Am I in perimenopause, or is this menopause?
The early signs and symptoms of perimenopause might surprise you.
I am asked this question all the time. Many fear the answer, especially as it has been sold to us as just a biological ending of our fertility, youth and value. But menopause is so much more than just our biology. It is a profound phase of psychological and spiritual growth, not just an ending but a transformation and also, a new beginning.
First, let’s clarify how perimenopause and menopause are different. Perimenopause changes start for most in their mid to late forties, though can start as earlier. And menopause really refers to the rest of your life after you’ve gone at least a year without a period. Most people will be in their 50’Everything up until that time is perimenopause.
(NB: Some people do experience changes as early as their mid-30’s and this much less common occurrence is more accurately referred to as premature ovarian insufficiency. It is a serious and related condition that requires careful management that is in some ways different to perimenopause later in life. Your symptoms and life experience are also likely to be different at this stage.)
Everyone’s experience of symptoms is different and while there is a lot of talk about hot flushes and weight gain, those are not necessarily the first signs of hormonal changes relating to perimenopause. In my experience cycle changes, cognitive and mental health changes and musculoskeletal symtoms are much more likely to present as early symptoms but are often overlooked as they may not be considered as early menopause symptoms (depending on who you talk to).
I think it is important to know it is not all about symptoms. Other profound changes are happening too – you might already sense that, or feel the truth of it as soon as you read those words. The changes of menopause represent a major transition in a woman's developmental arc, shifting focus from external caretaking to internal self-actualization. The significance of this change is not to be underestimated. But nor is it to be feared.
Know this: whatever you are struggling with already will likely be magnified by menopause – whether that is a specific health issue, your relationship/s, your work or something else. Wherever that crack is, menopause will likely pry it open.
Saying that, some people will coast through menopause and ask what all the fuss is about. Others will experience profound and deep changes and sometimes dark times that require a great deal of support. Learning to prioritise some time to care for yourself is an absolute non-negotiable during this time. We’ll talk about that a lot in your first Foundation consultation.
Common and uncommon symptoms are legion, but I consider the following to be common. You may experience all, some or none of the symptoms listed here. It is not an exhaustive list so if you’re symptoms don’t match, let’s talk and see what we can figure out.
Common changes in perimenopause:
fatigue
changes in mental health, including anxiety, depression and other issues
new, changed or worsened musculoskeletal issues;
sleep disturbance
thermoregulatory issues (usually hot, but sometimes hot and cold, night sweats etc.);
mood changes from intolerance to flat out rage and often grief;
menstrual cycle changes (shorter, longer, heavier, lighter, missed periods);
cognitive changes including brain fog, forgetfulness and losing words
genito-urinary changes (increased frequency of UTI, vaginal dryness, decreased libido, changes in continence)
metabolic and weight change
changes in bone density
oral health symptoms including dry mouth
gut and microbiome changes
It is important to recognise that due to the general nature of some of these changes, proper testing is essential to understand where you are. Getting appropriate support for your specific presentation is important and finding the right team is key.
Most importantly, remember, this is a transition period and most of these symptoms will resolve with time, or can be well managed with appropriate support and treatment (eg: hormones, counselling, lifestyle modification, etc,).
If you are in need of support and understanding of the changes you’re experiencing, starting with a [Foundation consultation] with me will give you some clarity, action steps and support as you embark on understanding your own menopause transition.
If you feel in need of more urgent support, contacting a good women’s health GP is a good place to start. Or contact
Beyond Blue: Call 1300 224 636 or use the Beyond Blue Online Chat to talk to a counsellor about mental health and mood changes.
Lifeline: Call 13 11 14 for 24-hour crisis support.