For women, work and personal demands often escalate in your 40s. This is also a time of hormone chaos known as perimenopause.
You might put the creeping anxiety, fatigue and sleepless nights down to stress. After all, as a woman in your 40s you can find you’re juggling a demanding job with teenagers, ageing parents, mounting bills and health concerns.
Then again, these symptoms are also signs of perimenopause.
What’s perimenopause?
We’ve all heard of the menopause. This refers to when a woman has her last period, usually in her early 50s. It’s also a term we generally use to refer to the symptoms women experience around this time.
We hear much less about the years leading up to menopause, a stage called perimenopause. During her mid to late 40s a woman’s sex hormones – oestrogen and progesterone – start to fluctuate more than normal, due to the ovaries running out of eggs and winding down. This can last four to five years and trigger the same symptoms women experience during menopause.
“Your hormone levels are fluctuating wildly during perimenopause,” Jean Hailes’ endocrinologist Dr Rosie Worsley, explained to the ABC.
Dr Worsley points out that during perimenopause you can have both super high and super low levels of oestrogen, which can give you different symptoms. Symptoms of excess oestrogen include breast tenderness, while insufficient oestrogen can trigger hot flushes and night sweats in some women.
What you might notice
Not all women experience symptoms of perimenopause. Around 20 per cent will have no symptoms, 60 per cent will experience mild symptoms, and 20 per cent will have symptoms that interfere with daily life.
Along with hot flushes and breast tenderness, women can experience:
- irregular periods that can be heavier, lighter, shorter or longer than usual
- moodiness, irritability and anxiety
- fatigue
- trouble concentrating
- migraine and headaches
- vaginal dryness and loss of libido
- problems getting to sleep and staying asleep
- itchy and dry skin
- weight gain for no apparent reason (without changes to exercise or diet)
Tough on your mental health
Mood changes, including feeling more teary or irritable, are common symptoms of perimenopause and you may also notice increased anxiety. There’s also research to show that women are at an increased risk of depression.
“Some studies suggest women are two to four times more prone to depression in perimenopause, and we think one of the major factors is hormone instability,” says Dr Worsley.
That’s because oestrogen affects mood a lot in some women, and hormones like progesterone have a role too, acting on the brain through a complex number of mechanisms.
Treatment is available
If your symptoms are disrupting your quality of life then see your doctor or a health practitioner experienced in women’s health.
What treatment you need depends on what symptoms you have, and how much they interfere with your life. If you’re experiencing hot flushes, then hormone therapy (menopausal hormone therapy or MHT) may be the most effective treatment. You will need to discuss with your doctor your individual risks and benefits if you’re considering MHT.
For other women, a low dose oral contraceptive may help, and it provides birth control too, which MHT doesn’t. Other medications may also be suitable, depending on your specific symptoms.
If you’d rather not take medication, there are other steps you can take to support yourself through perimenopause:
- Avoid triggers for hot flushes, including warm temperatures, hot drinks, alcohol, caffeine and spicy foods, and dress in layers so you can remove clothes as you need.
- Keep exercising. If you’re feeling particularly tired, then take a gentle walk.
- Eat healthy foods. Fill your plate with half vegetables, and include a palm-sized serving of lean protein at mealtimes. Include healthy fats every day, such as olive oil, avocado, seafood, nuts and seeds.
- Limit your alcohol to no more than 10 drinks a week.
Will eating soy reduce hot flushes?
Flushing and sweating can be distressing symptoms of perimenopause, and are caused by falling oestrogen levels. Phytoestrogens in foods may help ease the symptoms of low oestrogen. These are substances that occur naturally in plants that can mimic oestrogen in the body. However, only about one third of women who eat dietary phytoestrogens experience an improvement in their symptoms, because they have the specific gut bacteria that convert the phytoestrogens to a more potent form.
Foods that contain phytoestrogens include:
- Soy products such as whole soybean milk, tofu, miso, tempeh and soy beans
- Oats, rice, barley quinoa, and rye
- Flaxseed, sesame seeds, sunflower seeds and almonds
- Chickpeas, lentils, alfalfa, mung beans
There’s no need to worry that eating soy products will increase your risk of breast cancer – the evidence in fact points to the opposite. But supplements containing soy are not recommended – eating whole soy foods is safer.
This article was previously published in the Well at Work Newsletter
