Mood swings? Painful periods? Sleep problems? Meet the perimenopause
You may think that the menopause is miles away, but lead-up symptoms can start in your 30s
Text: Jo
Given that women have to endure a menstrual cycle, pregnancy, childbirth, the pain of waxing, plucking, threading and lasering (and everything else society tells us that we, as females, have to go through), you would have thought we have enough on our plates. Wrong. In between starting our periods and ending with the menopause, we have with another joy to deal with: step forward, perimenopause.
Along with insurance plans and where to go for dinner two weeks on Saturday, the menopause is not likely be on your mind right now. But if you’re in your 30s and suffering from unexplained weight gain, mood swings, trouble sleeping, heavy periods and hot flashes (that are nothing to do with Singapore’s sweaty climate), you might want to consider the perimenopause as a possible cause.
How is perimenopause different to menopause?
According to statistics, the menopause can usually be expected in the age range of 42 – 58 years-old. Marked by the event of not having your menses for one full year, the average age for women in Singapore is 49 years-old, whereas in Western societies it’s 51 years-old.
What many women are unaware of is that a range of physical and mental ailments can occur in the years running up to menopause. According to research by the Cleveland Clinic, symptoms tend to happen 3–4 years beforehand. However, it’s been reported that symptoms can appear as early as 10 years beforehand. Brain fog, lethargy, loss of sex drive — the list is endless.
Perimenopause (the term ‘peri’ means ‘surrounding’ or ‘near’) is the transition phase up to menopause: the point when your ovaries stop releasing eggs. It’s marked by a drop in estrogen, the main female hormone produced by the ovaries. “As female hormone levels are slowly reducing, women may experience more symptoms that are suggestive of menopause,” explains Dr Michelle Chia of Singapore’s DTap Clinic.
Perimenopause, or not?
So how do you know if you’re perimenopausal, or just feeling out of sorts? According to Dr Chia, the most telling sign is a change in your menstrual cycle. “Periods might be shorter than usual or longer than usual. The flow might be different, and you might even skip one,” she says.
Of course, every woman is unique so experiences of perimenopause will vary. “It really depends on the individual,” Dr Chia continues. “Some women have severe complaints that affect their lives, others may barely notice anything until they’re closer to menopause.” And let’s not forget about genetics. “There may be an element of perimenopause which is hereditary. Some women may experience earlier symptoms, or more significant symptoms if their mother went through the same thing.”
As always, if you’re worried you should consult your doctor. Bear in mind though, that there isn’t an official diagnosis of perimenopause. However, if you have a family history of early menopause, are a smoker, or have had a hysterectomy or cancer treatments such as chemo, there’s more chance of early perimenopause and menopause.
What to do?
In the absence of being able to run away to a remote island with Netflix for an entire decade, there are many ways you can make perimenopause easier to deal with.
“Regular exercise, staying hydrated, stopping smoking and moderating your alcohol intake can help to ease symptoms,” says Dr Chia. Your body will require more of certain nutrients. For example, muscle mass decreases during perimenopause so it’s recommended that you up your daily intake of protein. Lift your mood with Omega-3 fatty acids, fill up on fibre to reduce sweet cravings and include more calcium in your diet to ward off osteoporosis.
Seeping well is also crucial. Too little sleep or broken sleep can lead to myriad issues which will just exacerbate any existing issues. Says Dr Chia. “Getting a good night’s rest of 7–8 hours’ sleep is essential.”
Dr. Sigred Grobys, Naturopathic Doctor at COMO Shambhala Urban Escape in Singapore also recommends natural sleeping aids such as valerian, L-theanine or 5-HTP. “These can all be helpful in cases of insomnia and anxiety as when the adrenals become stressed, they require more nutritional support and mineral supplementation,” she explains. “5HTP is a precursor of melatonin which is the hormone that helps the body get into deep, restorative sleep and which is often deficient,” she explains. “Valerian has sedative but non-addictive properties and most people sleep very soundly when using it (however, 10% of people experience fitful sleep and vivid dreams, but you have to try it to know!).” Sigred continues, ”Magnesium — particularly magnesium glycinate — is the most helpful mineral when it comes to sleep, as it’s both a nervous and muscular relaxant. “Again, it has no addictive properties and it helps replenish a deficiency that is often stress-induced.
Above all, pay attention to your body and mind. Tracking symptoms of your menstrual cycle and moods is a smart idea, and you can highlight any major changes later to a doctor (a period tracking app is great for this). Meditation or a mindful technique will keep you in tune with your body and what it’s going through.
In some cases, menopausal hormone therapy or very low doses of hormones to supplement estrogen levels can be prescribed, but this is not for everyone. “It’s a treatment option which should only be used in women with severe symptoms affecting their day to day life,” warns Dr Chia. “You will also need to be counselled carefully on the side effects of hormonal therapy.”
What’s important to remember is that it’s likely you’re not alone. “The problem is that women tend to think that many health issues we experience are ‘just normal’ and ‘what women have to go through’. We end up suffering in silence when so many of us are in the same boat,” says Dr Chia. “Having a community to talk to can make it easier to cope, even if it’s support from just a few close friends.”
So, reach out to those of a similar age and say; 'Do you know about perimenopause? Have you started going through this?’ If you struggle to open up to friends, you can always get support from a councellor.
Lastly, various research has found that sex during menopause and perimenopause can ease symptoms, reduce hot flashes and minimise period pains. So, enjoy …but don’t scrimp on contraception. It might be perimenopause, but it’s still possible to get pregnant.
