Perimenopause

The word "Menopause" actually means - Final Period.  The part of your life where you are menopausal is actually after your periods have stopped and should be a time where you start to feel pretty human again.

The turbulent times that some people experience leading up to their last period is actually known as perimenopause and is a time frame that can last anywhere between 2 - 12 years before your final period.

Perimenopause is a bit like going through puberty again.  Very often, if you have children, one of your children in your house will be having their first puberty as you are going through your second.  The universe is very good at planning things like this.  One level of thinking about this coincidence is so the parent and child can empathise and support each other with their transitions better. 

The reason that I say it is like a second puberty is because the hormone levels are so similar to the first puberty you went through.  The difference is that  this time, instead of starting this transition as a child, going through puberty and coming out the other side into your reproductive years, hormonally, you will now do this in reverse.  You will come out of your reproductive years and finish with similar hormone levels to when you were a child.  That`s not a bad thing!  Remember  how life was much simpler and you were generally pretty happy as a child?  You had stable hormones, which are a great thing to look forward to.

Take a look at this diagram:
​​

​You can see the similarity can`t you.   The child and the menopausal woman have low and stable levels of progesterone with mild bumps of oestrogen, and the teen is similar to the perimenopausal woman in terms of progesterone levels.  It is during this final stage of menstruating that oestrogen has a grand finale and goes wildly high between dips, like a grand finale of the orchestra of hormones reaching great crescendos, or a rather haphazard firework show to finish off the reproductive years.  It is that fluctuating level of oestrogen and the combined falling progesterone that causes all those crazy symptoms you may be familiar with.

Whilst it is absolutely normal and to be expected to have these high and low oestrogen moments, the reason that some women suffer more than others can be down to oestrogen rising even higher than the graph above.  It can also be to do with levels of inflammation in the body.


Perimenopause itself can be divided up into sections:


​

Stage 1

During this stage you may start to notice small changes to your cycles and even to your mood and energy levels.  Your breasts may get more tender and you may get a few headaches or start to suffer with disruptions to your sleep.  You may notice weight being layed in places you previously didn`t have to worry about, or it difficult to lose weight.
Your menstrual cycles may shorten slightly, but only by a few days.  During this time, you may have less progesterone than before but an increase in oestrogen.  This can cause heavier periods and more pain than you previously had.  

Stage 2

It is during this stage that you might start to encounter hot flashes and night sweats.  This is because you still have the lower progestorone and fluctuating oestrogen as before, but now your oestrogen is dropping lower than previously.  During this time, you will notice more variation in your cycle length.  Cycles could vary each month as much as 7 days or slightly more.  You may still have many of the symptoms from stage 1

Stage 3

You will begin to skip periods during this phase, so a 60 day cycle or more is normal.  Night sweats and hot flashes can get pretty intense during this phase as oestrogen continues to drop very low in between peaks.  The peaks mean that you may still have to deal with some heavy periods but your breast pain may start to ease.

Stage 4

This is the stage that starts with your final period.  You are in this stage for 12 months after having your final period.  After that.... congratulations! You will graduate to a freer and more liberating stage of your life, known as menopause.

During this time your body has got to get  used to having continued lower oestrogen.  It might be a little bumpy to start with but it will ease up and iron out as you move through this part of your life.  If you get a sudden and unexpected period within these 12 months, you have to start counting again.  Be careful with whichever method of contraception you use during this time.  Unexpected and unplanned pregnancies can occur.


​