Understanding perimenopause - what you need to know

As women, what we can all guarantee is that we will go through perimenopause and menopause - just like we went through puberty.

But it can be a really confusing time. But understanding perimenopause and menopause is the first step to ensuring this is an easier process and part of our lives.

At Zing Wellbeing we are big believers in education and we have teams of experts who are on hand to help educate and inform us so we can make the best health choices for our own circumstances.

And we are also big believers in a holistic health approach and seeing food as medicine - this is why we have invested in menopause meal plans (great for perimenopause too) and meal plans that help to balance women's health - such as gut health meal plans and high protein meal plans - you can access them all in our health program.

Understanding perimenopause

As women get older, the number of eggs in their ovaries decreases, which gradually lowers the production of key hormones, specifically estrogen and progesterone.

This decline isn’t always steady—often, the ovaries will release hormones erratically. This inconsistency leads to varying hormone levels, which can cause a range of symptoms.

Perimenopause, the phase leading up to menopause, can start as early as 10 years before periods completely stop. This transition usually begins in a woman’s late 30s or 40s but can vary widely depending on individual factors.

By the time perimenopause begins, levels of another hormone, testosterone, are often already lower. Though commonly associated with men, testosterone is also produced by the ovaries and plays an important role in women’s health. Typically, testosterone levels peak in the late 20s or early 30s and then start to decline.

What is Menopause?

Menopause occurs when the ovaries have exhausted their supply of eggs, leading to a more significant drop in hormone production, which causes menstruation to cease. Medically, menopause is defined as having gone 12 consecutive months without a period. After this point, hormone levels remain low for the rest of a woman’s life.

Hormonal Changes and Their Impact

The hormones estrogen, progesterone, and testosterone are essential for more than just reproductive health. They influence nearly every cell in the body, and when their levels drop, various symptoms can arise.

The brain is particularly sensitive to these hormonal shifts, which can disrupt sleep, mood, and memory. Women might also experience headaches and have difficulty regulating body temperature, leading to hot flushes and night sweats. Other common symptoms include fatigue, muscle and joint pain, reduced libido, recurrent urinary tract infections, vaginal dryness, and discomfort during intercourse.

During perimenopause, periods may continue but often become unpredictable, with changes in flow or frequency.

Most women will experience some symptoms, but the intensity and duration can differ significantly. Some women have only mild symptoms, while others find the changes severely impact their quality of life.  For some, symptoms are temporary and ease after menopause; for others, they may persist or worsen over time.

How is Perimenopause Diagnosed?

There is no single blood test that can reliably diagnose perimenopause. While blood tests may help rule out other potential causes of symptoms, they are not definitive because hormone levels fluctuate throughout the day and month. Instead, healthcare providers rely on a woman’s reported symptoms and clinical evaluation to make a diagnosis.

Long-Term Health Impacts

The drop in hormones during perimenopause and menopause not only causes symptoms but also influences long-term health. Lower estrogen levels can increase the risk of conditions like heart disease, stroke, and cognitive decline. Women are also more vulnerable to osteoporosis, fractures, type 2 diabetes, bowel cancer, osteoarthritis, and mental health challenges such as depression.

Managing Symptoms and Improving Wellbeing

It is always a good idea to talk to your Doctor about your own personal situation to decide the best way to manage perimenopause and menopause symptoms.

Lifestyle modifications are highly beneficial during this phase. Eating a nutrient-rich diet that is high in plant based protein, low in sugar and processed foods, minimising alcohol, reducing stress, engaging in regular physical activity, and avoiding smoking are all essential. Prioritising good sleep, practicing mindfulness, and reducing stress and anxiety also provide relief. The Zing Wellbeing program take a holistic approach to health and cover all of these areas with group coaching support each week.

Hormone Therapy (HT), also known as HRT or MHT, is also one of the most effective options for managing perimenopause symptoms. By stabilising hormone levels, it helps alleviate symptoms and can lower the risk of certain long-term health conditions. 

Can HRT work with natural remedies during menopause

Many natural remedies can help complement HRT and assist in reducing side effects. HRT is one of the most effective treatments for hot flushes as it directly addresses estrogen decline. Herbal medicine like sage can also assist with heat and may allow a lower dose of HRT to be effective.

HRT also helps to stabilise mood by balancing estrogen and progesterone. There are many herbal medicine that can assist with anxiety, depression and mood which are safe to use with HRT including Withania, Passionflower and Magnesium. For brain fog and concentration Bacopa and Ginkgo can be effective as well alongside fish oil, DHA and Choline.

Supporting bone health is essential through menopause and ensuring you are getting all bone minerals during this time is essential. HRT supports bone health as estrogen protects against osteoporosis. Vitamins like calcium, vitamin D, magnesium and weight bearing exercise may also assist.

Insomnia is common during hormonal transitions and HRT can be used to improve sleep quality alongside herbs like chamomile, passionflower and even kava. Magnesium will also assist and you can chat to your GP about melatonin if needed.

Using natural herbal based creams and lubricants can assist with vaginal dryness and discomfort during menopause and protect against infections, fissures and tears.

Avoiding paraben based or synthetic creams is essential to vaginal health. HRT does assist by stabilising estrogen but localised support via a cream is also essential.

Many herbalists make individualised cream or recommend those made by other herbalists, for example Mother’s Love made by Skin Doona is a must have for many peri- and menopausal women.

Lastly, it is essential to keep an eye on heart health during this time and while HRT stabilises hormones to support heart health and may improve cholesterol levels, you may need further support in the form of CoQ10, magnesium, Omegas and a diet rich in antioxidants.

Women who have never experienced high blood pressure or cholesterol before may find this change during menopause so it is important to monitor.

Every woman is different and while many may benefit from HRT herbal remedies can be used as adjuncts as well as without prescription medicine. In combination with lifestyle changes and exercise these strategies may be enough to smooth the transition and alleviate symptoms.

While some herbal preparations and supplements are popular, evidence supporting their effectiveness is limited. In some cases, other prescribed medications such as antidepressants, gabapentin, pregabalin, or metformin can be helpful for managing specific symptoms.

And if you want meal plans, recipes and a holistic approach to health and menopause you can access them all in our health program.