Shepparton Women’s Health Centre gynaecologist Dr Margreet Stegeman.
Photo by
Megan Fisher
Understanding the transition before menopause — with gynaecologist Dr Margreet Stegeman from the Shepparton Women’s Health Centre.
Menopause. Hasn’t enough been said about this already? Another article on hot sweats, not sleeping, moodiness, sore joints, vaginal dryness, frequent urination, anxiety, depression?
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Well, if enough is said about menopause, let’s talk about the years leading up to it, the perimenopause. These years are not a walk in the park either.
This phase in a woman’s life lasts on average six years, but can be as long as 10 years. That is right, 10 years before your periods stop and you become postmenopausal you can be perimenopausal.
It is usually characterised by irregular periods. Typically, the periods will get shorter before they become very irregular. This is caused by the ovaries running out of eggs.
Other symptoms include hot flushes, mood swings, headaches, not sleeping well, anxiety, depression, difficulties concentrating, “foggy brain”, weight gain, feeling bloated, sore joints and muscles and low sex drive.
Often women describe feeling exhausted and worn out. There can be difficulties with getting up and making it through the day.
In this time of your life, the premenstrual tension that you felt in the week leading up to the period can become a full-blown war zone, an irrational feeling of aggression without a particular cause. Beware the housemates.
It is awful for all involved and assumed to be caused by a change in the hormones, the overall lowering in oestrogen and a rise in progesterone in the week leading up to the period.
There are usually no tests needed as the symptoms make the diagnosis. There are also no hormone levels that will explain your symptoms or how you feel.
You need to get advice and help to get through this time. You can try to reduce the hot flushes by cutting back on caffeinated drinks such as coffee and tea, lowering the intake of alcohol, avoiding spicy foods, layering clothing and using fans or air conditioning.
Staying fit and healthy, exercising regularly, sleeping enough and eating a healthy diet, and quitting smoking: all help battle the symptoms.
It is also a time of weight gain, an average of half a kilo per year between the ages of 45 to 55, and this especially manifests itself around the waist.
An increase in waistline is associated with an increased risk of blood pressure issues, heart disease and diabetes.
Lowering the calorie intake and increasing your exercise levels are solutions. Around this time, it is good to start with weight exercise too as this will counterbalance the loss in muscle mass and protect against the weakening of the bones.
You still need good contraception, as even though your ovaries are running low on eggs, they can still ovulate and get you pregnant.
Sometimes hormonal treatment to balance out the hormones is required. The pill for instance can overrule your hormones, stop the fluctuation caused by ovulation, and replenish the lack of oestrogen, thus also helping for hot flashes and night sweats.
It can even out the moods and bring peace to the household. This is not suited for everyone in this age group, so talk to your doctor about options.
In short, the perimenopausal years can be a difficult and confusing time in a woman’s life but there are options to help you get through this.
