Perimenopause

What is Perimenopause?

Menopause and perimenopause are both stages in a woman's reproductive life, but they refer to different phases. Perimenopause is the transitional phase leading up to menopause, characterised by hormonal fluctuations and symptoms, while menopause is the point at which menstrual periods cease permanently, marking the end of a woman's reproductive years. It occurs naturally between the ages of 45 and 55 years, with a median age of 51 years.

Perimenopause typically begins several years before menopause, although the exact duration can vary from woman to woman. During perimenopause, hormone levels, particularly oestrogen, fluctuate irregularly, leading to changes in menstrual cycles and various symptoms. Women may still have menstrual periods during perimenopause, but they may become irregular. 

How long does Perimenopause last?

Perimenopause can vary in duration from woman to woman. On average, it lasts about four years, but it can range anywhere from a few months to up to ten years or more. Factors that can influence the length of perimenopause include genetics, overall health, lifestyle factors, and medical history. During perimenopause, hormone levels fluctuate, leading to changes in menstrual cycles and various symptoms. Once a woman has gone 12 consecutive months without a menstrual period, she is considered to have reached menopause, marking the end of perimenopause. However, it's important to note that symptoms like hot flashes and night sweats may continue into postmenopause for some women, even after menstrual periods have ceased. If you're experiencing symptoms of perimenopause and are unsure about the duration or severity, it's a good idea to discuss your concerns with a healthcare provider. They can provide personalised guidance and support to help you navigate this transitional phase.

What is recommended to support women through menopause and perimenopause? 

It is increasingly important for women to look after their physical and mental health. Pharmacists can help women keep track of their symptoms and provide resources on management strategies. The goal of managing menopause is to alleviate symptoms and reduce any risk of complications such as osteoporosis. There are several treatment options available to manage the symptoms of perimenopause and menopause, ranging from lifestyle changes to prescription medications. 

Here are some common non-pharmacological approaches

• Lifestyle changes like a Healthy diet - eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help support overall health and manage symptoms like weight gain and mood changes. 
• Regular exercise:Engaging in regular physical activity, such as walking, swimming, or yoga, can help reduce symptoms like hot flashes, improve mood, and promote better sleep. 
• Stress management:Practising stress-reduction techniques such as meditation, deep breathing exercises, or mindfulness can help alleviate symptoms of stress and anxiety. 
• Avoiding triggers: Identifying and avoiding triggers such as caffeine, alcohol, spicy foods, and tight clothing can help reduce the frequency and severity of hot flashes and night sweats. 
• Hot flushes can be reduced by wearing layers to remove when needed, having a cool drink of water, and avoiding triggers such as caffeine, spicy foods, a warm environment, stress, hot weather and alcohol.

If symptoms persist or are not alleviated by non-pharmacological interventions, it is advisable to seek guidance from a medical practitioner. 

Reference: 

1. Stress, Anxiety and Ageing. Healthdirect 2023. At: https://www.healthdirect.gov.au/stress
2. Menopause. eTG complete. Melbourne: Therapeutic Guidelines; 2020
3. Australian Menopause Society (AMS) 2022. At: www.menopause.org.au/about-ams
4.  Australian Government of Health. Healthdirect. Menopause. 2020. At: www.healthdirect.gov.au/menopause
5. Menopause. Mayo Clinic 2022. Mayo Foundation for Medical Education and Research (MFMER). At: www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401
6.  Managing postmenopause. Australian Journal of Pharmacy; 2022
7.  Clinical tips: Menopause/Perimenopause. AJP. 2019