Are you in perimenopause? Bizarre signs that might confirm so

For women and all other gendered humans who menstruate, menopause is a crucial chapter in their lives. While menopause is something every menstruating human experiences, the experiences are quite individual-unique. For some, it causes a few hiccups in normal life, while for others, it might feel overwhelming. However, even before menopause occurs, perimenopause arrives. Now, perimenopause and menopause begin at different times for each menstruator. And there are lots of symptoms that signal the arrival of perimenopause. Some of those symptoms are well-known, such as hot flushes and weight gain; some lesser-known ones are brain fog and anxiety.

What is menopause?
Menopause is a point in time 12 months after your last menstrual period. Menopause is a natural stage in a woman's life when her ovaries stop releasing eggs and she can no longer get pregnant. Following the menopause, you enter the post-menopause stage. In this third phase of the menopause transition, you may still experience symptoms, commonly for a further five to seven years, though many experience symptoms for longer than this.
What is perimenopause?

Perimenopause is the time around menopause when your ovaries gradually stop working. The perimenopause marks the start of the menopause transition. It is the time when your body starts to change, typically over five years but it can be up to eight to ten years before menopause occurs. During this time, your periods can become irregular and you may start to experience menopause symptoms. This is a natural process that causes physical and emotional symptoms. It does not need treatment, but treatment can help ease symptoms. Treatment includes hormones, antidepressants, and lifestyle changes.

Perimenopause may begin as early as your mid-30s or as late as your mid-50s. Some people are in perimenopause for only a short time, while others are in it for several years. Even though your menstrual cycles are unpredictable and your hormone levels are declining, it’s still possible to get pregnant in perimenopause.

The average length of perimenopause is about four years, but it can last up to eight years. Some people may only be in this stage for a few months, while others will be in this transition phase for several years.

Symptoms of perimenopause:

Generally, the first sign of perimenopause is irregular periods. You may go from having predictable menstrual cycles to spotting randomly or missing periods altogether. A lot of people also experience the most common signs of menopause like hot flashes and vaginal dryness early into the menopause transition.

Even though the symptoms vary, many people experience at least one of the following symptoms:

Irregular periods and unusual flows: As ovulation slows, your menstrual cycle will become irregular. This can mean shorter or longer cycle lengths, missed periods, and fluctuations in menstrual bleeding. Your periods may be heavier or lighter than normal.

Physical changes: Menopause changes your metabolism, which can result in changes to your body composition. You may gain weight more easily or find that your physical functioning is different.

Changes in mood like irritability, anxiety, depression, or mood swings: Irritability and mood changes are common in the transition — but it’s often hard to know if it’s PMS or perimenopause. Talk to your doctor if you’re experiencing heightened anxiety, depression, or unusual mood swings.

Significantly low libido: Women often lose the desire to have sex due to physical issues like vaginal dryness or pain. Hormonal mood changes can also affect your sex drive.

Hot flashes and night sweats: Changing estrogen may cause a sudden feeling of heat in your upper body. A hot flash can cause heavy sweating, blotchiness, and cold shivering that lasts anywhere from 30 seconds to 10 minutes.

Vaginal dryness causing discomfort during sex: Low estrogen levels cause the vaginal tissue to lose its elasticity and become thinner. Vaginal atrophy causes dryness, pain, irritation, and bleeding after sex.

Urinary urgency and increased frequency: The muscles in the vagina and urinary tract weaken during menopause. This can lead to stress incontinence or involuntary peeing during a sneeze or cough.

Insomnia: It’s common to have difficulty falling or staying asleep due to hormonal changes. Night sweats or nocturnal hot flashes can also disrupt sleep during perimenopause.

Hair, skin, and nail changes: Estrogen contributes to skin elasticity, so as it drops, you may notice sagging skin. Hormonal changes can also cause dry skin, hair thinning, or brittle nails.

Phantom smells: Phantosmia is a condition where one smells things that aren't there, such as smoke or tobacco when no one is smoking. Phantosmia is quite common during perimenopause. Other changes to your sense of smell during perimenopause include being able to smell things more or less strongly than you used to, or even disliking certain smells, like perfumes or cleaning products.

Change is body odour: Apart from Phantomsia, perimenopausal people often experience Dysosmia, a distorted sense of smell that can make one think they smell bad even when they don’t.

Noise sensitivity: Perimenopausal syndromes often include noise sensitivity in a number of ways that includes Tinnitus, which is a ringing in the ears that can come and go, and may be more noticeable in quiet environments. Menstruators going through perimenopause may experience mild to moderate hearing loss, and have difficulty hearing high-pitched sounds or understanding speech in noisy environments. Fluctuating hearing levels or increased difficulty processing sounds can be caused by elevated cortisol levels, which can impact the inner ear and auditory pathways.

Treatment for perimenopause:

Although menopause is not a disease, hence not curable, there are treatments if the perimenopausal symptoms take a toll on one’s day-to-day life.

Creams and lubricants can treat symptoms like vaginal dryness and discomfort. Some people find relief from menopausal symptoms using herbal products like black cohosh or red clover

Prescription medications can address various challenges affecting one’s daily life. For example, birth control might alleviate heavy or painful periods in perimenopause. Other prescription drugs can mitigate hot flashes, insomnia, or mood swings.

Hormone replacement therapy (HRT) is a common treatment for hot flashes, vaginal dryness, and insomnia. It comes in the form of pills, skin patches, or vaginal creams or gels.

Perimenopause is a good time to evaluate what’s working in your overall wellness routine. As your body changes, consider switching up your diet and exercise plans. Certain exercises like strength training can help regulate hormones and metabolism. Pilates can strengthen the pelvic floor and decrease urinary incontinence. You may also try cutting alcohol and caffeine to promote better sleep.
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