Does menopause or perimenopause explain my symptoms?

Dr Alison Vickers a Sydney GP with a special interest in care of women during perimenopause and menopause discussed symptoms.

The short answer

If you have noticed your periods are lighter, more irregular, or you are starting to miss periods, and at the same time, you are having hot flushes, night sweats, and difficulty sleeping, then almost certainly perimenopause/menopause explains your symptoms. You may also have noticed you are feeling more irritable or anxious, have vaginal dryness and joint pains, and are not thinking as sharply.

The long answer

It surprises me how there are so many similarities and also differences between the women I see going through perimenopause and menopause.  

Do all women get symptoms of menopause?

Some women are lucky and have almost no symptoms at all, and around one in four women experience severe symptoms.

I am less than 45. Could these symptoms still be menopause?

YES.

Even women in their thirties can go through menopause. If you’re under 45, and especially if you are under 40, and suspect menopause, it’s crucial to see your healthcare provider. You may have Premature ovarian insufficiency (POI). Early diagnosis is vital for understanding menopause and the benefits of treatments like hormone therapy, which can prevent osteoporosis, heart disease, and dementia.

What is the range of symptoms women experience through perimenopause and menopause?

Changes to periods

• Missed periods/no periods
• Lighter and more irregular periods
• Heavy periods and bleeding between periods

Physical symptoms

• Hot flushes or hot flashes (Australian women have flushes !)
• Night sweats
• Problems with sleep
• Joint pains
• Brain fog
• Weight gain
• Skin changes
• Dry, Itchy or uncomfortable skin (like insects crawling on it)
• Worsening headaches

Brain symptoms

These can start before your periods even become irregular and include:

• Depression
• Anxiety
• Crankiness
• Mood swings
• Forgetfulness \brain fog
• Trouble concentrating

Urogenital (bladder, vulva and vagina)

• Vaginal dryness
• Going to the toilet to pass urine more often
• Pain during sex

What is the difference between premenopause, perimenopause and menopause?

• Premenopause – The time in a woman’s life starting at puberty when the ovaries produce an egg regularly around every 28 days. Hormone levels are the same each cycle.
• Perimenopause – The transition phase in a woman’s life when the ovaries are on and off and erratically producing eggs and hormones. Hormone levels are up and down.
• Menopause  – The time in a woman’s life after the last egg is produced. Hormone levels stay low after this time.

You may also like to read What is happening to my body during perimenopause and menopause?

Are the symptoms during the perimenopause different from the menopause?

Yes.

During perimenopause, when estrogen hormone levels are bouncing up and down, you can have breast tenderness, more headaches, retain fluid or have worsening PMS.  Importantly, you still need to make sure you have contraception at this time if you do not want to fall pregnant.

During perimenopause, which lasts 4-8 years, many of the physical and psychological symptoms are more pronounced. The good news is that for many women, these symptoms start to settle down as their body gets used to the lower estrogen hormone level.

Unfortunately, with the lower estrogen as time passes, vaginal dryness and discomfort and bladder problems, and pain with sex become more of an issue.

Is there treatment available

YES!

Lifestyle strategies and natural therapies may help manage some of these symptoms.

Hormonal treatments or menopause hormone therapy (MHT) is a highly effective treatment and can have additional benefits for women.

For women who choose not to or can’t have hormone therapy, there are also other non-hormonal options available to manage these symptoms.

Hormone used inside the vagina, contained in creams, vaginal tablets or pessaries, can also be very helpful for urogenital problems like pain with sex.