Perimenopause affects millions of women worldwide, yet until recently it was a rarely mentioned and often misunderstood stage of life.
In some countries and communities, it is still a taboo subject.
Perimenopause is a gradual transition towards menopause, when hormone levels in a woman's body begin to change and reproductive function gradually decreases.
It begins when hormones – estrogen, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone – begin to fluctuate.
This hormonal change triggers a wide range of physical and emotional symptoms that can significantly affect daily life.
According to the UK's National Health Service (NHS), the most common symptoms of perimenopause are:
- Irregular periods
- Hot flashes and night sweats
- Problems with concentration
- Anxiety or poor mood
- Difficulty sleeping
- Decreased sexual desire
- Vaginal dryness
Symptoms can begin gradually as early as the late thirties, and according to the World Health Organization (WHO), most women enter this phase by their mid-forties.
Understanding what is happening in the body and taking certain steps in a timely manner can make this transition period easier.
Hormone replacement therapy (HRT) is an option for some women, but many successfully relieve symptoms naturally through lifestyle changes, either alone or with HRT.
Here are some ways to relieve symptoms.
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1. Nutrition that supports hormonal balance
A balanced diet contributes to hormone regulation by providing the body with necessary nutrients, while poor eating habits can cause imbalances that affect mood, energy, metabolism, and overall well-being.
It is recommended to enter:
- Foods rich in phytoestrogens - such as flaxseed, soybeans and lentils
- Fruits and vegetables – antioxidants help fight inflammatory processes
- Whole grains – stimulate metabolism and maintain energy levels
- Lean proteins – help preserve muscle mass
- Healthy fats – avocados, nuts and seeds stimulate hormone production
2. Regular physical activity
Physical activity improves mood by stimulating the secretion of dopamine, a neurotransmitter associated with feelings of pleasure and motivation.
Regular exercise also positively affects the reward system in the brain, increasing the amount of available dopamine and the number of dopamine receptors, which contributes to feelings of pleasure.
This neurochemical response highlights the important role physical activity plays in maintaining mental health and emotional well-being.
Research from the University of Exeter, England, has shown that menopause does not hinder muscle building, as resistance exercises significantly improve hip function, flexibility, and balance.
A combination of different activities is recommended:
- Strength training – Contributes to building muscle and maintaining bone density
- Yoga and stretching – Improve flexibility and reduce stress levels
- Aerobic exercises – They strengthen cardiovascular health and contribute to sleep regulation
3. Managing stress with mindfulness
Stress can significantly worsen perimenopausal symptoms such as mood swings, anxiety, and sleep disturbances.
A 2019 study by the Mayo Clinic in the United States (US) showed that mindful attention and lower stress levels were independently associated with reduced menopausal symptoms in middle-aged women.
The recommended techniques are:
- Meditation – Relieves anxiety and improves concentration
- Deep breathing – Calms the nervous system
- Journal writing – Regular writing contributes to emotional relief and a better understanding of one's own feelings
4. San treba da bude prioritet
Addressing sleep problems during perimenopause can be challenging, as the underlying causes—hormonal changes—are complex and difficult to manage.
Levels of estrogen and progesterone, hormones crucial for sleep regulation, decline unevenly, making it difficult to find a universal solution.
Additionally, symptoms such as night sweats, anxiety, and emotional swings vary in intensity and frequency, so a combination of lifestyle changes, hormone therapy, and medication is often necessary.
Additional factors, such as changes in sleep patterns due to aging and an increased risk of sleep apnea, can further complicate the situation.
That's why it's often necessary to try different approaches to find what works.
Good sleep hygiene includes:
- Bedding – Comfortable fabrics like cotton and moisture-wicking materials help maintain body temperature, while certain mattresses, especially memory foam, can trap heat and worsen discomfort.
- Going to sleep at the same time – Helps regulate natural biological rhythms
- Avoiding caffeine and screens before bed – Reduces overstimulation of the nervous system
- Cold and dark room – Promotes deeper and better quality sleep
5. Herbal preparations
If you are considering using herbal remedies with hormone replacement therapy (HRT), it is important to know that some herbal ingredients may affect the effectiveness of the medication.
For example, St. John's wort may reduce the effectiveness of HRT tablets and capsules.
Also, turmeric, which contains the active substance curcumin, in high doses may potentially act competitively with estrogen receptors, although the evidence is currently limited.
Other herbal remedies, such as evening primrose oil, soy, red clover, black cohosh, and ginseng, are often used to relieve menopausal symptoms.
However, doctors warn that without rigorous clinical trials, the safety and effectiveness of many dietary supplements have not been proven.
Therefore, it is extremely important to consult a doctor before combining herbal preparations with hormone replacement therapy or other medications for safety and effectiveness.
Kathy Abernethy, director of menopause services at the health platform Peppy, points out that many women turn to supplements, but that there is not strong scientific evidence for all of them.
He emphasizes that a balanced diet is the best way to provide necessary nutrients, although supplements such as vitamin D and calcium can be beneficial, especially during the winter months.
It also warns about the safety of supplements, stating that products purchased online or abroad may not meet prescribed standards and can affect the effects of prescribed medications.
Abernethy advises always reading the label, consulting a pharmacist, and not using supplements as a substitute for necessary medical therapy.
Some herbal remedies can help reduce hot flashes.
These sudden changes in body temperature are mainly the result of hormonal changes, primarily a drop in estrogen levels.
This drop affects the hypothalamus, the body temperature regulation center in the brain.
In response, the body triggers processes such as vasodilation (widening of blood vessels) to get rid of "excess" heat, which leads to an intense feeling of heat, redness of the skin, and sweating.
6. Building an emotional support network
Perimenopause can be exhausting and emotionally demanding, but you don't have to go through it alone.
Experts recommend talking to friends, a partner, joining support groups, or seeking professional help from a therapist, who can ease your problems and provide a sense of security.
How long does perimenopause last?
Perimenopause usually lasts several years, and experts estimate that it is most often between four and ten years.
Duration is influenced by genetics, lifestyle and general health.
Menopause itself is actually just a day, the day when a woman has not had a period for 12 consecutive months.
A study on women's health conducted in the US in 2022 showed that black women generally enter menopause earlier and have more pronounced symptoms, including hot flashes, depression, and sleep disturbances.
In contrast, Japanese and Chinese women reported fewer vasomotor symptoms, such as hot flashes, during perimenopause.
Impact on relationships
Shahrzad Purabdolah, a psychosexual and family therapist from London, tells the BBC that perimenopause symptoms can strain relationships, both romantic and family, as well as relationships with children.
Lack of communication, especially about intimate matters, can lead to emotional distancing and resentment.
However, she emphasizes that with understanding, patience, and a willingness to adapt, partners can strengthen their relationship during this transitional period.
How to distinguish perimenopause from other conditions?
Perimenopause symptoms often overlap with symptoms of other conditions, such as thyroid disorders, anxiety, or chronic fatigue syndrome.
For example, irregular periods and mood swings can also indicate hormonal changes and thyroid problems.
Fatigue and so-called brain fog can be associated with perimenopause, but also with vitamin deficiencies, while joint pain and headaches can be symptoms of other health conditions.
Tracking symptoms, either using a mobile app or keeping a diary, and consulting with a doctor can help determine whether it is perimenopause or another medical condition.
Although blood tests can provide insight into the condition, the results can be unreliable due to fluctuations in hormone levels.
Therefore, the most reliable approach is a detailed discussion about the symptoms and insight into the woman's medical history.
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