WHAT SYMPTOMS AM I EXPERIENCING AND WHY?

​After the shocking list of 34 symptoms of perimenopause in my blog yesterday (check them out of if you haven’t already done so!), I wanted to focus on the more common symptoms that you may be experiencing, and give you some understanding and knowledge of why they are happening.  I am a big believer that if you understand why it is happening, you can deal with it in a more positive way and it has a lesser impact on your day to day life.
 
We cannot escape perimenopause, it is a natural part of a woman’s ageing process, marking the end of her reproductive years.  But it can also be seen as a time of liberation.  However, some of us do not have as smooth a ride as others, and that’s ok because you will get through.  I hope I can support you through this chapter of your life.
 
I am going to focus on the top 5 symptoms, and the amazing thing is that 3 of them relate to the brain!  If I asked anyone what they thought was the first symptoms that a woman experiences at the start of perimenopause, I think most people would say hot flushes/night sweats.  But did you know that it is usually the cognitive symptoms that we experience first?
 
The cognitive changes are frequently referred to as “brain fog”.  Have you ever walked into a room and forgotten what you went in for?  Me too!  You may feel like your brain is full of cottonwool, forget names, trouble finding the right word, difficulty retaining information, multi-tasking, lose your keys etc.  These are probably all things you could do with your eyes closed and at the same time, until those pesky hormones started to change!  You may feel like you are going mad at times, and are now resorting to write endless lists, and a list of all the lists you’ve written. 
 
Well, let me reassure you, you are not losing your marbles, just your oestrogen levels! We have oestrogen receptors in the brain which help support the growth of new nerve cells to form new connections and keep good quality messages reaching the brain.  As these oestrogen levels fall during perimenopause the brain uses up more levels of glucose and the cells do not renew as quickly and efficiently, causing the brain to slow down slightly. 
 
We also produce low levels of testosterone which also strengthen the nerves in the brain which are responsible for clarity of thought.  Testosterone also strengthens the arteries supplying oxygenated blood to the brain, important for memory.  So as testosterone levels start to fall during perimenopause, so does the clarity of thought. The good news though is that this is fuzzy brain sensation is temporary, until the brain adapts to the lower levels of oestrogen and testosterone.
 
Other symptoms of falling oestrogen levels in the brain include anxiety and depression.  Oestrogen helps regulate several other hormones that affect mood, including serotonin and dopamine (happy hormones) and norepinephrine (stress hormone). The lowering of oestrogen levels reduce production of serotonin and endorphins, but increase levels of adrenaline and cortisol which lead to feelings of irritability and anxiety, low mood and stress. These can also affect sleep patterns which, in turn, affect the ability to cope with every day stresses.  It is very common for GPs to prescribe antidepressants during the perimenopause because women report these symptoms of low mood and anxiety, when the root cause is the altering levels of oestrogen and testosterone.
 
The changes in hormones can also have a dramatic effect on libido.  Libido is actually quite complex in women because it is not just based on hormonal levels. Other symptoms during perimenopause can have an effect, such as insomnia, lethargy, fatigue, weight gain, depression, anxiety, vaginal dryness etc.  During perimenopause the lowering of oestrogen and testosterone levels can affect levels of arousal, and with other physical changes making sex uncomfortable, it may be one of the last things on your mind. There are things you can do, which will be dealt with in a later blog.
 
Oestrogen is important for keeping skin cells plump and moisturised.  This includes the skin in the vulval area.  The female bladder, vagina and urethra are rich in oestrogen receptors.With the decline in oestrogen, the skin in the vagina and vulva become thinner and drier, due to reduced blood flow to the tissues.  This can lead to painful intercourse, incontinence problems, bleeding during or after sex, itching, and infection.  This can be very uncomfortable and affect self-esteem.  Again, there are treatments available, so don’t lose hope!
 
Finally, those pesky hot flushes/night sweats! Hot flushes are the most common symptom of perimenopause and are a form of vasomotor symptoms.  A hot flush (or flash) is a sudden feeling of heat, often in the face, head or neck, and may include a flushed face and sweating.  They occur when blood vessels, near the surface of the skin, dilate in order to cool down. Whilst the exact cause is unknown apart from the possible effect in the brain of declining oestrogen levels on the temperature and hormone control centre in the brain, there are triggers known to increase the incident of flushing.  These include:  stress, caffeine, alcohol, spicy foods, tight clothing, heat and smoking.
 
I hope that this gives you some insight into the symptoms you are experiencing.  They are a normal effect of declining hormones which we have no control over, but there are treatments available, which I will be looking at in my next blog.  There are clinical and natural/complementary therapies available. 
 

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