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What are the Early Signs and Symptoms of the Perimenopause?


We read and hear a lot about the menopause these days but perhaps not so much about the more subtle signs and symptoms of the perimenopause - that stage before the menopause when ostrogen levels begin to fall.

What is perimenopause?

Menopause is a term that refers to the permanent end of menstruation and the result of an ultimate decline of sex hormones (estrogen, progesterone and others) produced in the ovaries. Perimenopause marks the transitional period that leads up to menopause as those hormonal shifts begin to take place, signally the natural and normal ending of one’s reproductive years and encompasses the years leading up to menopause – anywhere from two to ten years – plus the first year after your final period.

The perimenopause typically begins in a woman’s late 40s but can start in the 30s as well. For some women, this time period can be just a few months but in others it can last several years. The average length of time for perimenopause is about four years. Despite a decline in fertility during this time, women can still become pregnant, as ovulation continues irregularly.

What are perimenopause symptoms?

In fact, they can be so subtle that you might miss them altogether and not realize what is happening to your body.

We set out below some of those easy-to-miss and early signs and symptoms of the perimenopause...

How our teeth can be affected

It is when those ostrogen levels start to fall that inflammation of tissues and muscles can appear including in the mouth, possibly leading to problems with the gums and the teeth when the body overreacts to any plaque buildup.  You may notice red, swollen or bleeding gums, pain and discomfort, a burning sensation or changes in taste.

It is important not to ignore such signs in the mouth, making sure to carry out good oral hygiene at home as well as seeing a hygienist regularly

The perimenopause can lead to changes in body odor

Those same ostrogen levels affect the hypothalamus gland which is responsible for body temperature.  You may sweat more easily or in more unusual places - around the hairline or the nape of the neck.  Such sweating can mean body odor changes too, becoming more intense.  This can be compounded by changes to the natural bacteria that lives on the skin.

Tinnitus is another complaint

Tinnitus is when you hear sounds that are not actually present - sounds like a ringing or whooshing noises.  Although it may only be mild, it can be annoying and even exacerbated by anxiety.  Ideally, you should try relaxation and distraction techniques to help to stop it getting worse and affecting your quality of life.

Concerns about hair thinning and loss

If this is one of your concerns, it is worthwhile seeking medical advice to rule out a more serious illness.  For example, thyroid conditions, nutritional deficiencies or fluctuations in iron levels and anemia can all compound the problem.  Sometimes, it is even genetic meaning it runs in families. 

However, hormone changes in perimenopause can cause hair to change rapidly.  The hair can become thinner, more wispy or frizzier - even falling out in patches.   A balanced diet is important while there  are other ways to help to restore the hair's lustre.

Pain and discomfort

As women get older, they will often be aware of vaginal dryness but there are other changes in the same area that are a sign of perimenopause.  These include pain in the vulva while itching can be a complication of the loss of volume of the labia majora, leaving the vulva less protected.  Although this can happen at any time, some women will experience it early.

Learning to live with changes

If you can approach the perimenopause with the attitude that this is simply the natural transition to the next phase of life, you may well find it easier to accept and to handle.

You can help the symptoms and address many of the practical problems by following an anti-inflammatory diet, getting adequate aerobic exercise and practicing stress reduction techniques.

Taking a quality multivitamin-mineral formula with a good dose of vitamin D is important for maintaining bone strength as well as for your general wellbeing. It is also vital to take part in weight-bearing exercise in addition to aerobics.




 Perimenopause - Symptoms and causes - Mayo Clinic

Menopause - Symptoms - NHS (www.nhs.uk)

12 Early Warning Signs of Perimenopause at 42-45 Years (womenhealthhub.com)