Symptoms, Stages, And How To Manage Your Perimenopause With Dr Hazel Parkinson

In this article, Hazel is here to help you better understand:

• How to identify if you are in perimenopause
• The three different stages of perimenopause and the common symptoms associated with each
• Why these symptoms occur
• Effective management strategies to alleviate symptoms

Perimenopause defines the natural transition to menopause, which may take years for the vast majority of women. Some big hormonal changes are happening in the body during this time; mainly involving falls and fluctuations in oestrogen and progesterone levels. 

Symptoms are generally either physical or emotional. I strongly feel the awareness of such symptoms could greatly help the process, making an easier menopausal transition for many women who currently suffer unnecessarily. 

In this article, I will be discussing the symptoms of perimenopause extensively, looking at some of the reasons behind the most commonly experienced symptoms — and, most importantly, what can be done about them!

Very Early Stages of Perimenopause (Late 30s to Early 40s)

The most common symptoms of early perimenopause include irregular periods, mood swings, and breast tenderness. Why? Allow me to explain:

• Irregular Periods: Hormonal fluctuations begin to affect the menstrual cycle, causing periods to become irregular.

The ‘Why’: Changes in oestrogen and progesterone levels disrupt the regularity of ovulation.

• Mood Swings: Increased emotional sensitivity, irritability, and mood swings.

The ‘Why’:  Hormonal changes impact neurotransmitters like serotonin, affecting mood regulation.

• Breast Tenderness: Increased sensitivity or pain in the breasts.

The ‘Why’:  Hormonal fluctuations cause changes in breast tissue, leading to tenderness.

• Fatigue: Unexplained tiredness or lack of energy.

The ‘Why’: Hormonal imbalances can affect sleep patterns and energy levels.

• Sleep Disturbances: Difficulty falling or staying asleep.

The ‘Why’: Changes in progesterone and oestrogen affect sleep-regulating brain chemicals.

• Weight Gain: Especially around the abdomen.

The ‘Why’: Slower metabolism and changes in hormone levels.

Early Perimenopause (Early 40s to Late 40s)

• Hot Flushes: Sudden feelings of intense heat, often accompanied by sweating and rapid heartbeat.

The ‘Why’: Declining oestrogen levels affect the hypothalamus, which regulates body temperature.

• Night Sweats: Episodes of excessive sweating during the night.

The ‘Why’: Similar to hot flushes, caused by hormonal changes affecting temperature regulation.

• Decreased Libido: Reduced interest in sexual activity.

The ‘Why’: Lower oestrogen and testosterone levels can decrease sexual desire.

• Vaginal Dryness: Reduced vaginal lubrication, leading to discomfort or pain during intercourse.

The ‘Why’: Oestrogen helps maintain vaginal moisture and elasticity; its decline causes dryness.

• Urinary Issues: Increased frequency, urgency, or incontinence.

The ‘Why’:  The fall in oestrogen causes the tissue of the urethra to thin and the pelvic floor to weaken.

• Hair Changes: Thinning hair on the head or increased facial hair.

The ‘Why’: Imbalance between oestrogen and androgens (male hormones) affects hair growth.

Perimenopause (Late 40s to Mid 50s)

• Memory Problems: Difficulty concentrating or remembering things.

The ‘Why’: Oestrogen influences cognitive function, and its decline can affect memory.

• Joint Pain: Aching or stiffness in the joints.

The ‘Why’: Oestrogen has an anti-inflammatory effect; lower levels can lead to increased joint pain.

• Headaches: Increased frequency or severity of headaches or migraines.

The ‘Why’:  Hormonal fluctuations can trigger headaches.

• Heart Palpitations: Sensation of a racing or irregular heartbeat.

The ‘Why’: Low oestrogen levels can overstimulate the heart, leading to it beating faster.

• Skin Changes: Dryness, itching, or thinning of the skin.

The ‘Why’: Oestrogen helps maintain skin moisture and thickness.

• Osteoporosis: Gradual loss of bone density.

The ‘Why’: During menopause, a decline in oestrogen levels disrupts the otherwise consistent pattern of bone remodelling. This, unfortunately, results in a reduction in bone density.

A Holistic Approach

I believe that the best way to manage such symptoms lies in a holistic approach.

Why? Because most menopausal symptoms are best managed individually and holistically, and that approach can be dramatically improved by making very simple lifestyle modifications. Among those are healthy nutritional changes, exercise, and the management of stress.

The Power of Regular Exercise

Regular exercise, especially resistance training, improves muscle mass, longevity, and prevents osteoporosis. It also boosts mental health and cognitive function.

Nutritional Essentials

Key nutrients include Vitamin D, protein, calcium, and B vitamins. Salmon, legumes, nuts, and super fruits are some of the highly beneficial foods. Complement this with phytoestrogens from things like Legumes, Beans, and Flaxseed to help alleviate some of the more unpleasant symptoms associated with hot flushes.

Cooling Down Hot Flushes

More advice on the topic of hot flushes would be: staying cool, avoiding triggers like caffeine and alcohol, and using breathable fabrics such as cotton or linen, that allow the heat to escape.

Why Bone Health Matters (1.1)

Bone health is so important. Good bone health will prevent fractures or other bone related injuries that the body becomes more susceptible to as we age. Therefore, in perimenopause, we must focus on an adequate intake of both calcium and vitamin D, in addition to effective weight-bearing exercises, which are equally important for bone health, in my view. More to the point, there is plenty of research coming out about muscle maintenance and bone health.

Lifestyle Changes: Regular exercise, a healthy diet, sensible supplementation, and stress management can alleviate many symptoms.

Medical Treatments: Hormone replacement therapy (HRT) and other medications may be recommended by healthcare providers.

Support Networks: Connecting with others going through similar experiences can provide emotional support and practical advice.

Perimenopause is a unique and possibly quite disruptive journey for everyone who goes through it. But I remain optimistic. My words of encouragement would be this — with the right knowledge, support, and proactive decisions for the good of your health, you can get through it all with strength, confidence and grace. 

So, take care of yourself and others, stay informed, and never ever hesitate to seek help when you need it. You're not alone on this journey and you do not need to stay silent! 

If you have the right approach, it is definitely true that you can get stronger and more empowered than ever in perimenopause, both mentally and physically. Let’s spread the word.

A special thanks to Dr Hazel Parkinson

You can connect with Hazel and learn more about her work at Dr Hazel Skin Solutions. Follow her on Instagram at @drhazelskinsolutions or on Facebook at Dr Hazel Skin Solutions.

Taking control over your health is important during the perimenopausal phase for reasons that are long overdue. This could be attained with lifestyle adjustment, medical intervention, or simple changes, such as engaging with your community.

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For an inside look at the personal experiences of perimenopause, don't miss our blog on "5 Things I Wish I Knew Before Perimenopause" by Wizz Selvey, Valerie's Co-founder. It offers uniquely candid insights and solutions that resonate with what many women go through during this wildly unpredictable and challenging time.