Whilst we can establish that menopause is the absence of a bleed 12 months and perimenopause precedes it whilst you are perimenopausal it can be tricky to know if you actually are!
According to Jerilynn C Prior endocrinologist, perimenopause is met if you are having 3 of any of these 9 symptoms:

1. New onset of heavy/and or longer flow
2. Shorter cycles <26 days
3. New sore, swollen or lumpy breasts
4. New mid-sleep-waking
5. Increased menstrual cramps
6. Onset of night sweats, in particularly premenstrually
7. New or markedly increased migraine headaches
8. New or increased premenstrual mood swings
9. Weight gain without changes in exercise or diet

The transition to menopause is often marked by physiologic and psychosocial changes in varying degrees of severity and disruption for midlife women. Symptoms, particularly hot flushes and depressed mood, can begin early in the menopause transition, well before menstrual irregularities occur, and can continue well beyond the final menstrual period.

These and other acute symptoms of menopause are primarily multifactorial in nature, with biological changes interacting with other psychological, cultural, and socioeconomic characteristics of women. It is critical to determine whether symptoms are primarily associated with the menopause transition, and are likely to be time-limited, or whether the symptoms are a continuum of medical and other illnesses.

SYMPTOMS

Here are some of the symptoms you can experience in perimenopause:

• Insomnia, weight gain unexplained, mood swings, fatigue, anxiety, overwhelm, flooding periods close together and then further apart.
• Hot flushes – 30 seconds to 5 minutes average 2 minutes, recurrent transient episodes of warmth/flushing of the skin upper chest and face, severity varies, duration varies and frequency varies, some get anxiety, palpitations and increased heart rate(vasomotor) 75% women experience this as a hallmark – effecting quality of life due to declining. estrogen (this is higher in women whose ovaries have been removed).
• Night sweats (are hot flushes that occur at night) – intense perspiration, drenching
• Vaginal dryness can lead to painful intercourse.
• Thinning of vaginal walls with a decline in estrogen.
• Vaginal infections, vulvar pain, burning with urination, urinary tract infections, bleeding from vaginal tissues, fissures (genitourinary syndrome of menopause).
• Mood issues anxiety and depression.
• Sleep issues (difficulty falling asleep or multiple awakening).
• Brain fog – cognitive issues around memory and concentration.
• Reduced libido or change in sex drive and painful intercourse – peaks 45 to 64 years then plateaus.
• Weight gain- related to ageing and lifestyle, increase in fat in the abdominal region, decrease in lean body mass, increase in visceral abdominal fat associated with cardiovascular disease, diabetes, metabolic syndrome and decrease in energy expenditure.
• Dermatology issues skin and hair changes.
• Urinary symptoms are common but not related to estrogen loss, helped by weight loss if overweight and pelvic floor muscle strengthening which can also help urinary incontinence if regular.
• Overactive bladder.

 RISKS

• Bone health – osteopenia, osteoporosis, compromised bone strength
• Sarcopenia
• Cancer risk
• Ageing and diabetes are two risk factors for cardiovascular risk
• Cardiac health
• Osteoporosis

There are many elements to this next phase of life for women, understanding what is going on and being guided is extremely important and useful.