Menopause can start far earlier than you think

Perimenopause and menopause often get confused or lumped into one. Actually the distinction is crucial to understand which phase you are in, what support you need at this time and what symptoms you are likely experiencing so you can look out for them and be prepared.

Perimenopause is the transitional stage in which the body approaches menopause. During this time, menstruation occurs less frequently and on an irregular basis. You are likely to skip periods, then you may have heavier bleeding than you've ever experienced. Cycles become irregular and so do the number of days you bleed per cycle. 

Menopause is actually the anniversary of one year of no bleeding. So a woman is deemed menopausal when her menstrual cycle and fertile period has ended, and she hasn't had a period for 12 consecutive months. Many women feel that they regain a sense of clarity at this time as their menopausal symptoms have lessened and they have learnt to adapt. 

As 52-year old Karen described it, “Perimenopause was like entering a maze – confusing, with unexpected turns. Menopause, on the other hand, felt like reaching the center of the maze. You find a sense of direction and understanding."

Simply put, perimenopause is the journey and menopause is the destination. 

Many women claimed to have had limited understanding of the symptoms perimenopause can cause prior to going through it. Whilst it can vary drastically between individuals, more than 75 percent of women experience symptoms (Mira, 2022) and roughly 20 percent face more severe or long-lasting symptoms (NSW Health, 2023). 

Nuffield Health in the UK questioned 3275 women aged between 40 and 65. 62 percent of the respondents said they were experiencing hormonal changes and menopause symptoms which altered their behaviour or had a detrimental effect on their lives. Almost half (47 percent) of women with symptoms said they feel depressed, while more than a third (37 percent) said they suffer from anxiety. 

As 49 year old Sandra from Melbourne, Australia explained it, "Menopause brought mental challenges I hadn't encountered before, including moments of fatigue, occasional blues, and sometimes pretty deep ones. Loneliness was the biggest part, learning how to deal with that while still running a household surrounded by people and surrounded at work. I often wanted to just spill my guts, but had no idea how to talk or who to talk to." 

67 percent of women in the UK have a similar experience, expressing that there is a general lack of support or advice for those going through menopause (Nuffield Health, 2017). 

So what are the symptoms and what to expect? 

There are a few hero symptoms that are seemingly known or expected. A recent survey done in Australia by HCF highlighted that unsurprisingly, people knew of symptoms like mood problems (68 percent) and hot flushes (66 percent). The general understanding lacked, however, when it came to more nuanced symptoms caused by a change in oestrogen. 

45 percent of women failed to recognise they could be experiencing symptoms linked to the menopause despite reporting symptoms like joint and muscle ache, hot flushes, irregular periods, night sweats, mood swings and poor memory.  42 percent mistakenly believe they are too young or too old for symptoms and 25 percent of women simply put their changes or symptoms down to stress, dismissing perimenopause entirely (Nuffield Health, 2014).

There are 34 "commonly" reported symptoms of perimenopause and menopause all due to changes in hormones, specifically oestrogen and progesterone.

In 2022, Mira conducted a survey of 1,000 women between the ages of 50 and 65 in the UK about menopause, three quarters of women admitted aspects of their life have been affected by menopause. Their symptoms included; 

1. Moodiness (62 percent); 
2. Low sex drive (46 percent); 
3. Mental health challenges (31 percent); 
4. Relationships with partners suffered (27 percent);  
5. Social life suffered (20 percent); 
6. Time spent on hobbies/leisure activities decreased (15 percent); 
7. Relationships with members of family suffered (12 percent); 
8. Relationships with children suffered (8 percent); 
9. Relationships with friends suffered (8 percent). 

A 51 year old from Sydney Australia, said "Mood swings and occasional feelings of loneliness affect my well-being. I felt very inward and isolated from friends, family and my partner as I tried to understand the worse-than-teenage hormonal crazy I felt."

Another study of 5,000 women in premenopause, perimenopause and postmenopause in the UK, conducted by study OnePoll, only reinforced these findings by Mira. 

While we have discussed moodiness and mental health issues in general, the study revealed that as high as 9 percent of women have contemplated suicide while transitioning through menopause. It can be extremely challenging to understand that these suicidal tendencies could be a part of menopause, especially if you don't have a history of depression or anxiety.

Furthermore, a staggering 86 percent admitted to suffering mental health issues during their menopausal transitional years (pre to post), suggesting that more women than not suffer from mental challenges during the up to decade long transition into post menopause. 

53 percent suffered from low mood and depression, 50 percent reported anxiety, 42 percent reported anger and mood swings and 33 percent reported feelings of worthlessness. And while it might be easy to suggest that women of any age might suffer from these issues and it is not related to menopause, it was reported that 77 percent of these women confessed they had never experienced mental health issues prior to entering this life stage, and found these mental health issues difficult to live with. 

Mental health is nuanced and doesn't only include anxiety or depression. For 58 percent of women, their mental health challenges were reported as experiencing low energy and a lack of motivation. Without energy, vitality or a will to live an interesting and varied day, it can greatly affect the mental health of pre and post menopausal women. This rises to 67 percent among 46-49 year olds.  

These mental health issues have a long lasting timeline due to their linkage with oestrogen drops in the body. 15 percent (around 1 in 6) of women professionals are phoning in sick on a regular basis unable to face going to work due to the mental load of peri/menopause.

Sue from Perth, 53, said, "Hormonal shifts brought bouts of sadness and brain fog" and "Some days, clarity prevailed, while others, brain fog clouded my thoughts." 

If you are experiencing any issues with peri/menopause, please contact the phenxx team and we can provide you with resources and relevant information for your jurisdiction. No one should go through menopause alone and without support. Reach out to family and friends, professionals or even to our care team at Phenxx. 

If you care to share your story anonymously, please submit your story via our website or by email to hello@phenxx.com with the subject line, my menopause story.