Are you perimenopausal? What does that really mean and how do you know if you’re perimenopausal? Are there any clear symptoms that define it? Do you need a blood test to confirm perimenopause? How long should it last and when does it actually become the menopause? It can all be a bit confusing!  Here’s a quick explanation and run down of how you can tell if you’re perimenopausal. Spoiler – it’s not always easy! 

What does perimenopause mean? 

First up, a quick reminder of what the terms of the menopause 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’re heading towards the menopause and are starting to get symptoms, it’s called the perimenopause (peri means around or surrounding) and you are perimenopausal. The time after the menopause is called the post-menopause and when you’re there you’re post-menopausal. 

The symptoms of the perimenopause 

The typical and well known symptoms of the perimenopause are irregular periods, hot flushes and night sweats and if these are happening to you then it’s probably a sign you might be perimenopausal. Even those can be tricky though, for example, if you’re using hormonal contraception that stops your periods, then you won’t know if your periods are changing! You’ll need to be on the look-out for other symptoms and signs. There are many, many more symptoms of the perimenopause. 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 
  • Feeling anxious 
  • 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 perimenopausal 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. 

Being self-aware  

Sadly, menopausal symptoms don’t have a clear start and end date. They can creep up you very slowly and go on for many years. To add to the confusion, they can start, stop, go away and then come back. Symptoms might start eight to ten years before you reach menopause and go on for ten years afterwards too. Don’t panic, though, they aren’t usually severe for two decades! The British Menopause Society tell us around a quarter of women don’t have any symptoms at all and seven years is the average duration for symptoms.  

Having 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 perimenopause in your mind. 

Family history counts 

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, it might give you some indication of when you’re likely to reach the menopause. This is particularly important in the case of early and premature menopause. An early menopause is before the age of 45 and a premature one before age 40.  

Having a close relative with an early or premature menopause doesn’t mean you will definitely experience the same but it increases your chances. Knowing this helps you be one step ahead and alert to symptoms that might suggest your perimenopause comes before many of your friends.   

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. 

Do I need a blood test to diagnose perimenopause? 

You’d think it would be easy to have a blood test that tells you whether or not you are perimenopausal 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 perimenopausal 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, even hour to hour, and it can be very unhelpful and even misleading in making a diagnosis.  

Blood tests do have their uses though and if an early or premature menopause is suspected, then hormonal blood tests are appropriate and important so women can access Hormone Replacement Therapy (HRT). In this situation, usually more than one test is taken with four to six weeks between tests to confirm the diagnosis.  

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. 

Using 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’re 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’re perimenopausal can be hard! Being aware of the possible symptoms, being self-aware and using time can help. Regardless of whether you are perimenopausal 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. 

If you’ve enjoyed this blog you might like my free download ‘The Runner’s Guide to Perimenopausal Weight Control’. And, sign up to my newsletter for weekly tips and discussion about all things menopause and running.  

Featured image: Arek Socha from Pixabay 

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