1.3 Perimenopause: the actual transition phase

Perimenopause is the transitional time around menopause. The prefix “peri“ means “around” or “about”. In this context, it refers to the time around your last period. Your periods will gradually get lighter. Intervals between periods can become irregular. Perimenopause usually begins 1 or 2 years before your periods stop. It ends about 1 year after your last period. During this time, you may also experience symptoms that can be quite severe.

Common symptoms of perimenopause

• Hot flushes and night sweats

• Feeling tired and listless

• Difficulty concentrating

• Dry skin and hair

• Dry mucous membranes (for example dry eyes or vaginal dryness)

Practical tips to help with hot flushes and sweating:

• Alternate between hot and cold showers

• Exercise helps regulate body temperature

• Eating a light diet and staying hydrated helps reduce hot flushes

Practical tips to help with difficulty sleeping:

• Drink warm milk with honey
  This combination contains tryptophan. Tryptophan functions as a precursor to the sleep hormone melatonin, which promotes sleep.

• Minimise your caffeine intake, especially in the evening

• Avoid blue light (for example from your mobile phone display or computer screen)

• Keep your sleeping room dark

The profound changes that you will experience during this time may also give rise to big questions. For example:

• Who am I as a woman?

• How do I act as a woman in society?

• What is my function? Where is the sense in all this?

Practical tip:

This is a time where it is important to discuss and talk about these things with someone else. Talk to friends or family or use professional help.

Support your wellbeing: with plant-based products, psychological help or hormone therapy

There are a lot of ways to improve your wellbeing during this time.

Plants that help make the transition to menopause more comfortable

If your pain or discomfort is not too severe, phytoestrogens may help to ease the symptoms. Phytoestrogens are plant-based oestrogens. They are found, for example, in soy, red clover, black cohosh, beans, grain, nuts, legumes or tofu. Ask your pharmacist what products or teas are best to reduce hot flushes, mood swings, sweating or difficulty sleeping.

Psychological help

If you experience depressive moods or anxiety, irritability or weepiness, seek psychological help or counselling. Do not try to cope with these difficult emotions alone. You do not have to suffer in silence. There is plenty of help available: talk to a counsellor or psychologist. There are also special medicines your doctor may prescribe you.

Hormone therapy and bioidentical hormones

Hormone therapy uses hormones to reduce or eliminate symptoms and conditions that women experience during menopause. Women who opt for this treatment take medication which contains exactly those hormones which the body slows down producing at this stage. Medication is available in the form of pills, patches, creams and gels.

Many women still remember the results of medical studies which relate menopausal hormone therapy to breast cancer. But hormone therapy has changed significantly over the past decades: Nowadays, the therapy uses different hormones and the amount of hormones which women need to take has also been reduced. As a result, the risk of getting breast cancer is only very small. These new findings are based on decade-long research which has shown that hormone therapy which is carried out correctly will improve your health. It has a positive impact on many diseases, such as osteoporosis (a disease that weakens your bones), cardiovascular diseases or Alzheimer’s.

How does hormone therapy work? Hormone therapy nearly always uses bioidentical hormones. “Bioidentical” means that those hormones have the same structure than the hormones produced naturally in the body. Thus, they are exactly the same as the hormones that have been previously produced by your ovaries. Which and how many hormones you can take and in what form they should be provided differs for every woman and depends on many factors, such as your physical shape, pre-existing conditions or your family’s medical history (diseases or special health conditions in your family). For this reason, it is very important to discuss everything at length with your doctor. Your gynaecologist will advise you as to when which hormone levels will be helpful. Your hormone levels tell you how many hormones there are in your body. If hormone therapy is prescribed by your doctor, you will only have to pay the prescription fee.