When a woman reaches menopause, it’s not a sudden-onset event. It is preceded by perimenopause – a gradual process that’s experienced in various ways.

What is perimenopause?

Menopause happens when a woman’s ovaries do not respond as effectively to the hormones that stimulate ovulation and the production of oestrogen and progesterone. “It’s a process most women will go through that spans from the beginning of their inability to ovulate efficiently until a year after their last menstrual period,” says Dr Noelene Ballot, a specialist obstetrician and gynaecologist at Mediclinic Sandton. “This can last several months to several years, and is known as perimenopause.”

The perimenopausal process, which is unique to the individual woman, can occur from around the ages of 42 to 58 years. Some women are even unaware that they are perimenopausal, despite experiencing symptoms.

Individual experiences of perimenopause vary in terms of the symptoms and their intensity.

How do I know I’m perimenopausal?

Be aware that not all women experience symptoms – and if they do, no two individuals present with the exact same symptoms. Here are some common indicators of perimenopause:

Irregular periods – lengthening gaps between your periods. These may last from one to several months at a time.

Hot flushes and night sweats – a sudden feeling of being very hot and flushed in your face and upper body. They are often associated with feeling agitated and usually pass quickly.

Mood changes – hormonal changes may lead to mood swings, irritability and anxiety.

Sleep disturbances and insomnia – night sweats and anxiety can make falling and staying asleep difficult.

Vaginal dryness – causes painful sex.

Muscle and joint pains.

Dry skin and eyes.

Memory loss and brain fog.


Are there any treatments for menopause symptoms?

Yoga is one of the recommended lifestyle-related treatments to help reduce menopausal symptoms.

Hormone replacement and non-hormonal therapy. During the perimenopausal process, your oestrogen levels decline progressively and erratically. The most common treatment is hormone replacement therapy (HRT) to replace hormones that your body can no longer produce in sufficient amounts. However, if you’ve had a blood clot, thrombosis, or breast cancer, HRT is not advised, and your doctor will prescribe an alternative non-hormonal therapy.

Oestrogen and progesterone. If you have not had a hysterectomy, you will need to take oestrogen and progesterone to prevent uterine lining abnormalities. If you have had a hysterectomy (removal of all or part of the uterus), you only need to take oestrogen. The benefits of this type of treatment include reducing the risk of a heart attack, colon cancer and osteoporosis.

Vaginal tablet or cream. May also assist with vaginal dryness, making sexual intercourse less painful.

Lifestyle-related treatments. Include yoga, meditation and mindfulness, establishing a good sleeping routine, as well as an anti-inflammatory diet with limited sugar, alcohol and red meat.

Effective help for a new life stage

While the symptoms are sometimes debilitating, it’s important for perimenopausal women to know treatment is available and very effective. You don’t have to see this stage of life’s journey as a time of growing old. The right treatment can help you experience it as a wonderful opportunity for personal growth.

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