What are the first signs of the menopause…when do you know you are perimenopausal and what does that word even mean?
Just to clarify – the perimenopause is the most symptomatic phase of the menopause, you are actually only menopausal for one day, once you have experienced 12 continual months of no bleeding and you then go into your post menopausal years.
How many symptoms…
Every woman experiences their own unique menopausal journey. With over 34 different symptoms of the menopause that women can potentially suffer from, there are several different ways that your body can start to show the first signs of the menopause, all down to those declining hormones, in particular oestrogen.
Burying your head in the sand at the first sign of menopause…
Many women unfortunately still associate the word menopause with little grey haired grannies, this couldn’t be further from the truth. As a result they tend to ignore many of the first signs of the perimenopause that are going on, not wanting to think that they might actually be at that stage of their lives.
What age can you start to see the first signs of menopause…
The average age of menopause is 51 years, but from experience many women’s oestrogen levels will start to decline in their early to mid forties, with symptoms becoming more pronounced around the age of 51. To be honest it is such an individual health issue that trying to put a specific date on it is nigh on impossible. At either end of the spectrum there is a percentage of women who experience an early menopause called premature ovarian insufficiency (POI) or premature menopause, a percentage of women have a relatively late menopause, so after the age of 56 yrs and then there are the women who are plunged into quite an intense menopause following surgery or after chemotherapy or radiotherapy. (Find our menopause and age blog here)
It is very important if you are showing signs of premature menopause to go and see your GP. If there are no contraindications to you taking hormone replacement therapy (HRT) it is advisable for it to be prescribed, it helps enormously with all your symptoms and helps to prevent long term symptoms developing by protecting bone and cardiovascular health. POI is more common than people realise – an excellent website for prematurely menopausal women is the Daisy Network.
1 : 10,000 women are under 20
1 : 1,000 women are under 30
1 : 100 women are under 40
The common first signs…
The most common first signs of the menopause have to be hot flushes and night sweats (see our blog specifically about hot flushes here), with three in four perimenopausal women experiencing them, but to differing degrees. Some women just experience a faint glow whereas others look like they’ve just walked off a squash court! They are incredibly annoying, embarrassing and debilitating. Some women find their hot flushes are completely random, others find they are triggered by certain drinks, food or situations. The most common culprits are caffeine and alcohol, particularly red wine, I know all the good things in life! Then there’s spicy food or for some it’s just having a hot drink or moving into a hot environment. Ironing can even bring them on, (marvellous excuse to get someone else to do it!), or for some being in a stressful situation.
The best ways to tackle your hot flushes…
• Make sure you stay well hydrated
• Eat a healthy diet
• Do a variety of exercise which will help reduce the intensity and frequency of flushes.
• Keep a food and flush diary to find out your triggers.
• Practice and find out about positive mindfulness and learn simple cognitive behavioural techniques which again doesn’t cure the hot flush but can help reduce the intensity and frequency of them.
• If they are really affecting your quality of life then you might want to consider Hormone Replacement Therapy.
• If experiencing insomnia due to night sweats, make sure you stay well hydrated and practice diaphragmatic breathing (CBT) to help to keep calm and to ‘switch’ your brain off from the night sweat.
Other Physical symptoms…
One of the most common first signs of the menopause are changes to your menstrual cycle; missing that first period, which can send some women dashing off to their local pharmacy for a pregnancy test! Having heavy periods or any change to your usual bleeding pattern is very common.
Heavy periods can be extremely debilitating not only will those white pairs of jeans get relegated to the back of your wardrobe but the amount of sanitary products required can become ridiculous. Joking apart, experiencing heavy periods is awful and completely affects the quality of your life. The sooner you address the problem the better and make sure you get your iron levels checked too – incredible the amount of women who are borderline anaemic. This affects not only energy levels but contributes to insomnia, resilience to ill health…the list goes on. There are various medications that can be prescribed by your GP to help reduce the flow of blood and those awful tummy cramps e.g. tranexamic acid with other alternatives like having a mirena coil fitted, this has the benefit of providing contraception as well. Always ask your
GP for all options available so you can make an educated decision…it’s your body!
It’s important to always get any unexplained bleeding checked out by your GP and if they are concerned they can then refer you to see a gynaecologist.
The psychological symptoms
A lot of women will start experiencing these symptoms without even realising they are actually the first signs of menopause and their hormonal journey through life is once again off on it’s merry way! That brief ‘honeymoon’ period comes to an end, when for a short spell of time reproductive hormones have hopefully calmed down and plateaued out a bit. (I do however realise for some hormones are a life long battle.) The extra pressures at this time of our lives don’t help either. A common term heard is the ‘sandwich generation’. If you have kids you are sandwiched between their demands and the increasing demands of elderly parents, resulting in not much time to think about yourself. So, it can take a while to realise that what you are experiencing …irritability, anger, lack of concentration, memory loss , low mood swings (sound familiar?)…is not only down to the grunting, equally hormonal teenagers driving you nuts, but is contributed to by your own hormones starting to fluctuate up and down like yo yos!
Psychological symptoms can be some of the most debilitating symptoms out there, with many women hiding how they feel, especially within the workplace.
The most common symptoms experienced…
• Low mood swings…very different from full blown depression
• Lack of concentration
• Poor memory…ever felt like you need to walk around with a notepad around your neck!
• Panic attacks
All these symptoms are incredibly common as the first signs of menopause but many women panic, don’t realise that in many cases what they are experiencing is due to their hormones and wrongly assume they are losing their marbles! I can’t tell you the amount of times I’ve heard…’I thought I was getting early onset dementia’. On one hand we can joke amongst ourselves and if you are lucky you have good friends that will soon put you right, but some women sadly try and hide how they are feeling which can make matters worse. The more you talk about how you feel the better and you will soon realise how common these symptoms are.
What can you do…
• Have a really good look at your lifestyle choices… if you have a healthy diet, engage in exercise and give yourself smidgens of time for some rest and relaxation (R&R) your body will cope a lot better with any symptom.
• Look at how much caffeine and alcohol you have in your diet – try and minimise your intake, it is well known that both of these affect not only how you feel but contribute to insomnia, weight gain, joint aches…the list goes on.
• Get a food and flush diary on the go…no cheating! The healthier the foods you consume the more your body will thank you…no faddy diets or fasting. If you desperately want to fast do a natural fast so, have all your meals by 5.30 pm then don’t eat again until the following morning at 7.30am…easily the best way to incorporate a fast into your life without denying your body essential energy and nutrition throughout the day.
• Exercise – engaging in some form of exercise regularly helps with all symptoms and also helps to prevent long term symptoms from developing by looking after your bone and heart health. You don’t have to go and join a gym, just 10 mins of High intensity exercise (HIIT) is a good place to start. Set yourself realistic goals to make it sustainable, even just skipping for 10 mins can make a difference.
• R&R – if you can incorporate into your busy lifestyle small amounts of time for yourself throughout the week your body and mind will thank you.
'As with any information developed for Fountain Retreats the information in this post is accurate at time of posting and is for information purposes only. It is not intended to replace or substitute the judgement of any medical professional you may come in contact with. You should always seek advice from your health care professional regarding a medical condition’
About the author...
Author, Qualified Nurse
Ruth is a qualified nurse, gaining her registration and working at the Edinburgh Royal Infirmary.
She is passionate about providing women and employers with evidence based information and support, helping women to make informed decisions about how to manage their menopause and so improve their quality of life.
She has been asked to contribute on several occasions on various media platforms including, Radio 4s Woman’s hour, BBC Radio Scotland, Radio Borders, the BBC Insiders Guide to the Menopause documentary with Kirsty Wark and BBC breakfast.
Ruth is married with three children, three dogs and a cat, loves cycling, playing netball and tennis, spending time with family and friends and has a great sense of humour.
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