What is the perimenopause? Symptoms and treatments to know
“I’m getting the brain fog going through the pre-menostal [menopausal] or whatever it’s called, and I wake up and my bed is soaking wet. I hate it,” the former reality TV star and model said.
“So I’m just going to get my blood test because maybe I’m having an early menopause, I don’t know how it all works, but I’m still having my periods.”
What is perimenopause and how do you know if you’re experiencing it?
Menopause refers to the point when a person has gone 12 consecutive months without a menstrual period, signalling the end of their reproductive years. But perimenopause — the transitional phase leading up to menopause — can be more difficult to pinpoint. It often begins in a person’s 40s (sometimes earlier) and can last between seven and 10 years.
During this time, estrogen levels in the body fluctuate unpredictably, causing diverse symptoms. These may include irregular periods, hot flushes, mood swings, sleep disturbances, brain fog, anxiety and changes in libido. Because symptoms can come and go — and vary widely between individuals — many people don’t immediately realise they’re in perimenopause.
Symptoms of perimenopause
- Irregular periods
- Mood changes such as depression, anxiety and mood swings
- Hot flushes
- Difficulty sleeping
- Reduced sex drive
- Headaches
- Weight gain and changed body shape
- Palpitations
- Muscle aches
- Skin changes (such as dry and itchy skin)
- Vaginal dryness
- Recurrent urinary tract infections
- Sensitive teeth and painful gums
Why might perimenopause cause night sweats?
Price said that she’s been waking up to find her bed “soaking wet,” possibly due to night sweats. According to Dr Elise Dallas, women’s health GP and menopause specialist at The London General Practice, this may be due to fluctuations in oestrogen.
‘The gold standard treatment is hormone replacement therapy (HRT), which replenishes the declining hormones,’ Dr Louise Newson says
Alamy/PA
“These hormonal changes affect the hypothalamus, the part of the brain that controls body temperature, making it more sensitive. As a result, even small changes in your surroundings can cause a sudden wave of heat, sweating, and a racing heart, even in a cool room,” she told the Standard.
Hot flushes and night sweats — known as vasomotor symptoms — affect around 80 per cent of women, with about 30 per cent experiencing them severely. Symptoms can begin at any stage of perimenopause but often occur in later perimenopause, peak in the first year after the last period, and can continue for several years — on average around eight.”
Dr Dallas added that “stress, alcohol, spicy foods, and warm bedrooms” can exacerbate hot flushes and night sweats.
Why is perimenopause so frequently misdiagnosed?
Multiple studies have found that 85 per cent of women experience perimenopause symptoms, including night sweats, headaches and skin changes, yet it is frequently misdiagnosed.
“Perimenopause is frequently misdiagnosed because its symptoms are so wide-ranging and often mistaken for other conditions,” Dr Dallas said. “Some may not report symptoms at all, thinking they are too young.”
As well as this, it’s possible to experience perimenopause without having significant changes to periods. “Many healthcare professionals don’t connect these to hormone fluctuations, and medical training often lacks proper education on menopause and perimenopause,” said Dr Louise Newson, hormone specialist and founder of the free balance app.
How can perimenopause be treated?
Perimenopause symptoms vary from person to person, with varying levels of discomfort. “The good news is that perimenopause can be treated,” Dr Naomi Potter, founder of Menopause Care clinic and co-author of Menopausing, told the Standard.
“The gold standard treatment is hormone replacement therapy (HRT), which replenishes the declining hormones, mainly oestrogen and often progesterone. This directly addresses the underlying hormonal imbalance,” said Dr Newson.
However, HRT is not the only solution. “Some women choose lifestyle changes, such as improving diet, getting regular exercise, managing stress, and prioritising sleep. Cognitive behavioural therapy (CBT) has also been shown to help with mood and anxiety symptoms. And there are non-hormonal medications and supplements that can be considered too,” Dr Potter said.
“If you are worried about your symptoms, find that they are impacting your quality of life, or simply want to know more about managing perimenopause, speaking to a doctor is an important first step. A menopause specialist will be able to advise you on the best treatment plan suited to your individual needs and preferences.”
