Understanding Menopause

Wondering if you are going through perimenopause?  Learn how to recognise perimenopause symptoms in this short(ish) blog.

Perimenopause and menopause are natural phases in every woman’s life, yet it can often still be shrouded in mystery until we or someone close to us experiences it.  I hope and believe that this is changing, and I write this blog to continue raising awareness for women, since in one form or another, we all go through it.  Which means everyone – husbands, partners, children, friends too.

The time leading up to menopause, known as perimenopause, is characterised by a huge range of symptoms that can persist into menopause itself.  Understanding these symptoms, empowers you to be able to call out what might be happening to you, and to seek help.  I think it is this time that creeps up on you, surprises you, and can catch you out.

Menopause marks the end of menstrual cycles, officially beginning one year after your last period. This transition results from a decline in hormones such as oestrogen, progesterone, and testosterone, however this decline starts in perimenopause, and is the cause of the change in symptoms.  Oestrogen affects our levels of seratonin, dopamine & noradrenaline. These are our body’s natural antidepressants, so when oestrogen drops, so do our natural antidepressants.

Postmenopause refers to the time after menopause has occurred.

It is important to say that not every woman will have difficulties with their menopause.

When Does Menopause Occur?

In the UK, the average age for menopause is 51, whilst for the perimenopausal is earlier and this is crucial to be aware of.  Varying statistics are available, ranging from 40-47 years old for perimenopause to commence.  In addition, underlying medical conditions, cancer treatments and being aware of your own mother’s medical history, will also affect onset timing.

It is also important to note that while some women transition with minimal discomfort, others may experience symptoms for several years, with about 10% facing them for a decade or longer.

What are the symptoms of perimenopause and menopause?

Here’s a list of the most common symptoms that could be early signs of perimenopause.  It is important to be aware of the less common symptoms too, so that you can understand your body and feel empowered in acknowledging what might be happening for you.  The extensive list is below the most common symptoms – I recommend reading through them all.

Common symptoms of perimenopause and menopause:

• Hot Flushes and Night Sweats: Often described as sudden feelings of heat that seem to come from nowhere and spread throughout the body.  These are often accompanied by sweating, palpitations and flushing of the face.
• Sleep Disturbances: Difficulty falling asleep and interrupted sleep, leading to fatigue.
• Fatigue: Even when you do sleep it doesn’t seem like enough, and you find yourself nodding off during the day. 
• Mood Changes: Increased irritability, anxious feeling and low mood, even depression.
• Cognitive Issues: Memory lapses or “brain fog.”  Women often describe their brains feel like ‘cotton wool’.   You may notice that you are increasingly forgetful, cannot remember ordinary words, misplace things more than you used to, find it hard to retain information, and forget what you were saying mid-sentence.
• Physical Changes: Weight gain (and in different places to you are used to), joint stiffness, and vaginal dryness.
• Changes to your periods: We all know our cycles, and if you start to notice a change in it, perhaps periods slightly less frequently, heavier periods, lighter periods.  It is worth keeping a diary of the changes over a couple of months to raise your awareness.

All the other potential symptoms of perimenopause and menopause:

Mental health symptoms

• Crying spells
• Feeling emotionally numb
• Feeling more emotional
• Increased stress
• Low self-esteem
• Loss of confidence

Cognitive symptoms

• Low mental energy or lack of motivation

Physical symptoms and pain

• Restless legs
• Breast tenderness or swelling
• Itchy breasts
• Dry eyes
• Dry, brittle or weak nails
• Thinning or brittle hair
• Dizziness
• Tinnitus / ringing in the ears
• Heart palpitations
• Headaches or migraines
• Joint and muscle aches
• Joint pain or soreness

Skin symptoms

• Acne
• ‘Crawling’ or tingling skin
• Dry or itchy skin

Oral health symptoms

• Dry mouth
• Changes to sense of taste
• ‘Burning’ mouth or tongue
• Sensitive teeth
• Painful or infected gums

Digestive and gut health symptoms

• Bloating
• Acid reflux / heartburn
• Constipation
• Diarrhoea
• Excess gas

Sexual and urinary health symptoms

• Reduced sex drive
• Pain or discomfort during sex
• Vaginal infections
• Urinary/bladder infections

By making yourself aware of all these symptoms, you are empowering yourself.  Being able to recognise perimenopause symptoms allows you to start making choices and following up with healthcare professionals with greater confidence.  It can be really helpful to keep a diary over a few weeks or months as you experience these symptoms.  It remains a common problem that symptoms can be mistaken for other ailments, most commonly, anxiety and depression.

My story for your benefit

Of course, this is told with the benefit of hindsight.  When I reflect back, I can offer a little gratitude towards the physical and emotional effects I experienced entering perimenopause.  I possibly wouldn’t be where I am today, doing what I am doing, if those effects hadn’t impacted me in such a seismic way – I still wish they hadn’t been so hard on me though!

I had many of the common symptoms – irritability, loss of sleep, irregular period patterns and anxiety.  They also included many symptoms that I could not explain and led me to seeing a counsellor for the first time at 43.

💥 having an unexplained sense of loss (actually it felt like an emptiness I feared was depression until we talked it through)
💥 losing my sense of purpose and direction
💥 feeling disconnected from friends and no longer wanting to do what I’d previously enjoyed (felt like depression too)
💥 no longer enjoying wine because of the feelings I had the next day – who even was I?

💥 heart palpitations that kept me awake at night, that led to increased anxiety (I went for an ECG I was so worried – HRT took these palpitations away)
💥 itchy, itchy skin
💥 forgetting my words

These led to an absolute loss of confidence and desire for the career I had.  It was terrifying and I felt like such a failure!  I didn’t feel like I could do my job anymore, or want to!  Also read my blog on recognising the symptoms of burnout.  Perimenopause and it’s symptoms undoubtedly contributed to my “scrape” with burnout too.

Within 6 months of counselling, and I had to work hard in that time (I realise now how hard my counsellor was working too) I had gone part time and took some time to reflect on whether I really wanted to be a counsellor, or it felt exciting because of the changes it was bringing for me (plus lots of HRT I must add).  I also reduced my caffeine intake, alcohol and made healthier food choices.

I feel lucky and blessed. I was able to seize an opportunity. If I didn’t have that option, if I hadn’t had access to counselling and the tenacity to push the GP surgery for better support, it could have been a different story.  HRT (including testosterone) was a total game changer, I remember describing feeling like a floppy, raggy doll one day, and then an alert superwomen virtually the next day.  I did have to juggle with the type of HRT that I took though, and over time the dose I was taking did not have the same effect, so I also had to have an increase – it is constant monitoring.

I was able to study alongside working in a corporate job, part time.  During those four years of training, I was made redundant twice, and had bouts of needing time away from work, and additional talking therapy, but I survived it all and came out a stronger lady on the other side.  It was a four year struggle with myself and a change in the competencies I have and the desires that I have. It took a while to get to know myself again.   

I don’t want to make the navigation of perimenopause, its symptoms and effects sound too easy, but I do also want to give you more than a glimmer of hope!

Listen more to me and others on Menopause Natters with the brilliant Emma Noughton – https://open.spotify.com/show/7jGrQ90iGo2IiTYpULNhzD?si=23ec5588317d4189

Is there hope?

Yes!

There are so many more accessible resources out there these days, for you to educate yourself and empower yourself with knowledge, so that you can take action for yourself, which includes asking for professional medical help, and support from your employer, and from your close family.

I have provided a starter list of websites and Instagram accounts to follow, and you will find many more for yourself.

I hope my story helps to highlight the different experiences we all can have, the options available to us for help, and the glimmers of hope as you work your way through the symptoms and find ways to manage them.

See my blog Practical tips for body and mind during menopause  for more information and support. 

Useful resources

Websites and podcasts

Menopause Natters podcast – https://open.spotify.com/show/7jGrQ90iGo2IiTYpULNhzD?si=23ec5588317d4189

Dr Louise Newson podcast – https://open.spotify.com/show/7dCctfyI9bODGDaFnjfKhg

Menopause Care (by Dr Naomi Potter) – https://www.menopausecare.co.uk/blog

My Menopause Centre – https://www.mymenopausecentre.com/our-purpose/

Menopause Doctor and the Balance app (by Dr Louise Newson) – https://www.menopausedoctor.co.uk

Resources shared by psychotherapist and campaigner, Diane Danzebrink – https://menopausesupport.co.uk/

Black, gender inclusive podcast on menopause – https://blackgirlsguidetosurvivingmenopause.com/

Dietary advice – https://lizearlewellbeing.com/healthy-food/healthy-menopause-foods/

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@dr_naomipotter

@menopause_doctor

@menopausematters

@menopausenutritionist