Dr. Caoimhe Hartley
GP and Women’s Health Specialist, Co-Chairwoman of the Menopause Society of Ireland,
Clinical Lead Menopause Health, Dalkey, Clinical Lead of the Complex Menopause Clinic, Rotunda Hospital, Dublin
We often associate menopause with periods stopping and declining oestrogen levels. However, perimenopause, its stroppy younger sibling, is a different bag altogether.
The ovaries do not abruptly stop; they shudder, stutter, stop and start. Therefore, trying to diagnose perimenopause with blood tests is unhelpful. You are trying to measure something that will wax and wane; and there is no ‘normal’ range.
However, blood tests can be helpful to rule out other medical conditions, which mimic perimenopause and create some of the symptoms we associate with it, such as thyroid disease. So, consult your GP or pharmacist if you have any concerns.
Perimenopause oestrogen changes
Perimenopause is characterised by swings in oestrogen levels and times of oestrogen production, which are much greater than what would have been ‘normal’ in a menstrual cycle in your younger years. High oestrogen levels can be responsible for breast enlargement, breast tenderness, heavy periods and fibroid growth.
There may be cycles through perimenopause
where ovulation does not occur, which can
trigger abnormal or heavy bleeding.
Hormonal fluctuations and symptoms
There may be cycles through perimenopause where ovulation does not occur, which can trigger abnormal or heavy bleeding. These erratic hormone levels, for some women, will be responsible for cognitive changes (‘brain fog’ can peak during perimenopause), migraine headaches and mood changes.
Many women describe perimenopause as worsening of their PMS-type symptoms. Some will report a change in their cycle (periods may be heavier or lighter, more frequent or less frequent). Women must be assured that they are not losing themselves. Although some will fly through perimenopause, their brain unfazed by the hormonal ups and downs, others feel they have woken up in a different body.
Where to find perimenopause support
The message is not to be petrified of perimenopause but to know when and where to look for help. Do not feel that you have to wait for your periods to stop before having a discussion. Talk to your pharmacist or GP.
Visit the British Menopause Society’s informative patient website at womens-health-concern.org.
This has been paid for by Besins Healthcare. BHUK/2024/074-ROI. March 2024.
The opinions in the article are of Dr Hartley, not Besins.