How to manage your peri-menopausal symptoms

You're too young for menopause, but still noticing changes to how your body normally operates. Welcome to peri-menopause, the period of time before you enter the next stage of your reproductive life.

Dr. Elizabeth Farrell, a gynaecologist and the Medical Director of Jean Hailes for Women’s Health, says that it can be hard to know exactly when it starts, but if you're noticing changes to your menstrual cycle, chances are you're already peri-menopausal.

"The only marker we have is the irregular periods, however, some women will have regular periods until the final one. Therefore, the ability to know when peri-menopause starts is difficult," she explains.

There are a whole host of other symptoms to consider, so we asked Elizabeth the best way to navigate through peri-menopause.

Painful sex

During this time, you can expect your hormones to be fluctuating, often within short spaces of time.

"In the late stages of peri-menopause, some women could find their oestrogen levels may be low, which is why they experience vaginal dryness causing discomfort with intercourse," explains Elizabeth.

To combat painful sex and dryness down there, she suggests trying pelvic floor relaxation exercises or buying a good-quality lubricant beforehand. If it's still a problem, chat to your GP. 

Irregular periods

A women’s menstrual cycles may become irregular during peri-menopause.

"Some women will have regular periods up until the menopause (the final period), others may have a reduction in frequency and in the amount of bleeding they have, however, another group may have irregular periods associated with heavy bleeding, clotting, the onset of menstrual pain as well as new premenstrual symptoms," says Elizabeth.

If you've suddenly begun to bleed heavily, clot or experience cramps, Elizabeth advises to see your gyno or GP, just to make sure that it's definitely peri-menopause, and not anything else that could be cause for change.

Hot flushes

According to Elizabeth, around 20 per cent of women do not experience any symptoms relating to the menopause other than their period ceasing. They're the lucky ones!

"Most women will have mild to moderate symptoms, which include hot flushes and night sweats, with about 20 per cent of women having symptoms that impact on quality of life," she says.

If you find yourself asking, 'Is it hot in here? No? Just me?' more often, you diet can help you to cool down. "Some simple measures women can use to manage hot flushes is by reducing triggers such as caffeine, alcohol, hot drinks and spicy foods," says Elizabeth.

A handheld fan, or one you can pop in your handbag as well as a bottle of water and layered clothing will be your best friends when you feel warm. A cooling facial mist can also help.

For some women, Hormone Replacement Therapy(HRT)/Menopause Hormone Therapy (MHT) may be the only treatment that will relieve symptoms. "In the peri-menopause, it may be prescribed either as an oral contraceptive pill or a combination of oestrogen and progestogen," says Elizabeth. "Sometimes if contraception is required, and women have heavy periods the progestogen-releasing IUD with an oestrogen therapy such as oestrogen patch is an option."

If you're unable to take HRT, your medical professional can suggest other alternatives.

Fatigue and sleep deprivation

You might notice your sleep behaviour changes as you're going through peri-menopause."Hormone changes can influences sleeping patterns and sleep activity however, other factors such as cardiovascular disease, mood disorders and age impact on women’s sleep at midlife," says Elizabeth.

"Menopause symptoms may have a role in increasing sleep disturbances, therefore, treating hot flushes and night sweats is important, but it is also important to develop good sleep hygiene, too," explans Elizabeth.

Going to bed at the same time each night, sleeping in a dark room, keeping your phone or tablet out of the bedroom and meditating before bed can all help.

Elizabeth believes some foods may also help you sleep, like fish, seafood, turkey, legumes, eggs, red meat, dairy (yoghurt and cheese). "These foods contain the amino acid, tryptophan, which helps to produce certain hormones including serotonin and melatonin which may contribute to restful sleep," she says.

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