By Dr Kristen Mark ND

Signs of perimenopause

Perimenopause is the window of time where the body gradually undergoes the transition to menopause, or the end of the menstrual cycle. Reproductive hormone levels will fluctuate as they work towards an overall decline in production. Ovulation may begin to happen less frequently, menstrual cycles can become shorter at first, then become longer and somewhat unpredictable in terms of timing and flow. Other changes may include hot flashes, night sweats, changes in libido or vaginal dryness, mood changes (including mood swings, increased anxiety and/or depression), trouble with sleep, headaches or changes in ability to focus. 

The average age of menopause in Canada is 51. Perimenopause symptoms, or the signs that menopause is close, can begin years before the period stops. On average, symptoms show up around 47.5 years of age, but have been commonly known to appear 2-7 years before the last period happens. 

Not all people who menstruate will experience all or any of these symptoms. At a given age, these signs are often presumed to be associated with the transition into menopause. However, there is good reason to screen for other possible causes of your symptoms. For one, there are several health concerns that cause similar symptoms that will not resolve on their own. Further, more than one thing may be happening at the same time. Addressing overlapping health concerns is not only the best way to take care of your well-being, but will likely help to make this important life transition smoother and less symptomatic. 

How long does perimenopause last?

How long symptoms last can vary widely from 1 or 2 to 10 years. The duration and severity of your symptoms may be determined by a variety of factors, including hormonal health at the outset of perimenopause, stress levels, co-existing health conditions and genetic factors. Age, race, geographic location and economic status may also play a role in how and when menopause is experienced. 

Does perimenopause have to be horrible?

No! Perimenopause does not have to be horrible. You can experience stability, good health and joy during perimenopause. Menopause also does not need to mean the end of an enjoyable sex life - there is sexual joy, pleasure and expansion to be had after menopause!

When to get support for perimenopause

If you’re experiencing symptoms that disrupt your sleep, drain your energy, interfere with your ability to work or are impacting interpersonal relationships, or if you just don’t feel like yourself - please reach out for help. You need not be a helpless victim to an unpredictable hormonal rollercoaster ride. From lifestyle interventions to herbal remedies to nutritional supports and hormonal interventions, we have many tools in our Naturopathic toolkit that can help smooth out the bumpy road to menopause. We can help you reduce the frequency and severity of hot flashes, improve sleep, ease mood fluctuations and maintain the health and hydration of vaginal tissue. No struggle in this area has to be accepted as the new status quo - you have options!

If you’re in your 20s, 30s or even your early 40s and are experiencing these symptoms, it is a good idea to check in with your Naturopathic Doctor or other health care provider to screen for possible other causes. Particularly so if you still have fertility specific goals, in which case identifying a cause and starting treatment can be very much time sensitive. A proper investigation into the reasons why you may be experiencing these symptoms can be pivotal in not only managing symptoms, but potentially supporting prolonged fertility, and moderating other issues that may be pushing you into a menopausal state prematurely. It’s important not to assume that what you’re experiencing is perimenopause, particularly if you're under 43 years of age. Issues with hormonal signalling and balance, thyroid disease, and autoimmune conditions are just a few issues that can mimic the signs of perimenopause.  It’s also important in the absence of fertility concerns, as perimenopause-like changes can indicate a pathological process that needs attention and care even if you’re at the typical age of perimenopause onset. 

Perimenopause, menopause, and beyond!

If you’re confident that you’re experiencing perimenopause, this is also a great time to check in with your healthcare provider about changing considerations with respect to the maintenance of health after menopause. From a Naturopathic perspective, we want to support a smooth transition into menopause, and set the stage for optimal post-menopausal health. 

With the change in hormone production that comes with menopause, come different health risks. Knowing how to support the body at this next phase of life is critical to maintaining a happy healthy life in our 50s and beyond. Talk to your Naturopath about how to best support bone and heart health by optimizing nutrition and physical activity. Walk confidently into menopause knowing that your sex life need not suffer - there are supports available to help maintain the health and hydration of vaginal tissue, and to support a robust libido after menopause.