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Quick Question – How do I know if I’m peri-menopausal?

This time last year BBC Breakfast ran their brilliant menopause coverage which increased awareness, educated and informed the public on this important topic. I made a contribution and visited the sofa to talk to Louise Minchin about exercise and the menopause and I wrote a blog to enlarge on the subject too. It definitely started conversations but one year on are we still talking about it? Do we feel more knowledgeable? It’s important that the conversation continues. Women still have many questions and concerns. How do I know if I’m peri-menopausal? How can you tell if you’re in the menopause? These are questions I hear all the time so let me answer them in my #quickquestion series.

Terminology

First up, a quick reminder of what the terms mean. You reach the menopause when you haven’t had a period for 12 months, the average age for this to happen, in the UK, is age 51. When you are heading towards the menopause but not there yet it’s called the peri-menopause (peri means around or surrounding) and you are peri-menopausal. The time after the menopause is called the post-menopause and when you’re there you are post-menopausal.

Symptoms

The typical and well known symptoms of the peri-menopause are irregular periods, hot flushes and night sweats and if these are happening to you then it’s a clear sign you might be peri-menopausal. However and it’s a big however, there are many, many more symptoms which make knowing whether or not you are peri-menopausal very difficult. The list is long but here are some of the more common ones:

  • Feeling tired all the time
  • Poor sleeping patterns
  • Reduced energy levels
  • Weight gain
  • Mood changes including low mood and irritability
  • Forgetfulness
  • Vaginal dryness
  • Recurrent cystitis
  • Low sex drive
  • Breast tenderness
  • Headaches
  • Joint aches and pains
  • Palpitations
  • An intolerance of caffeine and alcohol
  • Just not feeling like yourself

Clearly, you can experience many of the above symptoms at any time of life, when you aren’t peri-menopausal and this makes it tricky to know what’s going on in your body. Just knowing what the possible symptoms are is an important step in identifying if you might be heading towards the menopause. Knowledge is power and you know what to look out for.

Self awareness

The thing is that menopausal symptoms don’t have a clear start and end date. They can go on for several years before and after the menopause, some say ten years either side! Having a good self awareness is key. Take time to notice your body, listen to it, really think about how you feel. Changes can be so insidious that you don’t even notice them happening. This can be a good thing but when the new normal has become that you are irritable and shout a lot at home, then this clearly needs identifying. Asking those around you if they’ve noticed anything can be helpful and opens up the opportunity to talk about the menopause. If you’re someone who likes to reflect through writing things down, then it can be useful to keep a journal of things you’ve noticed about your body and see if there is a trend or pattern, there may be neither but it helps to develop the skill of being self aware.

Be warned that symptoms can come and go over a long time period so it’s often just a case of making a mental note and keeping the possibility of the peri-menopause in your mind.

Family history

We tend to follow our female family members when it comes to timings of hormonal changes. If you are able to find out what your mother’s experience was then it might give you some indication of when you’re likely to reach the menopause. This is particularly important in the case of premature (early) menopause. A menopause before the age of 45 is considered premature and sometimes very early menopause, in the twenties or thirties can be a hereditary condition meaning it runs in families.

Bear in mind though that environmental factors such as diet and lifestyle can play a part in our hormonal profiles and the way we live now may be very different to that of our mothers or grandmothers.

Tests

You’d think it would be easy to have a blood test that tells you whether or not you are peri-menopausal but it isn’t that straightforward. It’s rare for GPs to offer a blood test to look at hormone levels when women are enquiring about whether they might be peri-menopausal or not. This is because a blood test gives you a snapshot of your hormones at the moment in time the blood was taken. Levels may fluctuate hugely over time and it can be very unhelpful and even mis-leading in making a diagnosis. Blood tests do have their uses though and if a premature menopause is suspected, then hormonal blood tests are appropriate and and usually more than one test is taken with four to six weeks between them.

Because some of the symptoms of the peri-menopause could be linked to other conditions, a GP might order blood tests, aside from hormonal ones, to rule out other medical conditions that might explain the way you are feeling. For example, if you are very fatigued and gaining weight, then they might check your thyroid function to make sure your thyroid gland isn’t under-active. Similarly, if you are experiencing palpitations and reduced energy levels, then they may check a full blood count to exclude anaemia.

Time

The use of time is so important in many things in medicine and working out whether or not you are peri-menopausal is one example. Are the symptoms progressive, are they becoming more frequent or have they gone away altogether? You don’t want to ignore things that might have an underlying and possibly even sinister cause and equally you don’t want to overreact to minor symptoms that you can manage yourself. It can be a difficult and confusing time and if you are unsure about a new symptom that is severe or persisting, then it’s always best to get checked by a health care professional, they will understand and may be able to give you quick reassurance.

Knowing whether you are peri-menopausal can be hard. Being aware of the possible symptoms, being self aware and using time can help. Regardless of whether you are peri-menopausal or not, it’s an ideal time to be looking after yourself physically and mentally, taking time to exercise, eat healthily and reduce stress. Have confidence in yourself, in your instinct and knowledge of your own body and how it feels but never be afraid to ask for help when you need it.

Featured image: Gratisography

There are more answers to questions like these and lots of health information to help you lead a happy and active life in my book Sorted: The Active Woman’s Guide to Health.Published by Bloomsbury and awarded First Place in the Popular Medicine category at the British Medical Association Medical Book Awards 2018.

www.drjulietmcgrattan.com

Disclaimer: I can’t give personal medical advice and as always with health advice, reading something online doesn’t replace seeing your doctor who knows your medical history and can assess you in person.  So, if you are unsure then always seek the opinion of a health care professional. 

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