“Think of perimenopause almost as a second puberty,” explains Dr Peta Wright, a gynaecologist at Eve Health in Brisbane, Australia. “The ovaries are running out of eggs but the pituitary gland starts working overtime, pushing the ovaries to ovulate. This can result in hormone swings, shorter cycles, heavier or irregular periods, hot flushes, vaginal dryness, libido changes, muscle aches, sore breasts and brain fog.”

Symptoms tend to dissipate as you approach menopause around age 51.

“20 per cent of women will move through perimenopause smoothly but 50 to 80 per cent will experience symptoms ranging from mild to severe,” adds Dr Wright.

There is no simple blood test to pinpoint perimenopause, so if something is bothering you, see your GP.

There are many different types of menopausal hormone therapy which can ease symptoms such as hot flushes and night sweats if they are interfering with your life.

In 2002, HRT was linked to breast cancer and fear persists. The Jean Hailes for Women’s Health organisation reports that the risk of breast cancer increases slightly following four to five years of HRT but only certain types; it further increases with long-duration HRT (up to or more than 15 years).

According to www.breastcancer.org, research strongly suggests that oestrogen-only HRT appears to increase breast cancer risk less than combination HRT. For healthy women in perimenopause, or less than 10 years after menopause, current evidence suggests benefits – such as a decrease in osteoporotic fractures and cardiovascular disease, and possible positive effects on weight shift from hips to the abdomen – outweigh the risks.

If you are considering HRT, discuss it thoroughly with your GP and have a yearly review. If you do decide to take HRT, ask if you can take a lower-dose formula and talk to your doctor about taking it for the shortest time possible.

For the first time in history, most women will live for 30 to 40 years after menopause, notes Liz: “So, my advice is to appreciate who we have come and what we may still achieve.”

“A conversation about perimenopause should always start with a holistic approach,” says Dr Wright. “Healthy habits can go a long way to improving or easing your symptoms before you even look at HRT.”

Her advice is to choose a Mediterranean diet, adding that some women find eating phytoestrogen-rich foods (such as tofu or soy) helpful, “although evidence is minimal”.

A few tweaks to your lifestyle can also help you navigate this transition and make life a little easier. You can try to:

• Exercise to keep your bones and cardiovascular system healthy and promote positive moods
• Meditate or practice mindfulness to ease mood swings and anxiety
• Sleep seven to eight hours a night to keep you feeling best
• Layer clothes and bedding in breathable fibres
• Connect with friends and family to help you cope and keep moods stable
• Take care of yourself; do not be last on your list because stress can exacerbate symptoms
• Quit as smokers may go through menopause earlier and suffer more from hot flushes
• Detox as endocrine disruptors like BPA, phthalates, parabens and pesticides may be linked to early menopause

Text: Vicki Bramley/bauersyndication.com.au

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