Perimenopause is perhaps the most misunderstood part of a woman’s life. We make a big(ish) deal of your first period and especially pregnancy, but when ovaries start winding down, so do helpful discussions about it. “Perimenopause is a tipping point that can shape a woman’s long-term health and quality of life,” says Dr Juanri Jonck, general practitioner at LifeLab in Pretoria. However, there are resources available – starting with these tips.
What Exactly Is Perimenopause?
Before ovaries cease producing oestrogen – menopause – there’s a transitional period, known as perimenopause. “During perimenopause, your ovaries release fewer follicles, which interferes with the communication between the pituitary gland (in the brain) and the ovaries,” explains Dr Jonck. “This can lead to massive spikes and drops in your previously well-controlled hormone levels.” And that includes the major players: oestrogen, progesterone and testosterone, says Dr Jonck. Perimenopause can last anywhere from four to 10 years, depending on individual hormone changes.
READ MORE: The 4 Best Exercises To Do If You’re Going Through Perimenopause
What Are The Main Symptoms Of Perimenopause?
“Remember that hormones are not just there to assist in creating more humans. Hormones are messenger molecules found in almost every tissue in the human body,” says Dr Jonck. Since this major transitional period affects all major hormones, virtually no part of your body remains untouched. “Initially, women are faced with pretty non-specific symptoms,” observes Dr Jonck. “This includes fatigue, forgetfulness, heart palpitations, itchy ears, itchy scalp, vaginal dryness, loss of libido, insomnia, joint pains and mood swings”. And, according to research, women from different ethnic backgrounds may experience varied symptom severity, with Black women more likely to face more frequent and intense symptoms like hot flushes and night sweats.
Perimenopause symptoms include:
- Irregular or changing menstrual cycles (heavier, lighter, shorter, or longer periods)
- Hot flashes and night sweats
- Mood swings, anxiety, irritability, or depression
- Difficulty sleeping and fatigue
- Memory problems and brain fog
- Lower libido
- Vaginal dryness and urinary tract infections
- Joint and muscle aches
- Weight gain and changes in body composition
At What Age Do Most Women In SA Start Perimenopause?
While global studies provide general age trends, South African data shows women often start experiencing perimenopausal symptoms in their late 30s and 40s. While global studies provide general age trends, South African studies show women often start experiencing perimenopausal symptoms in their late 30s and 40s. Research indicates that about 14% of South African women notice symptoms in their mid-30s, rising to around 53% in their 40s, with many experiencing symptoms that significantly impact their lives.
READ MORE: Why Am I Gaining Weight During Perimenopause?
How Is Perimenopause Diagnosed?
Clinically speaking, early perimenopause is present when there is a change of seven days within the menstrual cycle, meaning your cycle becomes seven days longer or shorter. But not every woman presents with this clean-cut sign. “Which is why we need to have a high level of suspicion for any woman over 35 years with symptoms or changes in their menstrual cycle,” says Dr Joncke. “Usually, by the time women reach my rooms, they’re already on a smorgasbord of medication which includes sleeping tablets, antidepressants, lubricants, anti-anxiety meds and anti-inflammatories. When all they needed were hormones.”
The diagnosis process can sometimes take time, as symptoms overlap with other conditions, and women might not immediately recognise the changes as perimenopause. Studies suggest many women may take several months to a few years before getting a formal diagnosis, largely because early symptoms are subtle and not often discussed openly.
READ MORE: How To Exercise During Perimenopause To Maintain A Healthy Body Composition
What Are The Treatment Options For Perimenopause?
Treatment aims to relieve troubling symptoms and improve quality of life. Hormone therapy (HT), where appropriate, is considered highly effective for symptoms like hot flashes and night sweats. Other medical treatments might include non-hormonal medications for mood changes or vaginal dryness.
