The first signs & symptoms of menopause

Today's topic:

Today on A.Vogel Talks Menopause, I'm going to be talking about the first signs and symptoms of the peri-menopause.

A lot of women are really confused, and they contact me because they don't know if they're starting the menopause, they don't know if their symptoms are to do with the peri-menopause, if they're the right age, or what on earth is going on. So today, I thought I would go right back to the basics.

What is peri-menopause?

So, what is the peri-menopause? Well, this is the phase before the menopause when your hormones start to subtly change, and these changes can start to cause certain menopause-like symptoms.  

Now, this is a transition time if you like. You might find that you get no particular problems at all. But some women tend to get a huge array of symptoms, and they really don't know what to do about them.

What is the average age to start peri-menopause?

The average age for this is 45 to 55. Now, it's just an average because nobody can know for sure what age we'll be, because we're all very, very individual.  

But we do know that quite a large number of women will start the peri-menopause in their early 40s, even some in their late 30s, while some probably won't start the peri-menopause until they're well into their mid 50s or not at all. So you can see it's quite a confusing time. 

What are the first signs and symptoms of peri-menopause?

So, what are the symptoms that you might experience? The most common early symptoms to look out for are:

Period Changes

It is likely that your periods are starting to change in some way. Now, there are several ways that this can go. Some women find that their periods start to get closer together, or they get heavier, or longer.

For other women, it's the complete opposite. They find that they miss periods or their periods get further apart, or they get lighter, or shorter. And there's a small number of women who find that, suddenly, their periods just stop, and they don't come back.

So, that's the first sign of peri-menopause: your periods can start to change. Now, just be aware that you can get a range of menopause symptoms in the peri-menopause, without your periods changing at all.

You may find that your periods are exactly the same, they come at the same time, they're completely regular, there's no change with them at all - but you may start to see other changes going on.

Mood changes

The major mood symptoms during peri-menopause would be things like anxiety, mood swings and irritability, especially just before a period.  

You might find that the week before your period, your symptoms become exaggerated. And we do know that a lot of women find that, if they've already had PMS regularly, they find that their PMS tends to get worse as well at this particular time.

Hot flushes & night sweats

We know that hot flushes and night sweats can start at this time, well before your periods actually stop for good. These are the most common symptoms of the menopause. However, there are other reasons for flushes and sweats, so it's worth checking with your doctor about these, including thyroid imbalance; food intolerances; chronic stress; dehydration; side effects of medication.

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Poor sleep & fatigue

We know as well that sleep problems can start, and fatigue can set in. And all that's happening here is your hormones are starting to change very subtly - not enough to change your periods, but just enough to trigger all these other symptoms.

Joint aches and pains

The other symptom that can very often occur, which can be very misleading, and what a lot of people mistake for ageing, is joint aches and pains.  

And this is a very, very common one. We were really surprised when we discovered that a lot of women, as they approach the menopause, start to get the joint aches and pains.

Vaginal dryness & low libido

You've also got things like vaginal dryness and low libido, that whole kind of low oestrogen package, too.  

What is the difference between menopause and peri-menopause?

Now, the difference between this and the menopause itself is that the menopause is where your periods stop for good. The menopause is really just one moment in time when your periods have stopped for good. The problem is that you don't know your periods have stopped for good until you've gone for two full years without having a period.  

The problem in this situation is that a lot of women can miss a period for three or four months. They think, "Oh, that's it. I'm in the menopause." And then their periods either restart again!

There are a number of women who will go maybe 18 months or more, and suddenly find that their period is coming back and they haven't reached the menopause yet.

So, the actual menopause is just the point where, retrospectively, you suddenly realise, "My periods have stopped for good." And that's it.

But, generally, we tend to class the menopause as the point where your periods are stopping and then, after two years without a period, you're then considered post-menopausal. That's basically it.

How can you tell if you are in peri-menopause?

Now, how can you find out if you're in the peri-menopause or if something else is going on? It's very difficult to tell, as I explained before, because everything is about averages. Tests can be very inaccurate at this particular point, especially if you're getting periods of some kind, because they depend on your hormone level on the day.

So, if your hormones are quite high when you get the tests done (even though they might dip two or three days later and cause certain menopause symptoms), the tests will come back saying that you're not in the menopause, and that can then confuse you even further.

5 questions to ask yourself to help you know if you are peri-menopausal

So, there's five questions that you can ask yourself, and that might give you a little bit of a better idea whether you're in peri-menopause or not:

Q1. Am I in the average age range?

First of all, are you in the average age group, 45 to 55?

Q2. What age did my mum or other female relatives go through menopause?

Also, if you can, try to find out at what age your mum, your grandmother, your aunties, or your older sisters started the menopause. Very often, it will happen at roughly the same age for close female relatives. 

Q3. Have my periods started to change recently?

Are your periods definitely changing? Has there been a change in length, or in time scale? And are they getting lighter or are they getting heavier?

Q4. Am I experiencing any of the other common peri-menopause symptoms?

Are you getting other symptoms of the menopause as well, that we talked about earlier?

Q5. Is there anything else that could be causing my symptoms?

Is there anything else that could be causing these symptoms? And I know I talk about it quite a lot, but it is quite important. We know that low thyroid function, low vitamin D, low iron, and low B12 can all cause a range of symptoms that look very much like the menopause, and sometimes it's very difficult to tell which is which or to tell them apart.

So, if you find that you've answered maybe four out of the five questions, then it's more than likely that you are approaching the menopause.

One important thing here is, if you do find that you're getting really confused, if you're worried about anything at all, especially if your periods are starting to get really heavy, then go and check with your doctor. They might not be able to tell you whether you're in the peri-menopause, but they may be able to check and make sure that nothing else underlying is causing these symptoms.

So, I hope that's given you a little bit more insight. Sometimes, it's really good just to go back to the basics because we tend to forget these things as we go along the way. If any of you have any other symptoms that you might think could be peri-menopausal, please do get in touch.