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Perimenopause

WHAT YOU SHOULD KNOW ABOUT PERIMENOPAUSE

 

Written by Eleanor Ruxton

A new sisterhood’s taking over. From royals to TV presenters everyone’s talking about perimenopause! So, we at FabLittleBag have asked ordinary women to share their stories. 

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What is perimenopause?

What is perimenopause

Perimenopause is a period of hormonal changes and symptoms leading up to menopause. Often beginning in a woman’s forties, these symptoms persist up to and even beyond menopause, with women experiencing symptoms for an average of seven years.

“It has the ability to turn your world upside down!” says Roberta, a naturopathic nutritionist and hormone expert, “everything that you took for granted, sleep, memory, your figure, your moods, your sex life, your confidence, can literally be turned on its head.” Like presenter Davina McCall, Roberta feared that her perimenopausal memory loss was dementia. “The memory loss and brain fog were terrifying,” she told us, “I seriously couldn’t remember a thing.” 

Cleo had a similarly frightening experience, “I ended up somewhere and didn’t know how I got there or where I was going to and how to get there, or how to cross a road,” she recalled.

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 For Catherine, another interviewee, having “a moan and a laugh with friends” is a necessary requirement of coping with perimenopause. “It’s like being pregnant again,” she jokes. “The hot flushes take you over and I have really itchy skin!”. For her, “hormones and anxiety were a double-whammy. There are so many different symptoms you can worry that you might be properly ill or dying.” “Talk to your mum,” she advises, “a ‘we’re in it together’ attitude helps.”

What are the symptoms of perimenopause? 

With as many as thirty-four symptoms, it’s no surprise that women assume they’re falling apart. Our interviews mentioned around twenty different symptoms, including…

  • Mood swings
  • Sleep problems
  • Palpitations
  • Anxiety and low mood
  • Fatigue
  • Brain fog
  • Irregular periods varying from light to heavy flow with spotting in between
  • Burning eyes
  • Headache
  • Dizziness
  • Dry and itchy skin
  • Allergies
  • Hot flushes and night sweats (made worse by booze)
  • Vaginal dryness
  • Loss of libido
  • Muscle tightness (including ‘frozen shoulder’) and joint pain
  • Hair thinning
  • Difficulties controlling weight gain
  • Slight urinary incontinence.

Reassuringly, Cleo reminds us that symptoms are not necessarily sudden or consistently debilitating: “The vast range of symptoms can creep into your daily life slowly. At first you think it’s simply your body changing as you get older. My symptoms varied over time and were worse when I had a period of hormone instability.”

For Gozi, the taboo of vanishing fertility weighed heavily on her mind. Also distressing was the fear of losing emotional control, of “becoming deranged”, as she puts it. Significant mental strain is certainly not uncommon, with around 1/3 women reporting feelings of anxiety and almost fifty per cent reporting low mood. Looking back, Gozi doubts how far these taboos reflected the reality of perimenopause. “Was it really true?” she asks, now able to reflect on perimenopause as a normal and natural process of hormonal change.

Perimenopause in the workplace

                             Perimenopause in the work place

This sense of crisis can often manifest at work, where the effects of physical discomfort and brain fog fuel fears of professional incompetence. As many as one in four women consider leaving their jobs due to the effects of perimenopause. And up to nine out of ten women feel that menopause has had a negative impact on their working lives, with one in  five women taking time off as a result of menopause symptoms. Given that menopausal women are the fastest growing demographic in the workforce, campaigners are determined to overhaul working practices and understanding of perimenopause and menopause. For Cleo, adapting at work was a challenge: “I hid my problems from my colleagues,” she told us, “I felt everyone could spot it from a mile away, but they never did! They just thought I was tired if I made a mistake.”

Emily Barclay, founder of Menowhaat, an organization set up to provide menopause education to businesses, told us how perimenopause affects working women: “We want to highlight that when women’s hormones are changing, they might struggle. As a society we make allowances for pregnant women, understanding that their hormones are all over the place, but when a woman reaches perimenopause the same accommodations aren’t made.”

Hormone Replacement Therapy

Perhaps the most detrimental menopause taboo hangs over hormone replacement therapy (HRT). Roberta was one of thousands of women “brought up with lots of fear about HRT”. Anxiety about HRT increasing the risk of breast cancer reached fever pitch in 2002 due to the publication of a flawed clinical trial. One million women stopped taking HRT in the years that followed. Having been re-evaluated, it is clear that HRT does not substantially increase the risk of breast cancer.

Gone are the days when we derived oestrogen from horse’s urine (yes, really!). In 2021, there are new methods of administering treatment that are better for women without an increased cancer risk and which are more effective in treating symptoms. It’s also plant-based now, thank goodness.

Yet even the medical profession is slow to overcome the legacy of the HRT scare. Despite being the recommended treatment for menopause, common among menopausal and perimenopausal women are experiences of being dismissed by a doctor. “Be strong and don’t let doctors dismiss you with antidepressants”, warns one interviewee. “Like all medicines, it’s progressed, so go talk to your doctor and if they aren’t meno friendly, ask for another one,” recommends another, adding, “naturopaths are awesome too.”

Emily stresses the dangers of menopause misinformation, stating, “women, rather than consult a doctor or other practitioner, will often rely on over-the-counter supplements without realizing that these can have side effects or contraindications with other medications/supplements they are taking.” According to Menopause Support, less than forty per cent of women experiencing perimenopausal symptoms will ask their GP for support, and some NHS menopause clinics (yes, they do exist!) can have a waiting time of six months to nine. Currently, only roughly 1/10 women take HRT for their symptoms.

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Leading the way in changing attitudes is HRT expert Dr Louise Newson, the ‘Menopause Doctor’. Newson believes we should approach menopause as a “long-term hormone deficiency” that can be treated by medication and lifestyle adjustments, like we’d treat any other deficiency.

Benefits of Hormone Replacement Therapy

As Newson and others point out, HRT in perimenopausal and postmenopasual women is useful in reducing the risk of serious health conditions associated with falling oestrogen levels. These include diabetes, osteoporosis, and even Alzheimer’s. Newson stresses that women on HRT generally feel more able to avoid obesity and its associated cancer risk. HRT also reduces risk of heart disease which we are seven times more likely to die from than breast cancer.

Online, challenging menopause misinformation has gone viral. Natasha Eglington, who runs a menopause support blog, thinks that viewing perimenopause as a long-term deficiency encourages women to not dismiss their symptoms as part of getting old. “I always thought that it's because when you turn forty everything starts going downhill, that’s what I told my friends when all the aches and pains started.”

"But it isn’t” about just getting older", she states, “it's because of a hormone, not a number.”

How to cope with Perimenopause

So what practical advice did these women have? Each emphasises the importance of education and most mentioned positive experiences with HRT. “Read everything you can”, says Roberta, adding, “I joined some great Facebook groups where the women share their experiences. They have brilliant insights, advice and camaraderie.” We need to make it as normal as puberty”, notes another.

Natasha credits the desire for open conversation for the rapid growth of her community of ‘meno warriors’ online. The women commenting on Natasha’s page feel they can open up to someone who isn’t emotionally involved with them. A lot of the time when we are feeling vulnerable, we go straight onto a page or platform and that’s when we are more likely to talk. "When it comes to going to the doctors, “by the time you have booked and got an appointment you may have lost the confidence to talk to someone honestly and openly." 

Also recommended were magnesium (Epsom salt) baths to help with stress and sleeplessness, buying a thinner duvet, dietary changes, a consistent exercise routine, and the use of supplements like menopace, MPowder, vitamin D, calcium, magnesium, and collagen powder. Several of our interviewees recommended avoiding alcohol, accepting somewhat reluctantly that “my perimenopause body and pre-perimenopause body and mind are just not the same”.

Yet as several of our interviewees noted, it’s not just women themselves that need to make a change. Currently there is a strong push for specific menopause training to be made mandatory for all GPs, spearheaded by the Make Menopause Matter petition. With over 150,000 signatures, this campaign doesn’t show any sign of slowing down soon.

Perimenopause is certainly no walk in the park, but when has being a woman ever been easy? Perhaps this year, for the first time in living memory, we can change attitudes towards the “last taboo” once and for all. If anyone thought that perimenopause was a sign of getting old, the passion and energy of our interviewees proves them wrong. After all, with an average life expectancy of eighty-three, perimenopause merely marks the transition to the rest of our lives. There’s no reason why we shouldn’t do it on our own terms.

Check out these resources designed to make your perimenopause journey easier:

  • Balance App - track your menopause symptoms
  • Alva - free consultation with NHS GP experts in menopause
  • My Menopause Doctor - Dr Louise Newson’s website for top-notch menopause and HRT info
  • Rock My Menopause campaign - get involved in this campaign to abolish the menopause taboo
  • Make Menopause Matter campaign - sign the petition to make menopause training mandatory for GPs
  • Henpicked: Menopause in the Workplace - updates on workplace policy and resources for providing menopause training in the workplace

● Natasha’s insta (@when_life_gives_you_menopause)

 

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