Perimenopause can be thought of as the first stage of the menopausal phase in a woman’s life and is the time before and around the final menstrual period.
Medically, it starts when the first menopausal symptoms appear and ends a year after the last menstrual bleed, or the point in time when menopause has been reached.
The term perimenopause isn’t often used; women experiencing symptoms usually refer to being menopausal or going through menopause.
As a woman ages, there comes a point when production of the female hormones driving the menstrual cycle starts to decline. This process means that eventually the ovaries stop releasing eggs each month—it’s Nature’s way of saying that, at this age, the woman is less likely to carry a healthy baby and that her reproductive life should come to an end.
Typically, this process begins in the mid-forties, and as hormone levels fall, an imbalance between estrogen and progesterone can occur.
Menstrual periods become irregular, heavier or more uncomfortable. Other physical and psychological symptoms may also be experienced; some women describe these as being similar to premenstrual syndrome (PMS) symptoms.
A wide range of symptoms can be experienced during perimenopause, and they’re generally the same as those present during the other stages of menopause.
However, a few symptoms are more frequently encountered during perimenopause. They include:
- Irregular, painful or heavier periods
- Breast pain
- Irritability or anxiety
- Feeling down or depressed
- Sleeping poorly
At the start of perimenopause, these symptoms may worsen in the week or so before each menstrual period and feel like PMS.
Women in perimenopause can also experience hot flashes and night sweats, whether or not they’re still having their monthly menstrual flow.
In addition, perimenopause can also give rise to muscle and joint pain. These are usually confined to the upper part of the body and described as neck or shoulder pain.
As perimenopause is a normal stage of a woman’s life, many prefer to treat the symptoms with natural remedies. A number of herbs can help, including:
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Agnus castus. Also known as chasteberry, this is the herb of choice if symptoms start after ovulation and disappear once menstrual bleeding starts, just as you might expect with PMS. It can be very useful if you have a number of symptoms, and can also help relieve painful periods and breast tenderness.
Valerian. The root of the Valerian plant is used medicinally and its extracts can help you cope better with stress and anxiety and help you sleep better.
Avena sativa. This is the plant we commonly know as oats. However, instead of the seed or fruit, it’s the leaves and stems of the oat plant that are used medicinally. It helps to relieve mild stress and anxiety.
St. John’s wort. This has a long tradition of use in helping to lift the mood of those prone to mood swings or feeling a bit down and sad.
Sage. Extracts of sage are now known to have the specific ability to relieve hot flashes and sweats. It can be used at all stages of menopause.
Arnica. Well known for its ability to help with bruising, this herb also has pain relieving properties. It’s useful if you suffer from neck and shoulder pain, muscle aches and joint stiffness.
Devil’s Claw. This plant grows only in the Kalahari desert and has a long tradition of use in treating joint pain and backache.
In general, doctors are reluctant to use prescription medicines to treat perimenopausal symptoms. However, if they’re severe and starting to interfere with quality of life, a number of classes of medication may be suggested.
Hormonal treatments include low-dose oral contraceptives to treat PMS-like symptoms, or hormone replacement therapy (HRT). In addition, antidepressants or sedatives may be needed by those suffering depression, anxiety or insomnia.