The menopause and the perimenopause: A balanced approach to medical and lifestyle management

The menopause and the perimenopause are natural phases in a woman’s life that can bring several physical and emotional changes. Understanding these changes and adopting a balanced approach to medical and lifestyle management can help navigate this transition with more confidence.

This article explains the differences between the menopause and perimenopause, how your GP can assist with your care, and explores available treatments for any symptoms including lifestyle changes.

What is the difference between the menopause and the perimenopause?

The menopause is officially defined when a woman hasn’t had a menstrual period for 12 consecutive months. It typically occurs between the ages of 45 and 55, but it can also happen earlier or later. During the menopause, the ovaries cease most of their oestrogen production, leading to the permanent end of menstrual cycles.

The perimenopause, on the other hand, is the transitional phase leading up to the menopause. It can begin several years before the last menstrual period, often at the age of 40, although it can also vary. Hormonal level fluctuations - especially oestrogen and progesterone - during both the perimenopause and the menopause can cause symptoms like irregular periods, hot flushes, vaginal dryness, sleep disturbances, and mood swings.

How can my GP assist with my menopause and perimenopause care?

Your GP plays a crucial role in your menopause and perimenopause care, assessing symptoms, offering advice, and creating an individualised treatment plan tailored to your needs.

If you’re experiencing symptoms that affect your quality of life, your GP can also confirm whether they are related to the perimenopause/menopause or another underlying condition through a discussion of your medical history and, if necessary, blood tests. Seeking medical advice early is particularly important if your symptoms are severe or begin before the age of 40, as this could indicate premature menopause.

Furthermore, your GP can help monitor your overall health during the perimenopause and menopause, providing guidance on maintaining bone density, heart health, and emotional wellbeing - all areas affected by lower oestrogen levels - to prevent osteoporosis and cardiovascular disease, for example.

What treatments are available for menopause and perimenopause symptoms?

Hormone replacement therapy (HRT) is one of the most effective treatments for alleviating symptoms like hot flushes, night sweats, and mood swings. It works by replacing the hormones - mainly oestrogen and, in some cases, progesterone - that the body is no longer producing. There are various forms of HRT, including tablets, patches, gels, and implants.

For women who are unable or prefer not to use HRT, non-hormonal options are also available. These include medications like selective serotonin reuptake inhibitors (SSRIs), which can help with hot flushes and mood-related symptoms. Additionally, vaginal dryness can be treated with over-the-counter lubricants or low-dose vaginal oestrogen creams.

Can lifestyle changes also help manage symptoms?

Lifestyle changes are a cornerstone of menopause and perimenopause management, complementing medical treatments and enhancing overall health and quality of life. Effective lifestyle changes include:

Diet

Incorporating plenty of fruits, vegetables, lean proteins, and whole grains provides the nutrients needed to strengthen bones and regulate energy levels. Phytoestrogens, found in foods like soy, flaxseeds, and legumes, can also help alleviate hormonal symptoms. At the same time, reducing caffeine and alcohol intake can help minimise hot flushes and improve sleep quality.

Exercise

Activities like brisk walking, yoga, swimming, and weight-bearing exercise training can help maintain a healthy weight, improve mood and sleep, strengthen bones and muscles, and enhance flexibility and balance. Moreover, regular exercise also has the added benefit of reducing stress, which is often heightened during the perimenopause and menopause.

Stress management

Stress can exacerbate symptoms like mood swings and sleep disturbances; practices like mindfulness, deep breathing exercises, and meditation can help alleviate these effects. Similarly, keeping a consistent sleep schedule, creating a relaxing bedtime routine, and optimising your sleep environment can further enhance sleep quality and improve rest.

The perimenopause and the menopause are very personal experiences, and every woman’s journey is different. Medical treatments and a healthy lifestyle can help reduce the severity of symptoms and improve physical and emotional health, promoting long-term wellbeing.