Read about the signs and symptoms of perimenopause

GlycanAge is a biological age test paired with expert advice to help guide your wellness.

Ride Out The Storm: Perimenopause Symptoms

Perimenopause (also known as menopause transition) begins before menopause. It can go on for several years, and it is the time when your ovaries gradually reduce oestrogen production. It tends to start for most women in their 40s, but it can begin in their 30s or earlier.

ARTICLE BY

The GlycanAge Team

Summary

During perimenopause, the body decreases in production of reproductive hormones (including oestrogen and progesterone). These hormones help regulate many of your body's systems and when hormones fluctuate, they can produce some noticeable and life-disrupting symptoms. There are some who will transition into menopause without much disterbance, while others can develop symptoms that are so severe it can impact their physical, emotional and mental health.
Every woman will experience the transition to menopause differently. However, one of the first signs most will notice will be perimenopause periods. When progesterone levels start to drop, the endometrium can no longer stick to the uterus walls, which is why women can experience such unpredictable bleeding. Heavy bleeding can also occur shortly before menopause as oestrogen levels rise before falling. The production of progesterone and oestrogen will continue to go down to low levels, which is when your reach menopause.
Some of the most common perimenopause symptoms include hot flushes, mood swings, problems sleeping and fatigue, low libido and vaginal dryness, urinary weakness and changes to their periods. There are many ways to manage these symptoms through lifestyle choices - such as exercise, diet, and some medical methods like hormone replacement therapy (HRT).
There are also some slightly less common perimenopause symptoms which are worth being aware of. For example, bad odour from the hot flushes, vision issues due to dry eyes, lowered oestrogen levels causing skin problems, hair loss, cold flushes in response to excessive sweating, and change in taste.

Introduction

For many women, perimenopause will last an average length of four years, but for some, it may only go on for a few months or continue for ten years. Perimenopause ends when women have gone for 12 months in a row without having a period.

The transition period lasts until the point when your ovaries stop releasing eggs. Then, during the last year or two of perimenopause, the drop in oestrogen starts to speed up. During this stage, many women experience menopause systems. Read on to find out about some of the most common and obscure perimenopause symptoms.Common Perimenopause symptoms

Pink women's underwear decorated with flowers pegged onto a clothesline isolated on white background.

A woman's transition to a time when they no longer experience periods can be challenging. For some, it can go on for up to 10 years before they finally reach menopause. The body, during this time, is decreasing its production of reproductive hormones – including oestrogen and progesterone.

These hormones regulate many of your body's systems, including body temperature and sexual health. When hormones fluctuate, they can produce some noticeable and life-disrupting symptoms. Some women will transition into menopause without noticing signs, while others can develop symptoms that are so severe it compromises their physical, emotional and mental health.

In the early stages of perimenopause, many women first notice the hormonal fluctuations that cause their periods to change. The length often becomes shorter than normal, or they experience spotting or heavy bleeding. This is linked to the decline in progesterone, a hormone produced by ovaries.

The hormone progesterone helps the tissue inside the uterus (known as the endometrium) stick to the walls of the uterus – which helps with pregnancy. However, when the levels of progesterone start to drop, the endometrium can no longer stick to the uterus walls, which is why women can experience such unpredictable bleeding. Heavy bleeding can also occur shortly before menopause as the levels of oestrogen rise before dropping. The production of progesterone and oestrogen continues to decline to really low levels, which is when menopause happens.

Some perimenopausal women experience a change in their periods up to a decade before reaching actual menopause. A hormonal contraceptive, such as an IUD or "the coil", can help control vaginal bleeding. It contains a synthetic version of progesterone which helps to keep the lining of the uterus sticking to the uterus wall. However, reducing the time periods will not be affected is impossible.

Woman laying on a bed trying to sleep with a wall light glowing in the background.

What other perimenopause signs can you expect apart from apparent changes in perimenopause periods? Here is a list of some of the most common perimenopause symptoms:

Hot flushes – Perhaps one of the most talked about perimenopause symptoms, it is estimated that between 50% and 85% of women over the age of 45 will experience hot flushes. Scientists are still not entirely sure what causes hot flushes, but they do know it is connected to hormonal changes which are occurring during the menopausal transition.
Mood swings – The mood swings experienced during perimenopause can go beyond irritability and feeling a bit low. Several extensive studies have shown an increased risk of developing depression during perimenopause. One of the best ways to help manage mood swings is by generally looking after yourself, getting the eight hours of recommended sleep per night, eating healthy food and exercising regularly. All the changes going on with the body can be challenging for some women to handle. It is important to remember these symptoms are caused by hormones and not necessary surroundings, so it might not be a job, partner or general life causing the mood swings.
Sleeplessness and fatigue – Having problems sleeping while entering the menopausal transition is another common symptom for women and can become worse when entering their period. Staying active, practising a calming bedtime routine and including meditation can help. Some insomnia medications are also available, but these are usually only used as a last resort.
Diminished libido and vaginal dryness – One of the knock-on effects of low libido is that the decreased sex hormone levels can also lead to vaginal dryness. This can be a very uncomfortable condition, but there are some treatments to help. One popular method is to use a local oestrogen treatment that comes in a gel or pessary. These can help with oestrogen levels and are considered safer than hormone replacement therapy (HRT) which affects the whole body.
Urinary weakness – As the levels of oestrogen decrease, women can experience urinary incontinence as the urinary tract contains oestrogen. Using local oestrogen gels or treatments can help alleviate the symptoms, but it is worth working on preventing this problem rather than trying to cure it. This is one of the reasons why doing regular pelvic floor exercises is so worthwhile. Of course, there is only so much pelvic floor exercises you can do, especially if the woman has given birth. Many women suffer from urinary weakness for years before perimenopause but are too embarrassed to seek help. It is worth getting this issue sorted before oestrogen levels drop, as the condition will only get worse.

Unusual Perimenopause Symptoms

A woman sitting on a sofa with her eyes closed wrapped in a warm grey blanket.

We have gone through some of the most common reported perimenopause symptoms, but as mentioned, every woman's experience is different. The body is going through a complex time of transition, and some may have some unusual symptoms. Here are some of the more uncommon symptoms:

Bad odour – The fluctuating oestrogen levels tricks the body into thinking it is overheating. This excessive sweating and hot flushes can cause some embarrassing body odour. As a result, some women find they will need to take more frequent showers to help manage odour.
Vision issues – Hormones can also affect ocular tissue composition. This causes changes in tear production which can cause dry, scratchy eyes and a change in vision. However, there are some eye drops which can help alleviate discomfort, but they should be closely monitored to ensure you are looking after your eye health.
Skin problems – With the lowered oestrogen levels, skin can become dry and thin, making perimenopause a time when exiting skincare routines to be adjusted to suit the changing skin needs. It is also possible for chin hair to start coming through, and bruising can occur more easily.
Hair loss – As many men experience hair loss as they age, some women may also have some thinning and loss of hair during perimenopause. This can also be due to inherited androgenic alopecia which can be triggered during this time. There are some great hair products which can help stimulate growth and help hide thinning areas.
Cold flushes – Most people are familiar with perimenopause hot flushes, but some women also experience cold flushes. The body sometimes responds to the excessive sweating needed to reduce body temperature by suddenly triggering a cold flash.
Taste changes – The drop in oestrogen also decreases mucus production, which is also in your mouth. This change can cause a dry mouth and can alter taste buds. Although this can be annoying, it can be used as an opportunity to try new foods and make some healthier diet choices.
Urge to conceive – It is still possible to get pregnant during perimenopause, and some women find their biological clock letting them know this is their last chance to have a baby.

Closing Thoughts

As you can see, perimenopause can significantly impact your daily life – including your relationships, family, social life and work. However, by growing knowledge of the symptoms women experience during this sometimes lengthy transition, we can learn ways to support ourselves and others around us. It is important to note that the perimenopause age and symptoms can vary broadly from person to person, so there needs to be an understanding of everyone's individual experience of the menopausal transition.

Frequently Asked Questions (FAQs)

What are the first signs of perimenopause?

One of the earliest things you may notice as your body enters perimenopause is a continual difference of seven days or more in the length of your menstrual cycle. Other common signs include hot flushes, sleep problems, unable to focus and mood swings. These are all common symptoms as hormones start to play havoc with your body.

Can I take anything for perimenopause?

There are plenty of methods for helping with perimenopause symptoms, including natural approaches and medications. One popular treatment is hormone therapy which involves systemic oestrogen therapy. This comes in pill, skin patch, spray, gel or cream form. It is presently one of the most effective treatment options for relieving perimenopausal symptoms.

What do perimenopause periods look like?

Perimenopausal periods will be slightly different for every woman. Some may experience spotting between periods, abnormally heavy bleeds, change in period colour (such as brown or dark blood), shorter or longer cycles, missed cycles and other irregularities.

Does perimenopause make you feel weird?

Many women indeed feel weird when going through perimenopause. This is often down to mood swings, irritability or feeling depressed during the lead-up to menopause. In addition, these physiological symptoms can be caused by the sleep disruptions associated with hot flushes, which are triggered by hormonal changes.

How do you survive perimenopause?

There are lots of ways you can make perimenopause a less painful experience. The first suggestion is to arm yourself with knowledge, as you will better understand what to expect and less likely to catch you off guard. Be sure to follow a healthy diet and lifestyle, which includes regular exercise, eating a balanced diet, good sleep habits, managing stress levels and becoming clued up on potential treatments – such as hormone therapy.