Did you know that perimenopause can start as early as your mid-30s?
Many women experience an array of symptoms as their hormones shift during the months and years leading up to their menopause. Heavy, light or irregular periods, hot flushes, mood swings, anxiety, and restless nights are all common signs and contrary to popular belief, women of all ages (but particularly from the late 30s), could begin to experience symptoms of perimenopause and may find a conversation regarding HRT useful.
It’s important to know that HRT won’t delay menopause, but it will help manage the symptoms of perimenopause. We’d suggest seeking advice sooner rather than later so that you’re fully aware of what to expect and your options when the time comes, and not wait until symptoms become unmanageable.
What is perimenopause?
Also known as the menopausal transition, it is the period leading up to menopause when a woman’s body undergoes hormonal changes that mark the end of her reproductive years. It typically occurs in a woman’s 40s to early 50s but can begin even earlier and last for several years. The transition can be gradual, usually beginning with changes in the menstrual cycle and you can still become pregnant during perimenopause even if you miss your period for a month or more.
Not all women experience symptoms (how fortunate is that!), but in the UK, perimenopause affects millions of women every year, yet it’s still widely misunderstood or goes undiagnosed. If you can recognise the signs and symptoms as well as the importance of seeking medical help early, then with potential treatment options such as HRT, you’ll be able to manage symptoms and reap the protective health benefits.
Signs and symptoms of perimenopause
These vary, but include irregular periods, hot flushes, night sweats, mood swings, sleep disturbances, and vaginal dryness. You may also experience weight gain, brain fog, and decreased libido (sex drive) which result from fluctuating hormone levels, particularly oestrogen and progesterone, which can impact a woman’s physical and emotional well-being.
While perimenopause is a natural stage of life, the onset of these symptoms can be confusing and distressing and it can have a big impact on your life. Often women who contact us for the first time are distressed, anxious and in tears because they have coped and managed (read suffered!) with each symptom because that’s what we do as women, we cope, we manage, we plough on. But, as these symptoms build up, the pressure builds too and it can sometimes have devastating effects.
One of the biggest challenges women may face when dealing with perimenopause symptoms is a lack of understanding or support from their GP. Many women who contact The Female Health Clinic report feeling dismissed, being told that they’re ‘too young’ or are not taken seriously when seeking help for their symptoms.
Hormone replacement therapy for perimenopause
Surprisingly, a lot of women still associate HRT only with menopause and are often shocked to learn that it is most effective to start HRT when perimenopausal for its potential health benefits.
Started in perimenopause, HRT can help maintain your muscle strength and bone density and reduce the risk of osteoporosis. By having a protective effect on the cardiovascular system, it can also lower the risk of heart disease and have a positive impact on cognitive function. So, not only can it help to manage symptoms such as hot flushes and mood swings, but it also has long-term, positive effects on the body.
Unfortunately, doctors are sometimes hesitant to prescribe HRT to alleviate symptoms (possibly due to lack of experience in managing peri/menopause) and cite concerns about the potential risks and side effects. Instead, we’ve found that they often prescribe antidepressants (which may be the only option for some women) for mood and anxiety; however, these will not address the underlying hormonal imbalance and HRT remains the most effective way to manage perimenopause symptoms, especially if started early.
HRT works by replacing the hormones that the body is no longer producing in adequate amounts. It’s not usually necessary to run blood tests to see if you have reached perimenopause but they can be helpful as a baseline when starting treatment and in some cases, they may be advised.
Despite all these proven benefits, there is still a stigma surrounding HRT use for younger women who may be reluctant to consider it as a treatment option. The mindset to ‘punch through’ symptoms or the fear of potential side effects has led to hesitancy among both healthcare practitioners and patients. However, women need to have an open and honest discussion with a knowledgeable doctor about the risks and benefits of HRT and make an informed decision based on their circumstances.
Alongside medical help, women should also consider making lifestyle changes to help manage perimenopause symptoms. This can include adopting a healthy diet, regular exercise, stress management techniques, and adequate sleep. These lifestyle changes can help alleviate symptoms and improve overall well-being.
In summary, perimenopause is a natural and inevitable phase of a woman’s life. It is helpful for women to be aware of the signs and symptoms, as well as the potential treatment options available. Seeking medical help early and exploring the possibility of hormone replacement therapy can have significant short and long-term benefits on physical and emotional well-being and contribute towards maintaining a healthy, happy and fulfilling life.