Welcome to our Doctor’s Q&A corner!
Today Dr Virdi answers questions on peri-menopause. Don’t forget to send in your questions for the next edition. All personal details remain confidential. We will only publish your question.
Question:
“How do I know if I’m in perimenopause? Is it normal for my periods to become irregular, heavier, or closer together? How long does perimenopause usually last?”
Answer:
How do I know if I’m in perimenopause?
Perimenopause is the transition leading up to menopause. During this time, hormone levels fluctuate, causing a wide range of symptoms that can vary greatly from woman to woman. Symptoms may start off mild and gradually become more noticeable as menopause approaches.
Menopause is diagnosed retrospectively when you have had no natural menstrual periods for:
24 months if you are under 50 years old**
12 months if you are 50 years or older**
By natural periods, we mean periods that are not influenced by hormonal medications such as contraception or hormone replacement therapy (HRT).
Common symptoms of perimenopause:
Vasomotor symptoms:
* Hot flushes
* Night sweats
* Palpitations
* Itchy or crawling sensations on the skin
Genitourinary symptoms:
* Vaginal dryness
* Vaginal irritation or discomfort
* Pain during sex
* Increased urinary frequency
* Urinary leakage or incontinence
Psychological and cognitive symptoms:
* Poor concentration or "brain fog"
* Forgetfulness
* Fatigue
* Low mood
* Anxiety
* Irritability
* Tearfulness
* Reduced libido
Physical symptoms:
* Headaches
* Muscle aches
* Joint pains
Is it normal for my periods to become irregular, heavier, or closer together?
Yes. Changes to your menstrual cycle are one of the most common signs of perimenopause.
Many women initially notice that their periods become heavier, more frequent, or both. This can sometimes be troublesome enough to require treatment, and in some cases further investigation, such as a pelvic scan, may be recommended.
As perimenopause progresses, periods often become increasingly irregular. You may experience longer gaps between periods, sometimes going several months without one, before they eventually stop altogether.
How long does perimenopause usually last?
Perimenopause can last anywhere from a few years to up to 10 years. Some women experience significant symptoms, while others have very few or none at all.
There is no single pattern, and every woman's experience is different.
Many women ask whether blood tests can determine what stage of perimenopause they are in. In most cases, blood tests are not particularly helpful because hormone levels fluctuate significantly throughout perimenopause and can vary from day to day.
Instead, the diagnosis is usually made based on your symptoms, changes in your menstrual cycle, and the impact these symptoms are having on your daily life, work, relationships, and overall wellbeing. This clinical assessment is often the most useful in guiding diagnosis and treatment.