What is Perimenopause?
Perimenopause means “around menopause” and refers to the period during which your body makes the natural transition towards menopause.
Women will start perimenopause at different ages, and signs such as irregular periods can start sometime in your 40s. However, some women might notice that these changes can start in their mid-30s.
Symptoms include:
- Irregular periods
- Difficulty with sleep
- Hot flashes
- Vaginal and bladder issues
- Decreased fertility
- Changes in libido
- Mood changes
The transition is largely due to changes in estrogen in your body and the uneven rise and fall of estrogen. When a woman has gone through 12 consecutive months without a menstrual period, it is considered that perimenopause is over and she has reached menopause.
TCM and Perimenopause
TCM recognises women as going through 7 cycles in their life, each lasting 7 years. The table below is an extract focusing on cycles 5-7. Whilst perimenopause might seem trending in the Western world at the moment and was largely ignored in Western medicine until more recently, the concept has been recognised within TCM for a long time. One of the focuses in the 5th and 6th cycle is the preparation of menopause. However, the preparation actually starts even before the 5th cycle because we believe that how a woman is nourished and cared for in her postpartum period, sets her up for her menopausal years.
*Adapted from 7 Times A Woman
Postnatal Depletion and Perimenopause
A recent international study found nine out of ten women had marginal or low levels of folate, riboflavin, vitamins B12 and D around the time of conception. Many developed vitamin B6 deficiency in late pregnancy. Our bodies continue to face depletion if nutrition is not adequately met. We then go on to raise young children and may even have more babies which then reach further into our nutritional stores.
It is not surprising that when we reach the age of perimenopause (which can start in the late 30s), we are experiencing symptoms and suddenly feel significant hormonal fluctuations like during postpartum. Many women I have personally spoken to, have mentioned that they feel emotions come up in their perimenopause years that reflected emotions that were unattended to during their postpartum.
Advance Age Pregnancy and Perimenopause
With women having more opportunities to further their education, focus on their careers better than ever before, many women are delaying when they have children There are options for this ranging from assisted fertility treatments to egg freezing.
Some stats:
The average age of mothers has been rising over time, from 30.0 in 2011 to 31.1 in 2021. Average maternal age has risen for both first-time mothers (from 28.4 years in 2011 to 29.7 in 2021) and those who have given birth previously (from 31.3 years in 2011 to 32.2 in 2021). The highest proportion of mothers were aged between 30 and 34 (more than one-third (38%) of all mothers).
These transitions therefore are beyond just the physical - the emotional and spiritual aspects of evolving as a woman need to be tended to as well.
In a report released in 2021 focused on older mothers in Australia, findings showed:
1 in 4 women giving birth in 2019 were aged 35 or over
2 in 7 mothers aged 35 or over were giving birth for the first time
What these statistics suggest is that an increasing number of women are birthing and in the depths of motherhood when they are in the window of perimenopause. So if you think postpartum hormones are intense, couple that with the hormonal changes of perimenopause, and you have a concoction that takes a woman on a wild ride.
Menopause and it's Impact on Livelihood
When women experience severe symptoms during menopause, it can negatively impact their quality of life.
Menopause is a transition that should be embraced, not avoided. Whilst fertility and menstruation will cease, vitality need not cease. The years from postpartum onwards should be used to further understand your own body, its needs and prepare for upcoming transitions.
Honoring the Transitions
Depending where you are in your 7 year cycles, it is important that transitions are honored. Whether it is menarche, pregnancy, postpartum, perimenopause - honour these transitions. The pillars that I created as part of Elan’s pillars of postpartum care I realise can be extended across all transitions, just tweaked slightly for nuances. Here is a brief highlight of how this might be done:
Celebrate the transition you are embarking on.
Instead of approaching it with fear, celebrate the
privilege of ageing and becoming wiser, more
confident and empowered as a woman.
Recognise what your body needs.
Maintain good sleep hygiene.
Nourish your bodies with nutrient dense foods.
Consume well balanced meals incorporating proteins and healthy fats.
Work on improving blood sugar levels.
Seek the support of professionals should you need.
Get your bloods tested.
Lean in on your village to support you and your family when you need.
Understand what changes might happen with your body.
Seek female figures who are willing to share their journeys so you can learn more about what to expect.
As we primarily focus on the postpartum period, we want to remind our community that postpartum is a season, in which we wish to continue to support mothers during pregnancy, postpartum and beyond. Watch this space as we delve deeper into seven cycles of a woman.
See Instagram post here.
