My Journey with Cushing’s disease
At 30 years old, I was fit, healthy and naturally a size 8–10. I knew my body well, which is why, when it started to
Hot sweats, changes to your menstrual cycle, vaginal dryness, and a lack of sex drive—for years, when we discussed these symptoms, we tended to put them down to menopause. However, menopause is actually the time when your period stops altogether. Did you know we’ve been neglecting to mention a whole other time of life?
This time of life is called perimenopause, which translates into the “time before your menopause”. So, let’s look at what perimenopause is, what age you go through it, the symptoms to look for, and the types of treatments that can help, before looking at how perimenopause might affect your sex drive.
As stated above, perimenopause refers to the time before menopause; it is usually seen as the transitional period between the onset of symptoms and the time your period finally stops (which is when you enter menopause). It is ultimately when the ovaries stop working in the way they used to and it can last anywhere from months to years, with many people commonly experiencing perimenopause for up to eight years.
For many females, it can be a confusing and scary time as it feels like the body is going through a second puberty, and your menstrual cycle becomes irregular. However, please be reassured this is a natural time of your life as you move through your body’s natural cycle and you often do not need treatment to tackle perimenopause (although you may wish to seek treatment to help alleviate the symptoms).
Currently, there are 10 symptoms of perimenopause that you can experience (although symptoms can vary from person to person). These include:
However, do recognize that while some experience many of these symptoms intensely, others may experience very few and can go through perimenopause and menopause with little to no difficulty. It is also worth tracking the symptoms you experience as some, such as irregular periods, could indicate other issues at this time of life such as uterine cancer.
Although it is more common for vulva owners in their 40s to experience the early symptoms of perimenopause, a small percentage of the population will experience perimenopause or early menopause in their 30s. Currently the average age for people to start perimenopause is between 40-45 years old. However, you may also find that you don’t experience any symptoms until your early 50s. Studies are looking into why early or late perimenopause occurs.
One of the first signs you may notice when you start perimenopause, and what usually sends people to the doctor, is changes to your menstrual cycle. Many find their periods become irregular (such as being longer, shorter or falling outside of their usual 28 day cycle). You might also find you’re experiencing hot sweats, mental health issues, muscle pain, or a decreased sex drive. For many, these symptoms are mild, but studies have found over 90% of those going through perimenopause seek medical help to elevate their symptoms.
If you notice your symptoms are ongoing, you might wish to book an appointment with your doctor to get a formal diagnosis and reassurance. Your doctor will consider your symptoms and age and potentially administer blood tests to check your hormone levels. Your doctor could also request a gynecology test to check your vaginal health and pelvic health to rule out other causes.
A great way to show your doctor your period is becoming irregular is to track your cycle, noting down symptoms and any mood changes; this will help you to understand if your period is irregular due to stress, mental health issues, medication, perimenopause, or for another reason.
Although perimenopause is a natural part of aging and cannot be stopped, there are treatments your doctors can prescribe to help with the symptoms, such as hot sweats, mood swings, brain fog, joint pains, mood swings, and even vaginal dryness.
Some medical treatments you can be offered to alleviate your symptoms are:
This might be a pill, skin patch, gel or cream. The aim of HRT is to replace the lost estrogen, but eligibility is dependent on your medical record and if you have a uterus you should also be prescribed progesterone. This can help with your menstrual cycle, hot flushes, and even bone loss.
This treatment releases just a small amount of estrogen, which is applied directly to the vagina and absorbed by the vaginal tissue. It can help relieve vaginal dryness, discomfort with intercourse, and some urinary symptoms.
Certain SSRIs have been proven to reduce hot sweats as well as tackle the mood swings and mental health issues that can develop during perimenopause. These might be used as an alternative when health issues stop you from being able to go on HRT.
Although this is usually prescribed to help with seizures, low doses of the drug have been shown to help with hot flashes. It is an alternative for those who cannot use HRT.
This drug can be prescribed for treating hot flashes by regulating the body’s temperature through blocking pathways in the brain.
Other remedies include CBT therapy (cognitive behavioral therapy) to help with mental health issues and mood swings. As well as this, for those who are looking for a more natural way to treat their challenges, supplements can help you with perimenopause symptoms. Amberen is a perimenopausal relief that tackles sleep loss, menstrual irregularity, fatigue, hot sweats, and many other symptoms through a mix of B vitamins, antioxidants, amino acids, minerals, and vitamin E.
For those who experience the worst of the symptoms during this period of time, sex might feel like the last thing you want. However, that doesn’t mean all intimacy has to end. From enjoying cuddling to reinstating date night to keep the spark alive, there are ways to enjoy intimacy without sex. If you do not want your sex life to end, masturbation, non-penetrative sex, and motivating yourself to have penetrative sex regularly, can help tackle vaginal dryness and the shrinking of the vaginal muscles.
Less intercourse and a diminished sex drive are entirely normal, but for those looking to keep things alive in the bedroom, Female Health & Fertility’s tips for sex during perimenopause are: invest in a good lube, look at slowing everything down, and focus on different parts of your vulva to keep things fresh and new. You could also try new positions or invest in foreplay and tantric massages to help you relax before the main event.
Perimenopause is a natural part of your menstrual life cycle and represents the time in your life when your ovaries stop releasing eggs and you stop menstruating. Although it can feel like it is a scary and frustrating time, with the proper treatment and taking care of your health that doesn’t have to be the case.
References:
Amberen. Clinical trial. amberen.com. amberen.com/collections/clinical-research
Delamater, L., & Santoro, N. (2018). Management of the Perimenopause. Clinical obstetrics and gynecology, 61(3), 419–432. doi.org/10.1097/GRF.0000000000000389
Gold E. B. (2011). The timing of the age at which natural menopause occurs. Obstetrics and gynecology clinics of North America, 38(3), 425–440. doi.org/10.1016/j.ogc.2011.05.002
Healthline. Premenopause, Perimenopause and Menopause. healthline.com. healthline.com/health/menopause/difference-perimenopause
McCarthy, M., Raval, A.P. The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease. J Neuroinflammation 17, 317 (2020). doi.org/10.1186/s12974-020-01998-9
Mayo Clinic. Perimenopause Treatment. mayoclinic.org. mayoclinic.org/diseases-conditions/perimenopause/diagnosis-treatment/drc-20354671
Santoro N. (2016). Perimenopause: From Research to Practice. Journal of women’s health (2002), 25(4), 332–339. doi.org/10.1089/jwh.2015.5556
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