Getting Started with Nabta Health; Your 101 Guide to Perimenopause and Menopause

Perimenopause is a natural process in a woman’s life caused by a normal biological decline in reproductive hormones. Perimenopause onset varies from woman to woman and can take place at any stage from a woman’s mid-30s (premature menopause) into her late 50s.  

Also known as the ‘menopause transition’, perimenopause lasts between three and 10 years. The average length of perimenopause is 4-5 years, and the average age of menopause is 51 years.

Menopause marks the end of perimenopause, when a woman has gone a full 12 months without menstruating. After a year of no menstrual periods a woman is considered to have gone through menopause to her post-menopausal phase. 

Induced menopause is when a woman’s menstrual periods stop due to medical treatments or intervention. Chemotherapy or radiation damage to the ovaries, and surgical removal of the ovaries result in medically induced menopause. 

Postmenopause is the ongoing phase of a woman’s life after menopause. It’s important to note that many women continue to experience the classic menopause symptoms for years after their ‘official’ menopause.

What happens to a woman’s body when she is perimenopausal? 

The hormones that flooded a woman’s body during puberty and her fertile years start to fluctuate due to the decline in the female reproductive hormones (estrogen and progesterone) produced by her ovaries. 

These hormonal deficiencies lead to many physical changes taking place in a woman’s body long before her ‘official’ menopause.  

What are the symptoms of perimenopause and menopause?

• Hot flashes / flushes
• Night sweats
• Vaginal dryness
• Irregular periods 
• Hair loss
• Weight gain and slowed metabolism
• Itchy or dry skin
• Disturbed sleep
• Urinary incontinence
• Mood swings and anxiety
• Brain fog or memory loss
• Low libido

The physical changes and symptoms women experience due to the reduction in hormones can be debilitating. 

What are the long-term health risks of menopause?

Long-term hormone deficiency increases women’s risk of chronic health conditions including cardiovascular disease, osteoporosis, type 2 diabetes, dementia, and bowel cancer.

How is perimenopause diagnosed?

A doctor will assess symptoms and may recommend a blood test to check follicle-stimulating hormone (FSH) and estrogen levels. As hormones fluctuate during perimenopause the test may be repeated after a few months if the results are inconclusive. Women who want to confirm their symptoms can also take a perimenopause test measuring the levels of three hormones from the comfort of their home. However, a hormone test isn’t always necessary, and some doctors will diagnose perimenopause based on physical symptoms.

Can perimenopause be treated?

Perimenopause and menopause are natural biological processes in a woman’s body and cannot be delayed or halted with treatment. That said, a healthcare professional may discuss Hormone Replacement Therapy (HRT) and lifestyle adjustments to help manage the physical impacts of hormone deficiency.  

What is HRT?

HRT replaces the hormones the body is no longer producing. The hormone treatment includes estrogen, and sometimes progesterone and testosterone if needed, and is given as a skin patch, gel, spray, or pill.

Most women report their perimenopause symptoms improving within 3-6 months of starting HRT. Taking HRT reduces the risk of developing osteoporosis, cardiovascular disease, type 2 diabetes, bowel cancer, osteoarthritis, and other health conditions due to hormone deficiency.

There are risks associated with HRT, including a small increased risk of breast cancer and blood clots in women with a family history. However, research has shown that for most women who take HRT the benefits outweigh the risks. 

A woman should always have a conversation with her healthcare team to decide the best approach for her individual circumstances.

Are there natural ways to reduce the symptoms of menopause?

Lifestyle adjustments can also be beneficial in managing perimenopausal symptoms. 

Women should try to eat a balanced diet with plenty of fresh fruit and vegetables, protein, whole foods, and foods rich in omega-3 fatty acids and calcium. Phytoestrogens can mimic the effects of estrogen in the body and occur naturally in foods including flaxseeds, sesame seeds, beans, soy, garlic, and cruciferous vegetables.

Stop smoking and cut back on foods that might disturb sleep or trigger hot flashes, such as caffeine and alcohol. 

And exercise is essential. The decline in hormones affects bone and joint health, so it is more important than ever to maintain strength and flexibility with regular cardio and weight bearing exercise. As a woman’s metabolism naturally changes with age, exercise will also help with weight control.

Can I still become pregnant during perimenopause?

While you are still having your period you can become pregnant. If you don’t want to be pregnant you should continue to use contraceptives until you are postmenopausal.

Understanding menopause

Health organisations and governments are increasingly recognising the gaps in knowledge and understanding of perimenopause and menopause and its enormous impact on women’s health and wellbeing.

Efforts are now being made to address gender inequalities in broader healthcare provision and rebalance the lack of menopause research. 

The last few years have seen investment in improving education around perimenopause with the goal of empowering the more than 50% of the world’s population who will go through menopause with evidence-based therapeutic support.

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