What is the difference between Peri-Menopause and Menopause?
It’s important to understand the difference between peri-menopause and menopause. I’d like to say that peri-menopause is your body's way of gently leading you into the next stage of life, but let’s face it, there is nothing gentle about it!
Peri-menopause can start as early as ten years before you are in full menopause, which is why it’s so easy to misdiagnose. The menopause itself occurs when the ovaries finally stop producing eggs altogether and is judged to be complete when a woman has not had a period for 12 months. The symptoms that cause so many women difficulty generally occur during the peri-menopause - the years leading up to full menopause.
We often hear stories where women feel they are too young to go through the menopause which makes it easier for us to accept it when a doctor diagnoses us with simple depression or anxiety, mistaking the symptom for the problem.
Paying attention to your body and knowing the signs can help you stand your ground if you seek medical advice.
Here's a reminder of some of the main symptoms:
Symptoms vary from woman to woman and I can’t stress enough how important it is to seek help if things are getting too much. Mental health changes are common. You are going through a major change and your hormones can become severely unbalanced. Some women report suddenly feeling suicidal, even though they have never had any previous problems with their mental health. If this is you, see your doctor sooner rather than later.
There are several ways to treat or help with the Menopause. HRT (Hormone Replacement Treatment) being the most commonly heard of. However, there are natural alternatives and it’s about finding the right treatment for you.
A great starting point is the NHS website where they explain ways to treat the symptoms individually. Be aware, though, that the term "menopause" is used interchangeably with peri-menopause, which does not appear on the site. There are, of course, alternative resources available, however, I would recommend, first and foremost, discussing the options with your GP s that you can make informed choices.
According to the guidelines issued by The National Institute for Health and Care Excellence (NICE), a FSH (Follicle Stimulating Hormone) test should be administered to women 40-45 with peri-menopausal symptoms. After 45, diagnosis will be made by looking at symptoms.
It’s unlikely you will be offered any treatment at this stage unless your symptoms are particularly troublesome. However, if your quality of life is compromised, once you have been officially diagnosed, you are likely to be offered HRT.
HRT (Hormone Replacement Treatment) - the Facts
HRT is a treatment offered to women to reduce the symptoms of the peri-menopause. It replaces some of the hormones that are at a lower level as you begin this cycle of your life.
Over the years, there have been reports and rumours around the effects of the treatment. There are pros and cons to using it but it’s about your own personal circumstances and what’s right for you.
HRT can replace two hormones: Oestrogen and/or Progesterone (which is replaced with a synthetic version called progestogen) .
HRT will involve either taking both hormones (Combined HRT) or just Oestrogen. Most women will be advised to take the Combined HRT as Oestrogen on its own can increase your risk of womb cancer. Oestrogen only HRT is usually only recommended to women who have had their womb removed.
The Risks vs Benefits
HRT has been associated with some forms of cancer. There is still a huge amount of research being done on this subject and NICE currently take the stance that the risks are very small. You can see the current statistics below.
It’s about making an informed decision based on your personal circumstances, research and advice from your GP.
Benefits can include:
Risks to consider include:
Possible Side Effects:
According to the NHS, side effects should subside after a few weeks.
There are certain circumstances in which HRT is unlikely to be suitable. If you fall into one of the following categories, you will need further discussions with a medical professional to decide if this is the right path for you:
How can you take HRT?
There are several ways to take HRT and you will need to discuss with your GP the pros and cons of each:
Each have their own risks and advantages so it’s important to learn the facts first. The NHS website provides information on each
There are, of course alternatives to HRT. From natural remedies, diet and exercise to other prescribed medication. There is no hard evidence that these are a good alternative, but that’s not to say they don’t work. We will be looking at some of these in future blog posts.
The bottom line is, take rumours with a pinch of salt, do as much independent research as you can and make a decision based on what fits with you and your lifestyle. There are risks to everything in life - only you can decide how life limiting your peri-menopausal symptoms are. Try alternatives, talk to your GP and come to a conclusion that feels right for you and your body.
Note: This article is based on treatment offered in the UK - other country's protocols May differ.
NICE Guidelines: Menopause: Diagnosis and Management https://bit.ly/2GhmEPE
Symptoms of the Peri-menopause: https://www.themidlifemovement.com/blog/peri-menopause-the-symptoms