Understanding perimenopause: A crucial transition in women’s lives

By Hermoine Macura-Noble
Special to The Times Kuwait

For many women, the word ‘menopause’ signals the end of their reproductive years, but few are as familiar with the transition that precedes it: peri-menopause. This natural phase, which typically begins in a woman’s 40’s but can start earlier, is a significant stage of life that deserves greater understanding and attention.

Tv Anchor and Author of ‘How to Menopause’, Tamsen Fadal explains you are technically in menopause when you’ve gone one full year without a period. The years leading up to menopause – when women start to experience symptoms, is called perimenopause.

“Perimenopause can last 10+ years and typically begins in your 40s…There are actually over 34 symptoms of menopause and perimenopause that are rarely talked about,” shares Fadal.

Experts say this phase can last anywhere from a few months to over a decade, with an average duration of about four years. During this time, hormonal fluctuations—particularly in estrogen and progesterone—can lead to a wide range of physical, emotional, and mental changes. Women’s bodies are affected by menopause thanks to the hormonal changes in estrogen, progesterone, and testosterone. Certain medications or surgeries can also kick-start the process.

Every woman experiences menopause differently. Some women may not experience any noticeable symptoms, while others may feel like they are experiencing every listed symptom by the doctors. The symptoms of perimenopause can vary widely in intensity and frequency. Some of the most common signs include: Irregular periods, hot flushes and night sweats, mood swings, sleep disturbances, changes in libido, vaginal dryness and cognitive changes such as ‘brain fog’ or memory lapses.

“Other symptoms include loss of breast fullness, Osteoporosis, urinary incontinence and weight gain, particularly around the abdomen,” adds Fadel. While perimenopause is a natural process, its symptoms can be challenging. Fortunately, experts say there are numerous ways to manage them effectively.

Dr Maria Karakoulaki, a leading functional Gynaecologist in the GCC & Menopause Expert at Gyneco Middle East explans further, “I wish there was a magic pill that could help with all these issues and be safe at the same time, but there is not. And this is because Peri-menopause and Menopause are very complex periods of our lives. This is the time that a woman has to consider seriously changing her lifestyle, if she has not done it so far…When you manage this season of your life, you need to supplement the missing hormones but you also have to optimize the woman’s health. The best and safest hormones are the Body or Bioidentical ones. They are both hormones with exactly the same chemical structure as the hormones that your body used to produce and there are many benefits using them rather than the synthetic ones. The treatment with the Body or Bioidentical hormones is individualized as opposed to the synthetic Hormone Replacement Therapy, which is one pill, the same for all.”

Dr Maria Karakoulaki adds that diet, exercise, sleeping well, destressing, supplementation with vitamins, minerals, antioxidants, are also equally important. This is also where lifestyle medicine comes in with vitamin injections, IV drips, personalized supplements and behavioral tools that take care of your body in a holistic way.

While perimenopause is a normal part of life for all women, some symptoms may indicate underlying health issues which is why it’s improtant to always consult with your Doctor. Women experiencing excessively heavy periods, severe mood changes, or symptoms that disrupt daily life should also seek medical advice. Early intervention can make a significant difference in managing the problem or the challenges of this transition.

Despite its prevalence, perimenopause remains an under-discussed topic, often shrouded in stigma or dismissed as “just part of aging.” Increasing awareness and education about this stage of life can empower women to seek help, make informed decisions, and embrace the changes with confidence. By understanding and addressing the realities of perimenopause, women can navigate this journey with strength and resilience.

“Please don’t give up looking for solutions. There is nothing like, ‘you have to live with it’…In the majority of the cases I see, there is always something you can do about it, you just have to address your concerns to the right people and ask to be heard,” concludes Dr Karakoulaki.

By Hermoine Macura-Noble
The first Australian English speaking News Anchor in the Middle East. She is also the Author of Faces of the Middle East and Founder of US-based 501c3 charity – The House of Rest which helps to ease the suffering of victims of war. For more from our Contributing Editor, you can follow her on Instagram, here.