WTF is Perimenopause and why do I feel like I do?

I believe in waving goodbye to the idea that midlife health is a desolate wasteland, where we are constantly held back by our bodies and minds, and saying hello to the glitterball disco that comes with age, experience, life adventures and an innate knowledge gained from being on this beautiful planet for a while! So let’s get into it shall we?

So, perimenopause can feel like a slap out of nowhere, just like in the old Tango advert (remember the weird and slightly creepy orange guy?). One minute, life’s normal; the next, your periods are a mess, and your mood’s all over the place to the point you can’t even stand yourself. So, what’s going on? In this piece, I’m about to break it all down for you: what perimenopause is, why it makes you feel like a different person, and (most importantly) what you can figgin’ do about it!

Read on as I provide solutions based on real women and real experiences (some anecdotal, of course). You can also hear my take on Valerie, a brand I’ve teamed up with because I’ve seen the real impact it has. 

Women tend to be more intuitive with their bodies than men and often know something is different, but when you have 48 (and more) possible symptoms to choose from, seeing the wood for the trees can be tricky. Typical (and I say this very loosely) perimenopause can start around the age of 45ish and often lasts for the best part of ten years. The average age in the UK to experience menopause is 51 years old. Menopause occurs when you have reached 12 months without a period.  

Your key female hormones are oestrogen and progesterone. Oestrogen, our busy bee hormone, is responsible for many of the symptoms experienced.  Found from our teeth to our toes and beyond, its somewhat erratic behaviour and eventual decline in the menopause transition can lead to night sweats, hot flushes, confusion, forgetfulness, mood swings, itchy skin, aches and pains and possibly painful and uncomfortable sex. 

This can leave women feeling like a shadow of themselves, lower their confidence and libido, provoke anxious times in the workplace and impact on social life and significant relationships.

I hear you all! Having a better understanding is one thing, finding the time, energy and focus to begin addressing these battering symptoms is an entirely different pile of unwashed and unironed laundry. 

Googling can help, there are some amazing and well-respected resources online. But as we know Dr Google or as I prefer Nurse Web… it is easy to feel overwhelmed with ‘helpful’ advice. I encourage women to take an opportunity to look at all areas of our life, where small adjustments can be made. 

Ultimately your physical and mental wellbeing is at the centre. Taking proactive steps to your whole health and lifestyle is invaluable and will serve you well for years and years to come. 

My Motto is “Start With You” Receiving support and guidance to recognise the adjustments, healthy choices and options available is vital, no one needs to feel alone. 

I can’t speak about options without a worthy mention of HRT, Hormone replacement therapy in perimenopause as it is widely recommended and evidence-based. It can help significantly with reducing symptoms. However, this needs to be prescribed safely and appropriately after a consultation that assesses your personal and family medical history. HRT can usually be taken alongside most supplements and works even better when combined with a holistic approach to health and lifestyle. 

Women are offered and have access to public health screening. This includes cervical screening from age 25. When women turn 50 they are invited to breast screening and from age 54, soon to be offered younger, bowel screening can be completed in the comfort of your own home. I direct women to Know Your Lemons for great infographics on self-examination of breasts. There are other wonderful sites for this too. Engage! It can be lifesaving! 

I like to address sleep first. If this can be corrected and a good night's sleep is achieved then quite frankly you could try ‘World Domination’ next! I advise women to refrain from caffeine after midday. Go for herbal tea or decaf versions. I promise your sleep will thank you for it. 

Hydrate before sleep, and choose comfortable clothing and bedding. Your room temperature should be around 18’c. Avoid alcohol as it will wake you, contemplating regrettable life choices around 2-3 am. Magnesium, Valerian and Camomile are known for their positive impact on sleep. AND this is the toughy- TRY to reduce phone and device time before and during the night. 

Sleep is notoriously hard to fix, and habits are difficult to establish. But when it comes to getting through perimenopause, this is a great starting point. 

Let’s talk a bit about bringing in some coping strategies! We have our friends, who are glorious, beautiful, crazy and amazing. But they might be enduring the same (ish) ride as you. In a world where wellness is at the fingertips of all, there are so many ones to choose from. To save you some time. I have a few up my sleeve.

Mindfulness doesn’t have to look like sitting cross-legged on a cushion in deep meditation. It can be as simple as taking a walk in nature and paying close attention to what’s around you. Instead of getting lost in your thoughts or scrolling on your phone, try tuning in to the sounds of the birds, the rustle of the leaves, or the feel of the ground under your feet.

Relaxation is a wonderful treat for the soul. And I am talking, bedding in deep. Think of a high-end savasana in yoga. Restorative yoga (with no f***s given). Allow your body to release, allow your mind to explore with gentle guidance. This enhances sleep, self-worth and deep comfort within your body. Variations are available for those who find lying down difficult. Sound baths can enhance the experience further. They can help with stress, anxiety, depression and pain.

Having trained as a yoga teacher several years ago, I agree with NICE guidelines recommendation of yoga and pilates being included in the management of perimenopause symptoms. 

I am going to ‘touch’ upon the need for support regarding sexual health and altered sexual function. Many women struggle with loss or reduced libido. This symptom when discussed in clinic is normally brought with a sense of guilt, loss of confidence and general concern for the client’s partner if they are in a relationship.

I am a big believer that communication, exploration and starting with yourself and your desires at this time can be just as helpful for building confidence, increasing libido and enjoying meaningful and sexy connections.

Lifestyle changes can impact positively on your physical health and wellbeing. Diet and weight loss is an ongoing virtual elephant (sorry!) in the room. There is no one way to reduce the extra middle roll often gained in perimenopause. There are many reasons why this happens. Our hormone oestrogen is to blame along with erratic blood sugars, visceral fat deposition and even our liver function. As we are all so unique it is a challenge to generally advise and there are many professionals out there who can provide in-depth knowledge and experience. 

I always suggest good practices, such as reducing sugar content, avoiding alcohol and reducing or stopping smoking. Mindful chewing and eating, with smaller portions and lots of veg. There are some dietary products which are known to potentially reduce symptoms of perimenopause. 

Exercise as we all know is wonderful for both physical and mental health. I advise to approach small steps but little and often. It can be very overwhelming and disheartening to set yourself tremendous exercise goals and not achieve them because of work, responsibilities and tiredness. In terms of protecting our bone health in peri and postmenopausal especially; strength training, stretching and balance are all recommended. 

You may find attending a class that is aimed at women more comfortable or go with friends and have a laugh. Remember there are products for leaky bits and a good bra is essential. Go prepared and smash it. Home and your favourite loungewear are waiting for afterwards. 

A final point to discuss is supplements. There are many to choose from and our body can require additional boosts to support all the shenanigans at this time. If you are here on Valerie reading this, then you are most likely aware of the benefits of using a liposomal product that is fully loaded with many of the minerals and vitamins your body would benefit from at this stage of life. The feedback from this product includes reduced feelings of tiredness and fatigue and increased feelings of energy. If we can find something to help feel this way, all the other little steps on the menopause waltz may feel more attainable and realistic in our lives. 

Women of this age are sexy, our minds and thoughts are sexy.  We have experience and we have most likely navigated the good, the bad and the downright ugly. Maybe we have made mistakes, perhaps we learnt from them, perhaps we didn’t! We have most likely felt love, felt anger and rage and felt like a total badass at times. Some of us have become mothers, wives and even carers for our parents, some of us have not, but we have all weathered the storm, bathed in the sunlight and possibly danced like lunatics under the stars. We all deserve our place in this world. 

With the right connections, community, treatment and management of this crucial life stage, we can have the control to flip the narrative of this perceived dark and dusty wasteland, replace the tumbleweed entering stage left with that of a glittering disco ball, full of light, empowerment and fun. Perimenopause is a time of tremendous change both physically and mentally. We are preparing for this other, more freeing and possibly adventurous time of our lives, but it comes with challenges that require careful navigation. We need to be informed and educated appropriately and safely but with relatable experience. Our expectations and goals need to be handled sensitively and discussed with consideration to you at the front and centre at all times. I hold bespoke consultations, workshops and events that are friendly, nurturing and honest.

Below you will find my go-to guide for getting the best out of your GP appointments in relation to your peri and postmenopausal health. 

This is the thing, perimenopause can act and look like several other potential health complaints, so I always recommend booking with your healthcare provider. I have some helpful tips to follow. 

• Ask if there is a clinician who specialises in or has completed some additional training in peri and postmenopause. This person may soon become your best friend as they will know their stuff and can also identify when additional investigations may be required.

In practice, I am cautious of sweeping everything under the ‘menopause carpet’.

The British Menopause Society has created the BMS Vision for menopause care in the UK. Point 5 identifies that every primary care team should have at least one health care provider with a special interest in menopause care. 

• Please ask for a double appointment or time allocated for at least 20 mins. Your first consultation is going to be full of information, questions and understanding, you just cannot and should not shoehorn this into 10 minutes. You will only be back again feeling unsatisfied. 
• My advice is to go prepared, download a questionnaire or make a list of what symptoms are bothering you. And don’t be shy with this. Symptoms can range from hot flashes and night sweats to bleeding gums, emotional changes, and even a burning sensation in the mouth. Remember to take the list with you. I advise screen shots. We always seem to have our phone with us! 
• Make sure you understand what has been said in your consultation, you should be offered lifestyle advice, a blood pressure check, a look at your cervical screening history, ensuring that you are protected by contraception if appropriate, making sure you are aware of breast health and discussing potential coping strategies and management of symptoms. This may include HRT. 
• And then, review! Go back, check in, and report back. It can take women a while to find the right treatment or dose. Your health care provider should be offering a 3 month review if you are commenced on HRT.

Disclaimer: Within my role in and out of the NHS, I adhere to confidentiality and the NMC Code of Conduct at all times. These views here today represent my own, based on my education and experience providing clinics and meeting those identifying as women from diverse backgrounds. This blog has been based on a general approach to perimenopause. I align my practice with the NICE quality statement; recognising peri and menopause complexities, including types of menopause, surgical, medical, early menopause and POI.

I currently work in primary care in the north of Wales, I am fortunate to be supported by former and present medical colleagues to provide peri and post-menopause consultations and reviews in the NHS that thoroughly meet the standards recommended by NICE guidance and The British Menopause Society. 

I also provide support for employers and employees in the workplace in regard to women’s health and well-being. I am hands-on in the Valerie community group sharing advice, events, webinars and most importantly support for women that isn’t available in the NHS. 

My consultations and therapies are set to provide wellness to women that gently softens the edges of traditional NHS appointments and holistically addresses women’s health and well-being safely with a sense of celebration, adventure, honesty and empowerment.  

Right now, I’m studying for a diploma with the Institute of Psychosexual Therapy and working on core accreditation with The British Society of Lifestyle Medicine.

Please reach out to me on hello@wearevalerie.com if you have any questions about peri and how to navigate what’s happening to your body.