If I could go back and do perimenopause again, this is what I’d do differently

What women wish they’d been told about the transition to menopause

 “It’s like being a teenager again, but in reverse,” a friend explains to me, describing her recent experience of being perimenopausal. “I just wish I’d found a GP who specialised in it, or who could have told me exactly what I was going through”. Defined as the transition phase into menopause, perimenopause can last anything from four to eight years before a woman’s final menstrual period. It can include heavy periods, tiredness, brain fog and anxiety.

My friend is not alone in her isolation. Increasingly women of a certain age describe being left unsure whether the smorgasbord of unpleasant symptoms they are experiencing are indeed hormonal, or just the result of the general exhaustion that seems to coincide with reaching our 40s. Welcome to the so-called ‘sandwich years’, where the spinning plates of raising teens, minding elderly parents and trying to level-up in our careers veer overwhelmingly towards a tipping point. It’s no wonder sleep is eluding us and anxiety creeps in after dark.

“Perimenopause can be the start of a pretty wild journey,” explains menopause nutritionist and online personality Emma Bardwell. “However, it’s important you make sure you’re the one taking control.” Her evidence-based, no-nonsense approach to this phase of women’s lives has made her one of the go-to names in women's health and nutrition.

That’s why she set up The M-Collective, a hub for information for those seeking more concrete answers about what they are experiencing. 

“I wish I’d known to start with tangible things like lifting weights earlier or getting my iron levels checked. I’d have read more about it, changed what I ate, steered clear of ‘clean-eating’ and meditated more.” The response from Bardwell’s online community to her post was telling.

“I was so bamboozled by all the conflicting information” wrote one woman. “I’d be telling my daughters to take the time to find what works best for them as an individual because what I’ve realised is that everyone’s journey is different, and what works for one friend, doesn’t work for the other."

“I used to wake at 3am and assume that I was an over-thinking, anxious person and that it was all my own fault,” explains another women. 

"Cutting down alcohol has been a game-changer and I now give sleep and relaxation the respect it deserves. I wish it hadn’t taken years and many doctors to figure out that I wasn’t just burnt out at work,” the 51-year-old continued. “For a while after I realised I was perimenopausal, I didn’t want to let it define me. But I also had to realise that I can’t defy it either. I think respecting the process is key.” 

Menopause Hub CEO Loretta Dignam at her clinic in Mount Merrion, south Co Dublin. Picture: Conor McCabe.

 For generations we didn’t speak about any of this. In recent years, many of us just thought menopause meant hot flushes and the end of your period. Loretta Dignam is a divorced mother of two adult children and founder of The Menopause Hub. She hopes that when it comes to the next generation, they’ll have the tools to understand even more about how our body changes as we age.

“I would have saved myself eight years of sub-optimal health and numerous medical tests had I known there was such thing as perimenopause,” she points out. “Instead, I was left feeling like a slow puncture.” 

Perimenopause, meaning ‘around menopause’ refers to the time during which your body makes the natural transition to menopause. In other words, it marks the end of the reproductive years. 

Women start perimenopause at different ages, although the average age is about forty-five. The changes may result in physical, emotional, psychological and sexual can also start in the early forties, but some women notice changes as early as their mid-30s. 

The level of oestrogen— the main female hormone in your body— rises and falls unevenly during perimenopause. This causes your menstrual cycles to lengthen or shorten and you might experience other menopause-like symptoms like sleep problems or vaginal dryness. Once you’ve gone through 12 consecutive months without a menstrual period, you’ve officially reached menopause. Cue the balloons. 

However, destigmatising menopause isn’t straightforward.

“My perception of women going through this used to be about old, grey, retired women," admits Loretta.  "I couldn’t relate to that, and I didn’t want to admit it. Of course, now I understand how far from reality that was. But there are myths that still need dispelling. 

We’ve a lot more to do to empower women normalise this very natural stage in our lives.

“If I had to do it over again, I wish someone had told me about the 40 plus symptoms you might start to experience during perimenopause,” she says. 

“I’d also have tracked my symptoms to see how they ebbed and flowed both personally and professionally. I wouldn’t have been afraid of HRT, and I wished I’d been informed about the type of hormonal profiling blood tests available."

Bardwell, meanwhile, worries that the dearth of information about menopause has started to turn into an absolute deluge. 

“This had brought with it a lot of misinformation and pseudoscience to the market, so women are having to pick through it all trying to work out what’s reliable and what’s simply just clever marketing.”

Given the global menopause market it said to be work over $17 billion, the explosion in Menopause talk also comes with a lot of ‘meno-washing’ pitfalls. “There’s an emphasis on expensive supplements, remedies and skincare products that simply don’t have the research to back them up,” explains Bardwell. 

“It’s overwhelming for women who are already feeling exhausted by the myriad of symptoms they are experiencing. “My advice is to pivot: Change up your diet. Try new exercises. Be ruthless about the stresses you allow into your life. I want women to know that there are tangible things we can do for ourselves. We don't have to suffer in silence.”