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Understanding perimenopause and an holistic approach to symptoms
Many of us haven’t heard of the term ‘perimenopause’, yet it’s a significant period in a woman’s life. Perimenopause is the transitional phase that occurs before menopause, and it can last up to 10 years. Although perimenopause usually begins in the mid-40s, for some women, it can start in their 30s. Like menopause, the hormonal shifts experienced during perimenopause can cause a variety of physical and emotional changes.
As life expectancy has increased, more women are spending a significant portion of their lives in the three phases of menopause. These include perimenopause, menopause and post-menopause. Yet many women feel unprepared or are unaware of what to expect. This article will help explain perimenopause, and offer insights, information, and support to help you navigate this stage.
Breaking the taboo
Many women are unaware of the symptoms of perimenopause, or even that this stage of menopause exists, because formal education on this topic is lacking. In school, we learn about puberty and sex education, but there’s little discussion about the changes that happen later in life. This lack of education means many women enter this phase unsure of what to expect or how to manage symptoms.
But times are changing. More women and healthcare professionals are beginning to have open discussions about the stages of menopause, and there’s a growing movement towards better education and empowerment.
Let’s understand perimenopause
Perimenopause is when a women’s body gradually begins to produce less oestrogen. It is the stage leading up to a women’s last period, before she reaches menopause.
Oestrogen and progesterone levels fluctuate dramatically during this stage, causing changes in a woman’s menstrual cycle, mood swings, and various physical and mental symptoms. Perimenopause can last anywhere from four to 10 years before a woman officially reaches menopause, which is defined as one full year without a period.
What’s happening in your body?
During this time, your ovaries start running out of eggs, which can lead to irregular periods, heavier bleeding, or skipped periods. Some women may ovulate twice in a single cycle.
Oestrogen levels decline quickly during perimenopause, which can affect various parts of the body, including the brain. Because oestrogen receptors are located in the hippocampus and frontal lobes, the regions of the brain responsible for memory and learning, many women can experience symptoms such as memory lapses, trouble concentrating and ‘brain fog’. In fact, up to two-thirds of women report memory issues during perimenopause.
Recognising perimenopause
So how do you know if you’re in perimenopause? The most-obvious sign is a change in your menstrual cycle. Periods may become irregular, either closer together or further apart. You may also notice heavier bleeding or other symptoms like tender breasts, cramping, and headaches - like the symptoms you may have experienced during puberty. Tracking your cycle can help you identify patterns and recognise when you’re entering perimenopause.
The impact on mental health
Perimenopause isn’t just a physical transition, it can also affect your mental health. Research shows that women in perimenopause are at a higher risk of developing depression compared to both pre- and postmenopausal women. Women with a history of postpartum depression or mood disorders are particularly vulnerable. It’s important to seek support if you’re struggling during this time.
The reality is many women navigating the changes of perimenopause are also managing careers and families. With increasing numbers of women remaining in the workforce during midlife, the symptoms of perimenopause, such as fatigue, mood swings, and difficulty concentrating, can impact work performance. And perimenopause symptoms are often under-recognised and not taken seriously. In some cases, severe symptoms have even forced women to leave the workforce altogether. It’s crucial to raise awareness about these issues, to help workplaces become more supportive environments for women going through this transition. There are resources available on the NSW Government website designed to equip managers and employees with the knowledge and tools to navigate this phase while at work.
Empowering yourself through perimenopause
Education and awareness are key to navigating perimenopause. By understanding the changes happening in your body and seeking the right support, you can take control of your health during this time. Here are a few steps you can take to help you along the way:
- Track your symptoms: keeping a journal or using an app can help you identify patterns in your cycle and symptoms.
- Educate yourself: the more you know about perimenopause, the better prepared you’ll be to manage it.
- Talk to your doctor: if you’re experiencing symptoms that interfere with your life, don’t hesitate to ask for help. Look for a healthcare professional who specialises in women’s health or ask your GP to refer you to one.
- Connect with others: talking to friends or joining a support group can make this journey less isolating.
- Take care of your body: regular exercise, a balanced diet, and stress-management techniques can help you stay healthy during this transition.
Holistic practices aim to treat the whole person, rather than just the individual symptoms. Many alternative and complementary therapies take this approach. A significant portion of Australian women – close to 40% – use complementary or alternative therapies, with emerging data to support their effectiveness. Some examples of popular complementary therapies are below. We also recommend that before embarking on any new programs, you discuss their suitability for you with your healthcare professional.
- Mindfulness techniques like paced breathing, and mindfulness-based stress reduction (MBSR) can help women manage symptoms like hot flushes, improve mental health, reduce anxiety, and even positively impact cholesterol levels. Although these methods may not reduce the frequency or intensity of symptoms, they can make them feel less distressing.
- Meditation is a practice that involves focusing or calming the mind using various mental and physical techniques. It can help reduce stress and promote restful sleep, among other benefits.
- Cognitive Behavioural Therapy (CBT) is a technique that can help people manage their emotional response to symptoms by reshaping negative thoughts. It encourages positive self-talk, and offers practical strategies like paced breathing to stay calm. This method has been proven effective for managing mood, sleep, and self-image challenges during perimenopause.
- Movement-based therapies like yin yoga, restorative yoga, and qi gong may help improve flexibility, joint mobility, and mental health. These gentle exercises can help alleviate stress, improve sleep, and enhance bone health, making them excellent options for holistic symptom management.
Let’s keep the conversation going
Perimenopause is a natural and important phase of life, but it’s often misunderstood or overlooked. By opening conversations and seeking proper education, we can empower ourselves and others to navigate this phase with confidence. Remember, you’re not alone — there’s a community of women who are experiencing the same journey, and we’re all in this together.
All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.
Sources:
https://www.healthdirect.gov.au/perimenopause
https://menopause.org.au/hp/information-sheets/perimenopause
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244939/
https://www.jeanhailes.org.au/resources/perimenopause
https://www.sciencedirect.com/science/article/pii/S0165032724006438
https://www.menopause.org.au/members/ims-menopause-live/menopause-and-work
https://www.who.int/news-room/fact-sheets/detail/menopause
https://www.verywellmind.com/benefits-of-mindfulness-based-stress-reduction-88861
https://www.healthdirect.gov.au/meditation
https://www.verywellmind.com/buddhist-meditation-8619603
https://www.thewayofmeditation.com.au/hindu-meditation
https://insighttimer.com/meditation-topics/christianity
https://insighttimer.com/muslimmeditation/guided-meditations/al-noor-muslim-meditation