Understanding Perimenopause: Your Guide to the Menopause Transition

Let me tell you about perimenopause - it's the lead-up phase to menopause that typically starts in your mid-40s, though some women notice changes as early as their late 30s. This transition usually lasts between 2 to 10 years, with most women experiencing it for about 4-5 years.

During this time, your body goes through significant hormonal changes, particularly in oestrogen and progesterone levels. The first thing you might notice is that your periods become irregular - they might be longer, shorter, or just unpredictable.

Common Symptoms

During perimenopause, you might experience:

1. Changes in your menstrual cycle

2. Hot flashes and night sweats (they can be quite intense!)

3. Trouble sleeping

4. Mood swings, anxiety, or feeling down

5. Vaginal dryness and uncomfortable sex

6. Changes in your sex drive

7. Feeling tired more often

8. Weight changes and a different body shape

9. Brain fog (those moments when you can't quite focus)

10. More frequent bathroom trips

Here's something interesting - perimenopause affects everyone differently. About 20% of us sail through with no symptoms, 60% have mild symptoms, and 20% find it really challenging.

Managing Perimenopause

Here's what I've learned about managing perimenopause:

1. Keep moving and eat well - it really makes a difference

2. Try some relaxation techniques like yoga (it's been a game-changer for me)

3. Get into a good sleep routine

4. Talk to your doctor about treatment options if things get tough

Once you've gone 12 months without a period, you've officially hit menopause. Yes, it can be challenging, but remember - it's completely natural, and with the right support, you can handle it!

Best Treatments for Perimenopause Symptoms

Let me share what I've learned about treatment options:

1. Hormone Replacement Therapy (HRT): This is currently the most effective treatment out there. It tops up your oestrogen and progesterone levels, helping with hot flashes, night sweats, mood swings, and vaginal dryness.

2. Birth control pills (low-dose): These can help manage those pesky hot flashes and night sweats, plus they keep your hormone levels steady.

3. Vaginal oestrogen: If you're dealing with vaginal dryness, there are local treatments like tablets, rings, or creams that can help.

4. Antidepressants: Some types (especially SSRIs) can help with mood swings and even reduce hot flashes.

5. Gabapentin: This medication was originally for seizures or nerve pain, but it's actually quite good at managing hot flashes, especially if you can't use hormone therapy.

6. Fezolinetant: This is a new hormone-free option that targets hot flashes (though we can't get it in New Zealand yet).

Remember, what works for one person might not work for another. It's really important to talk to your healthcare provider about what's best for you.

Non-Hormonal Treatment Options

If you're looking for alternatives to hormone therapy, here's what you should know:

1. Antidepressants (SSRIs and SNRIs): These can help with hot flashes - some women see their hot flashes reduced by nearly half!

2. Gabapentin: Another good option for hot flashes if you can't or prefer not to use hormone therapy.

3. Fezolinetant (Veozah): This new drug looks promising with up to 69% effectiveness for hot flashes (though we're still waiting for it in New Zealand).

4. Venlafaxine: This can reduce hot flashes by 60-65%, which is pretty close to what you'd get with low-dose hormone therapy.

5. Vaginal lubricants and moisturisers: These can really help with vaginal dryness.

While these non-hormonal treatments can definitely help, they generally don't work quite as well as HRT. The key is finding what works best for you - everyone's different! Make sure to have a good chat with your healthcare provider about your options.