New Tide

Shilpa Bhim
Gritty Pretty

Menopause usually hits after the age of 50s—but that’s not the case for everyone. Rarely discussed is perimenopause, the transition when your period flow and hormone levels begin to signal a change. Shilpa Bhim shares one woman's story of going through early perimenopause at 41.

Menopause. You’ve probably heard of it. Anyone with ovaries is likely to experience it, hot flushes and all. We’ve always been told that menopause is likely to enter our lives in our early-to-mid fifties. But the journey to menopause can begin much earlier.Enter: perimenopause. It’s the transition to menopause where your period flow and hormone levels in your body start changing. It’s an experience that’s not really spoken about, despite more than fifty per cent of the population in Australia being impacted by menopause.

Gritty Pretty chatted with Lucy Brooks, Founder and Director of Little Bird PR, about her experience with early perimenopause, including what symptoms she’s experienced, how it’s affected her day-to-day life and the treatments she’s sought as the tide turned and signalled a new life stage much earlier than she’d planned.

What Exactly Is Perimenopause?

Perimenopause signals the start of your journey to menopause. It usually occurs in two stages:

Early Stage: defined by changes in menstrual flow and in the length of the cycle. This stage usually begins in the late forties, but can begin earlier for some.

Late Stage: defined by missed periods and a drop in estrogen levels, leading to hot flushes and vaginal dryness. This stage usually begins when a woman is in her early fifties.

The next step is menopause, which is classified as twelve continuous months without a period.

Lucy Brooks is in the ‘early stage’ of perimenopause and she’s been living like that for two years. “It was early 2020, I was forty-one years old [and] out of the blue, my periods stopped.”

Having been diagnosed with endometriosis around fifteen years ago, Brook’s periods were often characterised by short cycles and heavy bleeding. But in early 2020, when Brooks was forty-one, her periods stopped altogether for a few months.

“I was doing F45 a lot. Suddenly we went into lockdown. I didn't do any exercise. We went to homeschooling. A lot of my clients went on hold. We had this massive life shift. And with that, my periods stopped.”

Brooks was seeing a naturopath at the time, to support her endometriosis. “I went on lots of supplements, but nothing was making a difference. Still no period, but also no other traditional symptoms like hot flushes.” She also had age on her side: “Traditionally, it's uncommon for women to really enter into the perimenopause phase until their late forties.”

By September, Brooks had only had one period and her period wouldn’t return again until July 2021. In between periods, Brooks was experiencing a wave of symptoms. Eventually, she was diagnosed with early perimenopause. “What I’m finding out with perimenopause is that it is very much stop and start. Your periods can come and go for many years until you really are in menopause.”

It's More Than A Hot Flush

Brooks has experienced a range of symptoms including extreme hot flushes and insomnia—both of which are typically associated with menopause. She also experienced other, less common or known symptoms.

“I’ve noticed that I bruise easily and experience headaches and brain fogginess … I definitely have noticed that my body's changed shape since being perimenopausal as well. Weight is much harder to shift since being in this transition. My hair has gotten a bit thinner and my nails are very brittle as well.”

Brooks notes that osteoporosis and heart disease are also common symptoms.

The ability to get pregnant is also complicated by perimenopause. While menopause means you no longer ovulate, and therefore can’t get pregnant, it’s a little more complex when it comes to perimenopause.

Brooks had already had children in her 30s. After being diagnosed with endometriosis she was advised by her doctor to start a family early. “My endocrinologist did say to me that women in this phase can still get pregnant. But you don’t know when your periods will start and stop—it’s hard to plan.”

“I would say if you’re going through this perimenopause journey in your thirties and early forties, and you wanted to have a family, it would definitely be a priority to speak to your doctor and look into what your options are.”

There Can Be Different Causes Of Early Perimenopause

Family history can be a cause, but that’s not the case for Brooks. “My mum went into menopause in her early fifties. My sister is forty-eight this year and her periods are like clockwork.”

Brooks says that her early perimenopause could be attributed to her endometriosis and related surgeries. “My endocrinologist has said that because I've had over five laparoscopies I might have damaged my ovaries and caused them to dysfunction early, which has put me into early perimenopause. That, combined with all the stress at the start of the lockdown.”

“Right Now, I’m Self-Managing My Symptoms”

Brooks has visited a number of specialists during her perimenopause journey so far. In addition to a naturopath and acupuncturist, she visited an endocrinologist during the period of September 2020 to July 2021, when her period had completely stopped.

“An endocrinologist is an expert in hormone imbalance. She ran lots of tests for me. And the tests showed that I was in menopause.”

Brooks explains that follicle-stimulating hormone (FSH) levels are measured. When a woman’s FSH blood level is consistently elevated to 30mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause. At the time of testing, Brook’s FSH level was one hundred!

“I was handed a script for HRT (hormone replacement therapy), which is a treatment to relieve symptoms of menopause. But then my periods came back!”

For now, Brooks is happy to self-manage her symptoms. The main symptom for her is insomnia, so she’s avoiding stress triggers like working or checking emails after 8pm. “I’m using an app called Evia. It helps you track your hot flushes and uses hypnotherapy and guided meditation to keep you calm, and help you to sleep.”

She’s also having open conversations with friends who are experiencing perimenopause or menopause to learn how to manage her situation, and has started doing light exercise “although I miss F45!”

“Who knows what the future holds. I could be in a real pickle in six months time and need to seek alternative solutions. But right here, right now, I'm kind of managing it.”

If you are experiencing changes in your menstrual cycle or perimenopause symptoms, seek professional advice from your doctor.