Health
Understanding perimenopause: The lesser-known symptoms beyond hot flashes
Michelle Bridges lifts the lid on some of the more surprising symptoms of perimenopause and shares how to protect yourself (and maybe even enjoy the ride).
By Michelle Bridges
Up until about 3 years ago I didn’t even know perimenopause was a word! And I’m not alone.
Perimenopause is a natural phase in a woman’s life that signals the transition into menopause, typically occurring in their late 30s to early 40s. For many, the first thing that comes to mind when thinking about perimenopause is the well-known symptoms such as hot flashes, night sweats and irregular periods. However, there are several lesser-known symptoms that can make this transitional period more challenging, particularly neurological changes and bone loss.
Understanding these symptoms is crucial for women navigating perimenopause, as it can significantly affect both quality of life and long-term health. Personally, night sweats, sleep deprivation, anxiety and feeling flat were enough to have me visiting my GP at the time. I was in my late 40s and not once did the word perimenopause come up. I was, however, offered anti-depressants…
Neurological symptoms: more than just mood swings
While many people associate perimenopause with emotional changes like irritability or mood swings, the neurological symptoms can go deeper and are more complex than commonly recognised. These symptoms can manifest in several ways:
1. Brain fog and cognitive decline
Brain fog is often reported by women during perimenopause, and it's characterised by difficulties with concentration, memory and mental clarity. This cognitive cloudiness can make it hard to focus on daily tasks or retain information.
Women may also experience forgetfulness, which can be frustrating and worrisome. Research suggests that fluctuating oestrogen levels can affect neurotransmitters in the brain, influencing mood, memory and cognition.
2. Sleep disturbances
Hormonal fluctuations during perimenopause can disrupt sleep patterns, leading to insomnia, restless sleep and frequent waking during the night.
This was me, I felt like a walking zombie. Poor sleep can exacerbate neurological symptoms such as irritability, depression and difficulty concentrating. The lack of restorative sleep can also contribute to memory issues and a general sense of mental fatigue.
3. Mood swings and anxiety
While mood swings are a better-known symptom of perimenopause, anxiety can also become more pronounced during this time.
Again, these symptoms entered my life when I’d never experienced anything like this in my past. Oestrogen plays a role in regulating serotonin, a neurotransmitter responsible for mood regulation. As oestrogen levels fluctuate, some women may experience increased anxiety, panic attacks or more severe mood swings.
4. Headaches and migraines
Many women also report an increase in the frequency or intensity of headaches or migraines during perimenopause. These neurological symptoms may be tied to hormonal fluctuations that affect blood vessels and neurotransmitter levels.
For some, these headaches can become debilitating, making it essential to track patterns and seek appropriate treatment.
Bone loss: a hidden concern
Another significant but often under-recognised issue during perimenopause is bone health. As oestrogen levels drop, women experience a decrease in bone density, which can increase the risk of fractures and osteoporosis. Bone loss during perimenopause is gradual but can accelerate if not managed effectively. Here’s how it happens and what you can do to prevent it:
1. The role of oestrogen in bone health
Oestrogen plays a vital role in maintaining bone density by promoting the activity of osteoblasts, which are cells responsible for building new bone. When oestrogen levels decline during perimenopause, bone resorption (the process of bone breakdown) can outpace bone formation, leading to an overall loss of bone mass.
2. The impact of bone loss
Bone loss during perimenopause often occurs without obvious symptoms, making it a "silent" issue. Over time, however, this can lead to weakened bones, increasing the risk of fractures, especially in the spine, hips and wrists.
Osteoporosis, a condition characterised by fragile and brittle bones, becomes a real concern after several years of bone loss. One in 4 who fracture a hip will die in the first 12 months without surgery and even with surgery around 30% will still die. And most of those falls are preventable with exercise, maintaining your strength, mobility and balance.
3. Preventing and managing bone loss
To mitigate bone loss during perimenopause, women (and men for that matter) should focus on lifestyle changes that support bone health. This includes:
- Adequate calcium intake: Aim for 1,000 to 1,200 milligrams of calcium daily from food sources or supplements.
- Vitamin D: Vitamin D is crucial for calcium absorption, so ensure adequate intake through sunlight or supplements. Read more about this here.
- Weight-bearing exercises: Activities like walking, jogging, skipping or strength training help stimulate bone formation and maintain bone density. Click here and I’ll show you how you can get started without the gym.
- Avoid smoking and excessive alcohol: Both habits can weaken bones and contribute to bone loss.
- Bone density tests: Regular screenings can help monitor bone health and catch any significant bone loss early.
The importance of awareness and medical support
Perimenopause is a complex period that affects various aspects of a woman's health. While hot flashes and irregular periods are often discussed, symptoms like neurological changes and bone loss can be overlooked and misdiagnosed. Raising awareness about these lesser-known symptoms is crucial for women to seek early intervention and proper care.
Women experiencing neurological symptoms such as brain fog, sleep disturbances and anxiety should consult with a GP who specialises in hormones. But note that some GPs aren’t adequately trained in managing perimenopause, so that’s something to consider.
There are many treatments, including lifestyle modifications, that can help alleviate perimenopause symptoms – hence why I developed The Perimenopause Method.
Additionally, for bone health, a focus on nutrition, exercise and monitoring bone density can help prevent the long-term consequences of bone loss. Ask for a DEXA scan – it’s imperative.
Perimenopause is not just about managing the obvious symptoms; it's about understanding the more subtle changes occurring within the body. With proper education and support, women can better understand this life stage and maintain their overall health as they transition into menopause.
In fact, what I would love is that they thrive! This time in life can actually be the best due to all the knowledge and wisdom we’ve clocked up, so let's make sure we’re around to enjoy these fantastic years!
Feature image: iStock/kate_sept2004
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