fifty plus (yes you read that right, five zero symptoms) associated with this hormonal shift. 

Perimenopause is the transitional phase leading up to the menopause. It can be a complex, and often, misunderstood journey for many women. Typically beginning in our 40s, though sometimes earlier, this period can last anywhere from a few years to a decade. During this time, the body undergoes significant hormonal changes which triggers a series of bodily changes. 

There is a crazy number of over fifty symptoms women can experience during this time. And (unsurprisingly) up until very recently, we knew rather little about them. With symptoms ranging from burning mouth syndrome to increases in depression to the infamous hot flash, we wanted to make sure you were up to speed and fully informed with these bodily changes. Every woman's experience is unique. But 90% of women experience them. So we wanted to give you the 101 on the symptoms so you can thrive during this life transition. Because perimenopause isn’t the end. It’s a new beginning. 

Changes in oestrogen levels are the key factor behind the perimenopause symptoms. “Oestrogen affects everything from your mood, hair, skin and even your energy levels” explains Dr. Natalie Getreu ovarian biologist and co-founder of Hertility Health. “A decrease in oestrogen during perimenopause leads to a hormonal upheaval.” And since everyone responds to these changes differently, there are a wide range of resulting symptoms.

“I always think of oestrogen as the queen of hormones” explains women’s health specialist Rebecca Heath. “It is very busy and often in charge.”

While oestrogen's primary function is regulating the menstrual cycle, it can also be found affecting most other areas in the body. “This includes the cardiovascular and musculoskeletal systems, the brain, skin and hair and even mucous membranes.” This explains why during perimenopause the fluctuation and eventual decline of oestrogen will affect all the areas where we usually find oestrogen, and we end up with such a wide range of symptoms. Yes, our hormones have gone wild. But if we know what they are doing, there are things we can do about it. Read on to hack your hormones — we have also included a symptoms checklist. 

Hormonal and Menstrual Changes 

The fifty or so perimenopause symptoms broadly fall into ten distinct categories. Firstly, there are the hormonal and menstrual changes. These are probably the most noticeable, ranging from irregular periods, to changes in menstrual flow and cycle length, as well as worsening of PMS symptoms or other gynaecological conditions such as fibroids or endometriosis.  

Vasomotor Symptoms 

Then there are the vasomotor symptoms. These are related to blood flow, and temperature regulation, most commonly recognized as the infamous hot flash. These symptoms include night sweats, cold flashes and increased sensitivity to temperature changes. 

Psychological and Cognitive Changes 

Next up are psychological and cognitive changes.

Hormonal fluctuations can significantly impact mood and cognitive function which explains why during the perimenopause there is an increase in mood swings, feelings of anxiety or irritability as well as difficulty concentrating, memory issues and brain fog.

In fact, there is newly published research which shows women are 40% more likely to suffer depression during this timeframe.

Urogenital and Sexual Health

Intimately connected to changing hormones, decreasing oestrogen levels impact our urogenital system and sexual function presenting several symptoms. These sexual symptoms include vaginal dryness, painful intercourse and decreased libido. Urological-ly speaking, perimenopausal women have a higher risk of urinary tract infections (UTIs) as well as incontinence and an increased need to urinate. 

Skin and Bone Health 

Oestrogen plays a crucial role in maintaining skin elasticity and bone density, which helps to explain changes in skin and bone health, most notably the seemingly random ‘burning mouth syndrome’.

Experienced by one in three perimenopausal women, this unpleasant sensation is a lesser known symptom, but one to watch out for nonetheless. Other symptoms include dry and itchy skin, increased wrinkles, thinning skin and tingling extremities, as well as an increased risk of osteoporosis.

Cardiovascular changes

Heart issues are also common in postmenopausal women, and these changes often begin during perimenopause. Palpitations and a racing heart, changes in blood pressure and increased cholesterol levels are all symptoms to watch out for. 

Gastro Internal Changes 

Digestive system issues, impacted by, you guessed it - hormonal fluctuations - including bloating, indigestion and changes in appetite. It’s also possible to develop new food sensitivities and allergies during this time too. Increased stress levels may also have an impact on digestive health. 

Other symptoms 

There is also a loosely defined ‘other’ symptoms category, which includes things like headaches or migraines, joint pain and stiffness as well as muscle tension or aches. While these don’t fit into any of the more clearly defined categories, they are, much like the other symptoms highlighted above, to be missed or glossed over.

Heath agrees, explaining that historically there was a ‘keep calm and carry on’ approach to health issues like menopause. With a lack of information available for medical interventions like hormone replacement therapy (HRT), doctors were cautious and risk-averse. “It [the perimenopause] wasn’t openly discussed and often viewed as something that you just got on with. Doctors were generally reluctant to prescribe HRT with opinions based on the risks instead of the benefits.” 

Heath also notes that the time in our lives when perimenopause strikes is also often a particularly busy one, making it easy to overlook perimenopause symptoms for tiredness or stress. “As women, we’re often working full time jobs, or caring for children, sometimes parents too. We can find ourselves balancing so many responsibilities and the symptoms of perimenopause often creep up on us.”

Things are changing. Thank goodness. With more female health companies (ahem- Valerie!) emerging we should be optimistic that a more supported perimenopause is on its way. And we’re leading it - on a mission to break the female pain cycle, we’re here to give you the goods on the perimenopause and how to manage it. 

The first step is education. Get as familiar as possible with the symptoms, tracking any changes so you have a clear picture of what is going on in your body. There are several symptom tracking Apps out there, many of which are free, which can help you do this. Testing your hormones, such as with Hertility’s at-home hormone and fertility test, can also be helpful in giving you greater awareness of your hormonal imbalances. 

Next, think about potential lifestyle changes, dependent on your symptoms and hormonal results. Ensuring you’re engaging in the right kind of regular exercise, eating a balanced diet and getting good sleep (in a nice cool room to manage the hot flashes!) all sound like basic tips but often overlooked. Managing stress with meditation and yoga can also have emotional and physiological benefits.  

Additionally, considering supplementing your diet with the right kinds of vitamins and minerals, like those found in Valerie’s Daily Essential Liposomal Shot, can give your body what it needs to thrive, not just survive, helping you feel like yourself again. 

And finally, consult your doctor and inquire into treatments such as HRT. Check in with a gynaecologist or menopause specialist to ensure you’re balancing your hormones and managing your health. We are changing the face of the perimenopause. Get to know these 50+ symptoms and practice self-care to ensure you’re not just surviving, but thriving during this period of your life.