What is Perimenopause & Menopause?

What is Perimenopause & Menopause?

Our mothers, aunts, and grandmothers who have lived beyond 55 years have all experienced menopause, so why has there been such mystery, shame, jokes and secrecy surrounding it until recently?

This blog will shed some light on what menopause is, help educate, prepare, and assure you that you are not alone.

Female health – a new area of research

It wasn’t so long ago that female health was thought to be too complicated and chaotic to investigate! The word hysteria comes from the Ancient Egyptian diagnosis of uncontrolled emotional outbursts to be blamed on spontaneous uterus movement!

Menopause has been vastly understudied and women have been under-represented in health research, especially in relation to diet and health. Research at Kings College London has pioneered menopause research and found menopause is a time of huge metabolic disruption. These findings have been the start of new ways of thinking and understanding the changes females face, but also look at why not all women have symptoms and what can be done to help navigate and minimise the effects.

The new wave of research will be the focus of future blogs with key findings to help empower and to take control.

What is the menopause?

Menopause is one of the very few stages of life that is recognised retrospectively; as a year must have gone by without any periods to know that the menopause has been reached, often at the age of 52. However, perimenopause is the period prior to menopause when the hormones fluctuate, causing many symptoms and periods can be very irregular.

Also, sometimes menopause is induced early for reasons such as surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy), cancer treatments like chemotherapy, and genetic or personal reason.

Sometimes the menopause can start early for reasons unknown.

Perimenopause is when symptoms start before the periods have stopped.

This of course can have a big impact on the quality of life, including relationships and work.

There are lifestyle and dietary changes that have been suggested to help with reducing or managing symptoms, along with medications that can replace or rebalance hormonal disruptions and help relieve symptoms.

Hormonal changes, particularly a fall in oestrogen production means periods are less regular and gradually stop altogether. The fall in oestrogen is also the cause of many menopausal symptoms.

Over half the population will go through menopause

With just over half of the population female, and life expectancy increasing, half of the lifespan is now spent post-menopause! Yet research in female health has only recently gained momentum and airtime, while frustratingly late it has now opened up the discussion.

Females born in the UK today can expect to live to an average age of 87, meaning more than 30% of life will be spent in the post-menopause phase. If we compare this to 1850, the female life expectancy was 45 when females died before menopause even started!

There are 1.2 billion menopausal women in the world at this very moment and 15 million of those women are here in the UK.


Symptoms typically last for about 4 years after your last period, and approximately 10% of women will experience symptoms for longer.

80% of women in the UK suffer from one or more symptoms.

Some women have one, none or multiple symptoms that last until the body finds a ‘new’ homeostasis.

Symptoms include.

  • Hot flushes

  • Night sweats

  • Psychological problems (such as anxiety and depression)

  • Problems with memory and concentration

  • Vaginal dryness

  • Urinary problems- increased uti’s

  • Loss of libido

  • Sleep disturbances

  • Headaches

  • Joint & muscle stiffness

Hormones and hot flushes

The most commonly reported symptom of menopause is ‘hot flushes'. These are described as “vasomotor instability”, in other words, a problem with regulating the autonomic nervous system which we have very little to no conscious control over such as blood vessels dilating or constricting, heart rate, sweating, and temperature control.

However, the autonomic nervous system is not the cause of hot flushes, but the delivery system relaying the ‘messages’.

Host flushes occur when there are falling levels of hormones oestrogen and progesterone, which during perimenopause steeply rise and suddenly fall causing great imbalances.

Hormonal fluctuations occur erratically and drive a number of symptoms.

The major changes in hormones are;

  • Decreases in progesterone, can result in increased water retention and bloating. While this is not a chronic condition and decreases once hormones stabilise, it will still become very uncomfortable and impact self-confidence.

  • Decreases in testosterone (yes, females need testosterone) results in loss of lean muscle mass.

  • Oestrogen is a fundamental regulator of the metabolic system of the female brain and body.

  • Oestrogen by design is an anti-inflammatory, neuro and cardiac productive, moisturiser and metabolic regulator; explaining why a drop of oestrogen has multiple short and long-term effects. Long-term, oestrogen depletion can cause changes to bone, cognitive function and the cardiovascular system.

What can we do to help

A healthy, varied diet and a healthy lifestyle, including not smoking, limiting alcohol consumption, physical activity and maintaining a healthy body weight, can help to reduce the severity of menopausal symptoms and protect against long-term health problems associated with loss of oestrogen.

Our next blog looks in more detail at nutritional support to nurture you body through the perimenopause and menopause. 

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