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Perimenopause

Following on from the previous article on menopause, we are now going to talk about perimenopause which can often be overlooked in many women. Perimenopause has stayed under the radar for a long period and has caused a lot of frustration for women who may not realise this may be the reason for the symptoms they are experiencing. There has been a lot of misconceptions and misinformation regarding both perimenopause and menopause, in particular, regarding the treatment options. Therefore we felt that perimenopause deserves a standalone article to ensure more people are aware of the signs and symptoms. 


Perimenopause relates to the time before menopause. It can often lead to an array of symptoms which can be worse than the symptoms that present during menopause. Perimenopause is the beginning of irregular menstrual cycles as a result of a change in hormone levels of oestrogen and progesterone. It can begin as early as the mid 30s or as late as mid 50s. The transition from perimenopause to menopause occurs exactly one year after the last menstrual cycle. On average the whole transition lasts for 7 years but can last for as long as 14 years. Certain women can have very severe symptoms while others experience no symptoms. 

During perimenopause a number of physical changes and symptoms can occur. The symptoms vary greatly from one woman to the next. The most common symptoms include but are not limited to: 


  • Irregular periods

  • Heavier or lighter periods

  • Hot flashes 

  • Urinary urgency 

  • Sleep problems 

  • Mood changes


The menopause symptoms questionnaire is a tool used to assess and monitor both perimenopausal and menopausal symptoms. It is worth completing to assess how symptoms change with time and treatment. Please find the link for this here: 



Follicle stimulating hormone (FSH) is produced by the pituitary gland. It is sometimes used as a tool to indicate the start of perimenopause. A consistent high level of FSH can suggest a woman is going through perimenopause. However multiple factors are considered to determine if a woman is going through perimenopause including but not limited to age, menstrual history, symptoms, body changes and hormonal changes.

Treatment of perimenopause can include hormonal therapy, vaginal oestrogen, antidepressants and exercise therapy. It should be noted that it is not a one size fits all approach and it is a process that will run its course with multiple treatment solutions. 


Book in for a woman’s health physiotherapy consultation to receive advice and information on how you can manage your symptoms. 

 

Contact us for a Womens Health Consultation.



References: 


Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina (Kaunas). 2019 Aug 11;55(8):466. doi: 10.3390/medicina55080466. PMID: 31405242; PMCID: PMC6722698.


Godoy-Izquierdo D, de Teresa C, Mendoza N. Exercise for peri- and postmenopausal women: Recommendations from synergistic alliances of women's medicine and health psychology for the promotion of an active lifestyle. Maturitas. 2024 Jan 28;185:107924. doi: 10.1016/j.maturitas.2024.107924. Epub ahead of print. PMID: 38599003.


Mishra N, Mishra VN, Devanshi. Exercise beyond menopause: Dos and Don'ts. J Midlife Health. 2011 Jul;2(2):51-6. doi: 10.4103/0976-7800.92524. PMID: 22408332; PMCID: PMC3296386.


Dąbrowska J, Dąbrowska-Galas M, Rutkowska M, Michalski BA. Twelve-week exercise training and the quality of life in menopausal women - clinical trial. Prz Menopauzalny. 2016 Mar;15(1):20-5. doi: 10.5114/pm.2016.58769. Epub 2016 Mar 29. PMID: 27095954; PMCID: PMC4828504.


Capel-Alcaraz AM, García-López H, Castro-Sánchez AM, Fernández-Sánchez M, Lara-Palomo IC. The Efficacy of Strength Exercises for Reducing the Symptoms of Menopause: A Systematic Review. J Clin Med. 2023 Jan 9;12(2):548. doi: 10.3390/jcm12020548. PMID: 36675477; PMCID: PMC9864448.


Zhao M, Sun M, Zhao R, Chen P, Li S. Effects of exercise on sleep in perimenopausal women: A meta-analysis of randomized controlled trials. Explore (NY). 2023 Sep-Oct;19(5):636-645. doi: 10.1016/j.explore.2023.02.001. Epub 2023 Feb 8. PMID: 36781319.




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