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Perimenopause: why the radio silence?

By Magnolia Miller


There is an information crisis in the field of women’s hormone health surrounding the experience of perimenopause. But if you speak to the average woman in her late-30s to mid-40s, she’ll likely know all about it. Because chances are, she’s probably right in the middle of it, though she may not completely understand it.

Every woman, generally by the time she is in her 20s, is aware that at some point in her life – usually in her 50s— she will become menopausal.  She knows when that time comes she will reach the end of her fertility and childbearing years, and will no longer have monthly menstrual cycles.  But, remarkably, that’s about all the average woman really knows.   


What is perimenopause?

According to a recent survey conducted by Healthspan of 1,000 British women, approximately 1 out of every 2 women surveyed (49%), were not aware that before they reach actual menopause, defined as 12 consecutive months without a menstrual cycle, that they will also experience a transition period called perimenopause. 

Perimenopause, also known as the time around menopause, is the 5-10 year period before actual menopause, when a woman’s ovaries gradually begin to decrease production of her sex hormones oestrogen and progesterone.  Eventually, her oestrogen and progesterone levels will become so low that she will no longer have menstrual cycles.  After 12 months of no menstrual cycles, she is said to be menopausal.

While some women will transition into actual menopause with little to no discomfort at all, most women, roughly 80%, will experience a variety of very difficult and bothersome symptoms which are associated with the fluctuating levels of oestrogen and progesterone.

In fact, while nearly half of the respondents in the Healthspan survey reported that they did not know what perimenopause was, 70% of them still reported that they had experienced many of the symptoms associated with perimenopause.


Symptoms of perimenopause

The most commonly reported symptoms are hot flashes, night sweats, mood swings, irritability, and insomnia. Many women also report unwanted weight gain, loss of libido, vaginal changes, anxiety, depression, heart palpitations, vertigo and dizziness, and crashing fatigue.

Symptoms of perimenopause can be emotional as well.  Half of the respondents in the survey reported that they experienced a drop in their self-confidence when they began going through perimenopause, and more than 6 out of 10 felt that their mental state was being affected as well.

Also noteworthy, is that over 60% of those in the survey who reported experiencing symptoms of perimenopause, did not seek help from a general practitioner.  In fact, nearly 9 out of 10 stated they preferred to treat their symptoms naturally.  Which could be due to the fact, that of those who did seek treatment from their practitioner, 38% reported that they were prescribed anti-depressants to treat all of their symptoms


So then, why the radio silence?

Given that so many women report having a difficult time with the symptoms of perimenopause, it is certainly reasonable to ask why so many also lack an accurate knowledge of what it is. Part of the answer might be found in the fact that until the 1990s, the term ‘perimenopause’ was not even part of the medical lexicon.  In fact, many medical professionals have long lumped the transitional period of perimenopause and the corresponding symptoms associated with it, under the all-inclusive umbrella heading of ‘menopause’.  

Moreover, many medical professionals today often use the terms perimenopause and menopause interchangeably, as if they are the same thing.  This, despite the fact that current medical literature clearly defines menopause as 12 consecutive months without a menstrual cycle. 

Is it any wonder then, that if medical professionals cannot agree even among themselves on accurate nomenclature to describe two very different medical experiences, that so many women are also confused and lack a clear understanding of the differences as well?  


Increasing awareness and what comes next

However, there is a definite bright spot on the horizon.  Thanks in part to the dramatic influence of technology and the internet, which provides easy access not only to social networks and support for health information seekers, but a smorgasbord of knowledge and information regarding every health experience imaginable: including perimenopause. 

There is a clear movement in the women’s healthcare industry toward not only identifying perimenopause as a distinct experience apart from actual menopause, but to also provide women who are seeking help for perimenopause symptoms access to accurate, well-researched information to help them cope with, and manage the experience. For the 90% of women identified in the Healthspan survey who felt there should be more help and information for women going through perimenopause, this is certainly good news!

If you are in your late 30s, or mid to late 40s, and are experiencing some of the symptoms discussed here, you too could be experiencing perimenopause.  And while it can be a very difficult and isolating experience, it’s important that you understand you are not alone.  It also important to know that the hormone imbalance during perimenopause and the symptoms associated with it, are temporary and transitional, and end once you reach actual menopause. 

And finally, while the average age of menopause is somewhere around 52, it is not uncommon for some women to become fully menopausal as early as their mid to late 40s, and as late as their 50s to early 60s.  So whether you’re in your late 30s, early 40s, 50s, or 60s, perimenopause is a very real and universal experience which every woman will go through until she reaches actual menopause.  It might be an easy transition for you, or it might be difficult, but, rest assured that it is normal, and temporary.

From Magnolia Miller

Magnolia Miller is a women’s health advocate and medical writer, and the founder and owner of Pink Zinnia Publishing and Health Communications, LLC, and runs the popular website The Perimenopause Blog, devoted to providing support to women going through perimenopause.


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