Perimenopause. Menopause. Postmenopause….
When I first entered what I now know was perimenopause at the age of 43, it was a word I’d never even heard of previously. It wasn’t even used in the doctor’s surgery. I actually discovered it hiding in a dense clinical trial document I was reading in order to try and find a reason for the symptoms I was experiencing!
Today, the word may be more familiar but its meaning - and indeed the words used to describe each biochemical stage of menopause - remain cloudy - and, to add to the confusion, are often used interchangeably.
If you’re as confused as I was, you’re not alone.
Infact, recent research in the UK revealed that 2 in 3 of us are ‘blindsided’ by the perimenopause. (source: Gen-M, Invisibility Report).
And this is what we need to know.
The three stages of menopause.
Perimenopause: is the time preceding menopause, which usually happens in your 40s and 50s, but can be earlier for some. Due to sex hormones starting to decline, your cycles of menstruation and ovulation may become irregular. You may notice increased anxiety, your sleep becoming more disturbed, weight gain out of the blue - particularly around the waist area, your sex drive going down, and your skin becoming drier too.
These symptoms can come unannounced, and slowly start to be more present to the point when you reach menopause.
Menopause: menopause itself is a single, retrospective date in the diary - the 12 month anniversary since your last bleed. For many of us it is a date we can not mark - we may be on birth control pills, HRT or we may simply have noticed our menstruation cycle change and eventually cease...but have no idea when we last bled! We may also be tipped suddenly from peri to post as a result of an underlying health condition that requires medication or surgery.
Post Menopause: is then, effectively, the rest of your life. And, for our generation, we may be lucky to live around 40..maybe 50% of our lives post menopause. At this point, your sex hormones will decrease and eventually plateau, and symptoms such as hot flushes and night sweats become more common for a while. This is also the time to start thinking about your bone and heart health more seriously.
Over time, some symptoms may ease, but urogenital symptoms such as vaginal dryness, urgency and frequency to urinate, and urinary tract infections are more common postmenopause due to low levels of oestrogen. The risk of osteoporosis, cardiovascular disease and mental health issues (including depression and dementia) also increases. It is important to be monitored and assess your individual risk for these conditions with your doctor.
The transition from perimenopause into menopause and postmenopause is a gradual process for most of us, and very individual. Some women can stay in peri-menopause for 7-10 years, while others have a quicker transition through menopause. The average age of women reaching menopause in the UK is 51
So, how can you tell if you’re perimenopausal?
The most common comment we hear from women at the start of perimenopause is ‘I simply don’t feel like me’. And, often the first symptoms are related to our minds. We feel more anxious about everyday things. We may get a sudden dose of ‘imposter syndrome’ at work. We start struggling with sleep. Our skin may change. We may feel bloated and uncomfortable in our clothes...
We often find it helps to hear the voices of others too, so here are some reflections from others within our customer community…
“The anxiety came out of nowhere - I assumed it was work stress, but it started creeping into every area of my life and I didn't know why until I started looking at perimenopause. It felt far too early to be thinking about it but then it all made sense.”
“I wish I had been pre-warned about how menopause would affect my brain and, specifically, thought patterns and memory. In recent years, I have increasingly lacked focus. I often experience a sheer overload of busy thoughts jumping from one thing to the other then can’t remember what I was doing. I have always been capable of clear decision making with a sharp focus so this is frustrating. My strong work ethic and motivation has also been hit by a lack of energy even though I am a healthy eater and exercise daily.”
“It starts waaaaay earlier than I thought (around 50 years is what I thought but with the power of hindsight, I think I started in my early 40s) and that the debilitating anxiety and plummeting self-confidence I experienced were due to perimenopause.”
“Peri menopause was not even a thing when I was younger and I always thought the menopause was just that your periods stopped and you got hot and sweaty. I wish I had known that symptoms like brain fog, anxiety and loss of self are linked to it. I had convinced myself that I am just ‘losing it’ weak and stupid.”
“I wish I’d known that you don’t have to have an irregular period or hot flushes ( the classic symptoms) to be peri menopausal. It can come in other forms like anxiety and low libido or less ability to cope with stress.”
“Perimenopause started far earlier than I thought it would. The myriad of unobvious symptoms just didn’t fit with what I’d always heard about menopause.”
What should you do if this sounds like you?
1. Make friends with your doctor:
The best first step is to visit your doctor. Make them your friend. Track your symptoms for a few weeks before you go. Request a double appointment if you are able. Share any concerns about prescription options too. Make sure you feel heard. HRT can be a fantastic option for many of us - and act as a preventative measure against some of the chronic diseases we become more at risk of as we age too. And remember, if you find doctor appointments difficult, you can take a friend with you.
2. Look at how you digest stress:
Even the best interventions do less when met by a body experiencing extreme stress. Stress not only exacerbates the symptoms of menopause, it suppresses sex hormone production too. There is a growing body of western research supporting the efficacy of many stress management practices that have been part of traditional medicine for centuries. From yoga to breathwork and tapping. From journaling to acupuncture and cold water therapy. Take time to explore what works for you.
3. Rethink what you put on your plate:
What we eat in midlife can make a big difference to how we feel. Look to up your intake of protein, fibre and complex carbohydrates. Choose plant-based powerhouses like leafy green vegetables, seeds (chia seeds are a firm favourite in our community!), and legumes like chickpeas and soybeans to deliver powerful nutritional goodness to balance hormones, promote bone health and protect your heart.
4. Supplement smartly:
PERI-BOOST, for use from the age of 43 or at the first signs of symptoms, is our multi-award winning whole-food led powdered supplement. With 29 ingredients, it provides a critical foundation layer in a simple daily scoop.
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MENO-BOOST, formulated to support you once you’ve had your menopause anniversary, focuses on cardiovascular support, bone health, metabolism, tiredness and fatigue, skin and more.
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MOOD-FOOD is loved by not just members of our community, but their spouses and younger friends too! These golden capsules of goodness harness the potential of Ashwagandha, the best researched adaptogen, Bacopa, Lemon Balm and 95% potency curcumin too. Take 3 a day if mood, anxiety, brain fog or sleep are troubling you.
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GUT-INSTINCT is our latest formulation and based on the insight from our community too, where 69% of you report feeling bloated. Different to the rest, this 5 star formulation is a prebiotic not a probiotic formula. If you’re struggling with bloating, bowel movements, new intolerances to food you love but no longer loves you back, it may be what you need to get your gut microbiota back in balance.
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5. Cultivate your curiosity! But perhaps the most powerful thing we can do to support our bodies and minds at this lifestage, is to approach it with a curious mind. Every individual’s journey will be different. Work out what works for you. And, I promise, Part 2 can be every bit as fulfilling and exciting as Part 1.
With love, Rebekah, founder of LIMINAL.
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