Perimenopause in your thirties: what are the symptoms to look out for?

Women can start to experience symptoms in their mid to late-30s, long before the menopause 

The symptoms of perimenopause are similar to those of menopause but can 'wax and wane'

Three out of ten Irish women who responded to a recent Boots Ireland survey on menopause didn't know what perimenopause is, while four out of ten felt the subject was not treated seriously. So what is perimenopause, what are the symptoms to look out for and what support is out there?

What is perimenopause?

Perimenopause or pre-menopause is the time leading up to menopause - the complete cessation of a woman's periods. This usually lasts around four years but can last anywhere from two to eight years. Women with perimenopause can start to experience symptoms in their mid to late-30s, long before most of us expect to experience menopausal symptoms. 

What are the signs of perimenopause?

The symptoms of perimenopause are similar to those of menopause – hot flushes, sleep problems, vaginal dryness and discomfort during sex, reduced sex drive, low mood, brain fog and difficulty concentrating. With perimenopause though, leading gynecologist Dr Nitu Bajekal says symptoms can “wax and wane”, and your periods may become irregular for a few months, then return to normal for a bit.

Dr Nitu Bajekal cautions women not to ignore 'red flags'

This up and down pattern can sometimes make women feel they are "going crazy," she says.

"For two or three months you’re having symptoms, then you’re not, your hormone levels fluctuate. You think, ‘Did I imagine that? Is this really happening?’” 

What can I do to ease my symptoms?

Dr Bajekal is a huge advocate for the role of lifestyle in managing the symptoms of perimenopause, citing nutrition, sleep and regular exercise as key. She recommends a diet loaded with plants and wholefoods – with plenty of legumes, beans, wholegrains, soya, leafy green veg and fruit – is rich in fibre, nutrients and plant oestrogens.

Dr Nitu Bajekal is a huge advocate for the role of lifestyle in managing the symptoms of perimenopause. Picture: Alamy/PA

“Identify your sources of stress and find ways of managing it, whether it’s through breathwork, yoga, meditation, walking with a friend. Avoiding alcohol and excessive caffeine and smoking; all these can make menopause and perimenopause worse.” 

What can my GP do to help?

If you’re experiencing symptoms that suggest perimenopause and they’re having a detrimental impact on your life, your GP might suggest hormone replacement therapy (HRT). Your GP may recommend you take this treatment until at least the age of natural menopause (about 51). This is to reduce your risk of developing osteoporosis and other conditions such as cardiovascular disease.

However, you may not be able to have hormonal treatment if you've had certain types of cancer, such as breast cancer.

If your doctor is dismissive of your symptoms, Dr Bajekal recommends asking to see someone with a special interest in women’s health and perimenopause and/or menopause.

What if it's not perimenopause? 

Dr Bajekal advises you never ignore “red flags” that could be a mistake as symptoms of perimenopause or menopause.

“I see it every day, patients who’ve been told, ‘Don’t worry, you’re having heavy periods because you’re heading to the menopause’. No – it’s not normal. If you’re having heavy periods, very irregular periods, new pain in your periods, you should not ignore it. And if you’re having pain or bleeding after sex, make sure it’s investigated.”