Seven things you need to know about the perimenopause by Jackie Lynch

1. Hormonal changes start to occur much earlier than you’d think in your 40s and they can affect you in a range of surprising ways, including emotional symptoms, dry or itching skin, weight gain, insomnia or thinning hair. Many women can feel confused and concerned by these symptoms because they’re still having regular periods and assume they’re too young to be having menopausal symptoms.

2. The perimenopause is not a linear process and your symptoms may be up one minute and down the next, as your hormones fluctuate. This is why a blood test is not the recommended approach for diagnosing the menopause for women over 45, because it will simply give a snapshot of your hormones at that particular moment. Your symptoms are a far more effective way of identifying what’s going on.

3. Progesterone is typically the first of the sex hormones to decline and this will often lead to psychological and cognitive symptoms such as anxiety, irritability, loss of confidence and brain fog, even if these have never been an issue for you in the past. If you’re already prone to pre-menstrual emotional symptoms, you may find yourself more tearful and your moods more erratic during the perimenopause. Hormonally-driven psychological symptoms such as low mood and depression may be more effectively managed by hormone replacement therapy. Studies have shown that many women have been inappropriately offered antidepressants for low mood associated with the menopause.

4. Your periods can go haywire during the perimenopause due to the fluctuation in hormones and you might find they get heavier, more painful and closer together rather than lighter and further apart, as you might have expected. Including plenty of omega 3 fatty acids in your diet helps to reduce the inflammation that can lead to pain and flooding, so eat oily fish like salmon, sardines or mackerel 2-3 times per week and add a spoon of ground flax seed to your breakfast cereal to keep your omegas topped up.

5. Diet and lifestyle can make a huge difference to the severity of your symptoms as you transition through the menopause. Focusing on blood sugar balance where you avoid sugary foods and white starchy carbs and eat a combination of protein and fibre with every meal and snack will support hormone balance, promote weight management, reduce anxiety and insomnia and improve your energy levels. Good sources of protein include meat, fish, eggs, pulses, soya, nuts and seeds and you’ll find fibre in vegetables, wholegrains and fruit.

6. The more stressed you are, the worse your symptoms are likely to be, because high levels of stress hormones adrenaline and cortisol will disrupt the production of sex hormones. Take practical steps to manage your stress by not over-loading your schedule, focusing on calming activities like yoga, walking in nature, massage, mindfulness and planning in regular ‘me’ time. Magnesium has naturally calming properties which support the nervous system and regulate the body’s response to stress, helping you feel better equipped to cope with the challenges of daily life. Eating 2 handfuls of leafy green veg every day will boost your magnesium levels, so stock up on spinach, watercress, rocket, kale and cabbage.

7. Your tolerance to alcohol and caffeine may change significantly during the perimenopause, so it’s important to be receptive to that and adjust your consumption accordingly. Your ability to metabolise caffeine can be affected which may cause or increase insomnia so that you need to stop drinking tea and coffee much earlier in the day than before to ensure a good night’s sleep. It’s also not unusual to find that you’re much more sensitive to alcohol than in the past – reducing your intake could save you from a very nasty hangover. Alcohol and caffeine are both also key players in hot flushes, so reducing or eliminating them can make a big difference if these are an issue for you.