Perimenopause - What's That?

While everyone has heard of the Menopause most women don’t recognise Perimenopause and the changes associated with this period of their lifecycle.  The idea that the symptoms of Menopause, are only some hot flushes, night sweats and mood swings has to be challenged as there are many changes happening to a woman’s body during this period and over a longer period of time that are now recognised to be part of the Menopause process.

So, what is Perimenopause and how is it different than the Menopause? What symptoms are associate with each of them? How can we help alleviate symptoms?

What is the Menopause?

Menopause is the time in a woman’s life marked by the end of menstruation and is usually a gradual process where your period becomes less frequent before stopping altogether.  Menopause is defined as the point in time 12 months after a woman's last period and the woman is no longer able to conceive.

The average age women experience Menopause at is 50-52 but this can range from 40-58 years of age. Certain treatments can also cause the onset of menopause, such as surgery to remove the ovaries, chemotherapy, radiation, or underlying medical conditions, for example Down’s syndrome.

What is the Perimenopause?

Whereas Menopause is a specific point in time Perimenopause is a transitional state leading up to that time “Peri” being the Greek word for “around” or “near”.  The perimenopause varies from woman to woman, sometimes it lasts 6 months and sometimes it is 5-10 years but it usually happens from 40-50 years of age.

I think it’s fair to say that most women don’t realise what is happening to their bodies at that age - particularly because symptoms are intermittent. The level and consistency of oestrogen and progesterone generally starts to become more irregular starting in a woman’s early to mid-30s. Woman may not have any symptoms yet, but hormonal changes are happening. Most women start to report symptomatic changes of perimenopause during their ’40s.

For what might be five to 10 years before a woman actually stops menstruating, your ovaries begin to produce fewer of the sex hormones oestrogen, progesterone and testosterone. While oestrogen decline usually comes closer to menopause itself, oestrogen fluctuations are thought to cause perimenopausal plights such as hot flashes, vaginal dryness, urinary incontinence, even impacting motivation and ambition.

Declining progesterone may be a factor in irregular or heavy bleeding—one of the primary complaints of perimenopausal women—and can also contribute to problems with sleep, memory and concentration, not to mention tender breasts and bloat.

Low testosterone can affect bone production and lean muscle mass, is a common culprit in lost libido (sex drive) and may be the missing ingredient when you’ve lost your mojo.

Pregnancy can occur even if you are no longer getting your period during perimenopause. It is advised to continue using contraception for two years after your last period if you are under 50 years old and for one year if you are over 50 years old.

Different Symptoms - Menopause V Perimenopause

There are roughly the same number of women going through perimenopause (46-50) as menopause (51-55). There are many symptoms that can arise throughout this chapter of your life and every woman experience these differently. Some women breeze through these years but for others it can be a very challenging time in their life.

On average, women will experience 9 symptoms. While some of the symptoms are similar in Perimenopause and Menopause they often occur at different stages and different degrees of severity. Symptoms relating to the brain tend to manifest earlier – in Perimenopause. Urogenital symptoms and physical symptoms like weight gain are felt more when periods cease – Menopause.

 

	Peri-Menopause	Menopause
Period Changes	Heavy, Irregular, Unpredictable,	No
Chance of Pregnancy	Yes	No
Hot Flushes & Night Sweats	Yes	Yes
Stress & Anxiety	Yes	Yes
Sleeping Problems	Yes	Yes
Brain Fog & Poor Concentration	Yes	Not as Much
Mood Changes	Yes	Not as Much
Low Energy	Yes	Yes
Skin & Hair Changes	Yes	Not as much
Urinary Changes	Not as much	Yes
Weight Gain	No	Yes
Joint & Muscle Aches	Yes	No
Heart Disease & Cholesterol	No	Yes

 

Treatment of Symptoms

HRT

Hormone Replacement Therapy (HRT) is the most effective treatment available to relieve symptoms caused by the menopause such as hot flushes, night sweats, mood swings and bladder symptoms.  All types of hormone replacement therapy (HRT) contain an oestrogen hormone. Taking HRT replaces the oestrogen that your ovaries no longer make in the same quantities as when you were younger.

HRT is available as tablets, skin patches or gel. The patches are usually changed twice a week and the gel is applied to your skin daily. The tablets are usually taken daily.

• If you still have a womb (uterus) it is important that a progestogen is combined with the oestrogen. When you take oestrogen the lining of your womb can build up which can increase your risk of cancer – endometrial hyperplasia. However, taking progestogen completely reverses this risk.
• If you are still having regular periods during perimenopause, then you will be given a type of HRT called sequential combined preparations that still gives you a monthly period (technically a withdrawal bleed). This type of HRT needs to be taken for around a year.
• If you have not had a period for one year (Menopause) or if you have taken HRT for one year then it is likely you will be given a type of HRT called continuous combined preparations which does not give you a period. It can be common and completely normal to have some light bleeding or spotting in the first few months of using this type of HRT. However, if you experience heavy or prolonged vaginal bleeding then you need to inform your doctor.
• If you have a history of a clot, increased risk of stroke, migraine, diabetes, high BMI, some bowel disorders or liver disease then you can still take HRT but it is likely that you will be recommended to use a patch or gel rather than a tablet. This is a safer and associated with less risks compared to having the tablet form of oestrogen. The progestogen is usually still given as a tablet.

There are many different preparations of HRT and if one type does not suit you then it is very likely that another type will suit you.  It is important to talk to your doctor or menopause specialist to get the right type of HRT. 

Side Effects and Risks of HRT

Side Effects of HRT are more likely to occur when you first start taking HRT and then they usually settle with time.

• Breast Tenderness.
• Nausea.
• Leg Cramps.
• Headache.
• Bloating.
• Greasy Oil Skin associated with Progesterone.
• PMS type symptoms or depressed mood.
• Can be some localised irritation to the skin with gel or patches so change the area (below waistline – not near breasts) where these are applied each time.
• Increased risk of blood clots or stroke – so usually use patches or gel for vulnerable patients.
• Increase risk of endometrial cancer so combination products used unless there is no womb.
• Some increase in breast cancer risk but HRT thought to be a promoter of breast cancer cells rather than an initiator. So, breast check and remain vigilant to any changes however small.

Benefits of HRT

The main benefit of HRT is that symptoms are improved and the sense of getting a bit of normality back.

• Symptoms Reduced.
• Sleep Improves.
• Mood Improves.
• Concentration Recovers.
• Increased Energy Levels.
• Hot Flushes and Night Sweats controlled.
• Reverse some of the Vaginal Symptoms – dryness and UTI infections.
• Joint Pain reduced.
• Skin and Hair Texture Improves.
• Risk of Cardiovascular Disease will reduce – lowers cholesterol levels.
• Risk of Osteoporosis will reduce.
• Some affects on risk of Dementia, Alzheimer’s disease, and Bowel Cancer but more study needs to be done on these.

How to alleviate symptoms without taking HRT? 

It is important to remember that the symptoms involved in Perimenopause and Menopause, and the severity of these symptoms, are different for all women. So choose a supplement that is suitable from your symptoms to help you best.

Health & Her Range

Health & Her is a new range of products specifically designed for women entering perimenopause and menopause giving them the supports the need to help alleviate symptoms. The range includes a peri-menopause supplement, menopause supplement, natural sleep aid, self-heating sleep masks and a sleep balm.

This range of products is definitely a game changer for women suffering menopausal symptoms. 

Health & Her Peri-Menopause Supplement is a daily supplement designed by nutritionists with a carefully formulated blend of natural plants, minerals, herbs, and phytoestrogens ingredients to provide support for the 9 most common symptoms of peri-menopause.

• Period Changes - Sage is traditionally used to support well-being during menstruation.
• Hot Flushes & Night Sweat – Wild Yam and Clover help women to cope with hot flushes and night sweats associated with the menopause.
• Stress & Anxiety – Ashwagandha supports relaxation in periods of nervous tension and anxiousness.
• Sleeping Problems – Avena Sativa Oat Extract helps support better sleep and decreases restlessness.
• Brain Fog & Poor Concentration - Gingko Biloba and Ginseng Panax help preserve cognitive function and concentration.
• Skin & Hair Changes – Zinc and Vitamin C contribute to normal collagen formation and the protection of cell constituents from oxidative damage.
• Mood Changes – Red Clover and Avena Sativa Oat Extract help women to cope with irritability associated with menopause.
• Low Energy – Lavender, Iron and Vitamins B6 & B12 contribute to the reduction of tiredness and fatigue.
• Joint & Muscles Aches – Vitamins C & D contribute to the maintenance of normal muscle and bone.

Health & Her Menopause Supplement is a daily supplement designed by nutritionists with a carefully formulated blend of natural plants, minerals, herbs, and phytoestrogens ingredients designed to help support 9 of the most common symptoms of Menopause.

• Sleeping Problems - Red Clover helps women cope with the common menopausal symptoms of restlessness and Chamomile contributes to a healthy sleep. 
• Hot Flushes & Night Sweats - Hop Extract and Red Clover help women to cope with hot flushes and night sweats associated with menopause.
• Anxiety & Stress - Ashwagandha supports in periods of anxiousness and helps maintain emotional stability. 
• Weight Management - Kelp contributes to weight management by increasing satiety and fibre intake. Flaxseed helps to maintain weight.
• Low Energy - Ginseng helps maintain physical and mental capacities in cases of exhaustion and tiredness. Vitamins B6, B12 and C contribute to the reduction of tiredness and fatigue.
• Skin Changes - Evening Primrose Oil helps with hormone balancing to help maintain healthy skin.
• Brain Fog & Poor Memory - Ginkgo helps maintain good cognitive function and Sage supports memory and brain performance.  
• Mood Changes - Hop Extract helps women to cope with irritability associated to menopause. 
• Urinary Changes - Dong Quai and Oat Straw helps maintain urogenital health. 
• Hormone Balancing - Vitamin B6 helps metabolise and balance hormones. 

Cleanmarine MenoMin is an innovative supplement specially formulated to support women’s nutritional needs when going through perimenopause and menopause. Cleanmarine MenoMin is rich in Omega-3 with Phospholipids, Vitamins B1, B2, B6, B12 and D3, as well as Rosemary Extract, Soy Isoflavones, Folate and Biotin.

With Vitamin B6 to help regulate hormonal activity, biotin to help maintain normal mucous membranes and hair, as well as Vitamin B2 to reduce tiredness and fatigue and Vitamin D to help maintain healthy normal bones This synergistic formulation is ideal for women approaching the menopause who want to feel good every day.

Flourish is an effective one-a-day supplement containing 25 nutrients, including evening primrose oil which has been specially formulated to be taken during and after the menopause. Flourish All in One Supplement is suitable for vegetarians and has no artificial flavours or preservatives.

• Vitamin D which helps to support the maintenance of normal bones.
• Vitamin B6 which supports the regulation of hormonal activity.
• Zinc to help maintain healthy skin, hair, and nails.
• Magnesium which supports the reduction of tiredness and fatigue.

For women who suffer severely from individual symptoms some targeted relief can be obtained from a range of products.

A hot flush is a sudden feeling of heat in your upper body which can spread. It can cause skin to turn red and patchy and may cause excessive sweating. If a hot flush occurs at night it is called a night sweat. Sage is particularly useful in treating these flushes and if the product is in liquid format, it is absorbed quicker.

A Vogel Menosan Drops contains extracts of fresh sage herb which is used to help women during menopause, for symptoms such as hot flushes and excessive night sweating. Sage appears to have a balancing effect on the hypothalamus, which can become overactive at this stage of life as it tries to regulate fluctuating hormone levels.

Disturbed Sleep can be a significant factor in exacerbating menopausal symptoms. Night sweats can cause interruptions in your sleep which can subsequently affect your mood and lead to a cycle of exhaustion.  There are many products to help improve sleep routine including eye masks, sleep pillow sprays and relaxing magnesium.

Using a soothing and calming pillow spray such as the This Works Deep Sleep Pillow Spray or Tisserand Sleep Better on your pillow before going to sleep is also a great addition to your sleep routine. This Works spray is infused with Essential Oils of Lavender, Vetivert and Wild Chamomile. This helps you to wind down after a hectic day by soothing the body and mind.

 

 

Health & Her Sleep Aid has been developed with expert nutritionists and contains a carefully formulated blend of vitamins, minerals and herbs to support the 5 key stages of a restful night’s sleep:

• Get to sleep – Chamomile aids a soothing transition to a restful and healthy sleep and Ashwagandha supports the onset of sleep
• Stay asleep – Hop extracts have a soothing effect and promote a good sleep. Saffron helps support relaxation.
• Improve sleep quality – Lavender helps to support relaxation and maintain a healthy sleep.
• Healthy sleep cycle – Cherries and 5HTP are a source of melatonin, which is a natural compound that helps contribute to the body’s natural sleep cycles and circadian rhythms.
• Wake refreshed – Vitamin B6 and Magnesium contribute to the reduction of tiredness and fatigue

Health & Her Sleep Aid Balm contains a combination of beautiful soothing oils to aid a restful and relaxing sleep cycle and is suitable for women experiencing hormone fluctuations.

• Sleep balm glides gently onto skin.
• Natural ingredients - Lavender, Clary Sage blended with Sweet Almond Oil, to support relaxation, when massaged gently into pulse points to help maintain a healthy sleep.
• Calming and relaxing natural aromatherapy scents.

Health & Her have designed a self-heating sleep mask to help relieve tension, soothe tired eyes and achieve a relaxing transition to a restful sleep. Inside each box you will find 7 individually wrapped sleepmasks. Simply slip the loops over your ears and wait for the air-activated warmth to gently relax you into a restful sleep.

The gentle warming relieves tension in the muscles and skin around the eyes and the space between the eyes. When heated, the sleepmask releases lavender extract to help soothe tired eyes and eases eye strain, which can relieve a headache or migraine.

Salin Plus is an award-winning medical device that combines the functionality of traditional air purifiers with the healing qualities of salt therapy in one, easy to use device. The device removes airborne pollutants, such as dust and pollen whilst releasing tiny, therapeutic salt ions that aid a clean and consistent sleep.  Enjoy cleaner, purer air and the healing benefits of salt therapy at home, so you can breathe and sleep better in a quiet, safe and efficient manner.

Mag365 magnesium powder is a proprietary process that provides a source of highly absorbable, effective, fast-acting water-soluble magnesium in ionic form. It is 100% natural magnesium and helps regulate the hormone melatonin which guides your sleep/wake cycle, and it aids the process of relaxation especially if you suffer from restless legs or a very active mind at night-time. Mag365 is available in different flavours – unflavoured and passion fruit.

With reduced levels of oestrogen in Menopause, collagen levels in your skin start to deplete and so your connective tissue between your skin cells can weaken and as a result your skin can become dry, less springy, less supple and you can notice your skin tone change, and the appearance of age spots or fine lines and wrinkles.

Increasing the production of collagen can help to alleviate these symptoms and boost collagen production in your skin.  There are many products that help boost Collagen production and here are our top recommendations.

Revive Active Beauty Complex contains a powerful blend of Peptan Marine collagen, hyaluronic acid (HLA), phytoceramides and antioxidants that work in harmony to support the skin, hair and nails helping to maintain their structure and function while helping to fight the signs of ageing.

Swedish Nutra Collagen is 100% natural and is formulate as a liquid for optimal absorption  while containing a range of key ingredients.

• 10,000mg bovine collagen which will minimise fine lines and wrinkles and improves skin elasticity.
• Vitamin B5 (pantothenic acid) has natural broad abilities to moisturise, soothe, heal and regenerate the skin.
• Biotin improves hair health and helps maintain a proper function of the nervous system.
• Supplementing with Hyaluronic acid (vegan source) can help promote healthy skin as it has moisture binding ingredients to keep skin supple and hydrated.
• Vitamin C, also known as ascorbic acid, acts as an antioxidant, helping to protect cells from the damage caused by free radicals. The body also needs vitamin C to make collagen, a protein required to help wounds heal.

During the menopause, you may become prone to recurrent lower urinary tract infections, such as cystitis this may be as a result of the changes in your skin and also changes in your vaginal bacteria, both of which can increase your risk of urinary tract infections.

Cystitis is a distressing condition caused by an infection and/or inflammation of the bladder and will occur in 4 out of 5 women at least once in their lifetime but even more during menopause. You may also experience an urgent need to pass urine and need to pass it more often than normal.

Bio-Kult Pro-Cyan is an advanced triple action formulation containing cranberry extract, two selected live bacteria and vitamin A specifically designed to boost the immune system and maintain the mucous membranes found lining the urinary tract.

Vaginal Dryness, itching and discomfort can occur in menopause. Flourish have a range of products that can help with symptoms of menopause.

Flourish Intimate Wash is specifically formulated for the menopause and contains chamomile extract and prebiotics to gently cleanse the external vaginal area and provide all day comfort, whilst maintaining your skin's natural balance.

• Gynaecologically tested, dermatologically tested and pH balanced.
• Vitamin E and glycerin to help hydrate and moisturise.
• Chamomile extract to soothe and calm.

Flourish Intimate Moisturiser is specifically formulated for the menopause and contains glycerin and chamomile extract to help moisturise and soothe your intimate area.

• Gynaecologically tested. Fragrance free. Vegan.
• Helps reduce the feeling of dryness.
• Provides all day comfort.
• Fast absorbing formula.

Flourish Menopause Test Kit can detect the presence of FSH in urine as soon as the concentration goes up from 25mIU/mL and over. This test is specifically designed for testing for menopause.

Replens MD Longer Lasting Vaginal Moisturiser provides symptomatic relief from vaginal atrophy and dryness. Provides up to 3 days long-lasting relief with each single application. Unlike most other lotions and lubricant based solutions Replens MD acts directly to the source of the problem, by delivering continuous moisture, making each single application last up to 3 days.

Its 2-in-1 effective formula treats vaginal dryness in 3 steps by:

• Replenishing vaginal moisture.
• Rejuvenating the existing dry cells.
• Supplementing the body's natural lubrication.

 

Skin Creams For Menopause

There are a number of brands that have specific skin creams designed for menopausal skin and more mature skin after the menopause.  Two ranges specific for mature skin that we would recommend are Vichy Neovadiol Range and Journey Skincare and Beauty Range.

Neovadiol Phytosculpt is Vichy's 1st anti-ageing, firming balm for menopausal skin. Targeting the visible signs of ageing, it visibly reinforces, tightens and redefines neck and face contours. Suitable for all skin types including sensitive skin, Phytosculpt melts in contact with the skin to allow for absorption but once cooled down, the balm transforms into a film that lifts and firms the skin.  The Vichy Neovadiol range comes in Magistral Day & Night Cream, Lip and Eye Contour, and also in a Rose Platinum Day and Eye Cream.

Journey skincare and beauty products were developed by award winning makeup artist Rhona Cullinan specifically for patients going through chemotherapy and radiation treatment. Journey is a chemical free, natural skincare range that helps with the effects of not only chemotherapy and radiation treatment but also those that have dry or maturing skin.  It is also suitable for extreme skin conditions such as eczema, dermatitis and acne rosacea. Journey beauty products are cruelty free and help restore confidence during difficult times.