The Perimenopause Phase
The symptoms of menopause are tied up with fluctuating hormone levels. Symptoms are worse during perimenopause than in menopause itself because this is when the levels fluctuate the most. Sometimes levels rise to normal levels other times they come crashing down. When you reach menopause your hormone levels are consistently low so they don't trigger symptoms in the same way, although some symptoms (often different ones) can still occur. In perimenopause the most obvious effects come from fluctuating levels of estrogen. Here's how it works:
1. Your ovaries produce less estrogen (specifically estradiol, one of the three types of estrogen). As a result less estrogen reaches your brain.
2. Less estrogen in the brain causes a decrease in endorphin levels. Endorphins are the so called happy hormones that keep our moods regular and act as natural painkillers which make us less sensitive to pain.
3. The brain panics because there are lower levels of endorphins hanging around so it thinks something is wrong. It reacts by sending out bursts of adrenaline to kick-start your system. Specifically it sends outnorepinephrine (the hormone that triggers fight-or-flight, see dangers of stress for a more detailed explanation).
4. The burst of norepinephrine raises our heart rate (causing palpitations) so that we are ready for action. It raises blood pressure, causing our blood vessels to dilate, leading to hot flashes and sweating. If you're sleeping you may suddenly wake up, or you might get a bout of diarrhea or flutters in your stomach.
Common Perimenopause Symptoms
Irregular Periods
Hormone fluctuations interrupt the ovulation cycle, some months you release an egg from your ovary, some you don't (hence declining fertility, see what age does fertility decline?). If you don't ovulate you don't produce enough progesterone to have a period. This results in irregular periods.
Headaches
Women already prone to bad headaches or migraines in the days before or after their periods may suffer more headaches during perimenopause. This is because you are likely to be particularly sensitive to low levels of estrogen. Women who experience their first migraine during perimenopause however usually find they disappear again after menopause.
Mood Swings
Mood swings are common feature in most women's lives. Mood can fluctuate around period-time, and during or after pregnancy - so it's hardly any surprise that mood swings feature again in our perimenopausal years. Although scientists don't completely understand why - it appears that low levels of estrogen (common to all these occasions) is linked to lower serotonin levels. Serotonin is another one of those 'happy' hormones related to moods. Low levels make us irritable, prone to feeling pain and less able to sleep soundly. Other related articles, see menopause and depression as well as the effects of depression.
Memory Failure
You may find you lose your train of thought half way through a sentence or you go to the store and forget what it is you went for. Memory problems are very common in perimenopausal women, this is because estrogen is necessary for facilitating communication in brain cell neurons. Fortunately as estrogen levels stabilize postmenopause, memory returns to normal.
Skin Changes
One day you look down at your hands and notice that the texture has changed. Suddenly you notice your skin is dryer, you may also have noticed a few extra crow lines around your eyes and patches of dry scalp on your head. Whether this is a natural part of the ageing process or if declining levels of estrogen speed up the process is still open to debate. See, menopause skin changes.
More Hair And Less Hair
Hormone imbalances can be responsible for hairs that start to appear on the chin or on the backs of your fingers. It can also cause loss of hair or thinning hair on your head. Although both estrogen and androgen levels are declining, the rate of estrogen loss is faster, meaning the androgen suddenly has more prominence. One side effect of this is hair loss. Read about menopause hair loss.
Fibroids
Nearly one third of women have fibroids by the time they are 50. Fibroids tend to get bigger as you approach menopause but don’t usually change or grow afterwards. Fibroids only require treatment if they become symptomatic - see symptoms of fibroids. Women with endometriosis may also find that it flares up in the years approaching menopause but then subsides and even disappears afterwards.
Breast Soreness
Breast soreness is a common feature of menstruation, pregnancy, breastfeeding and perimenopause. It is a symptom of hormone fluctuations. However, always consult a doctor if there is any nipple discharge or lumps (symptoms of breast cancer). Also, read how to carry out a breast self-examination, which is particularly important as we get older.
I feel like a loopy hypochondriac 