Perimenopause and Premature Ovarian Insufficiency (POI)

Perimenopause or premenopause are relatively new terms that have been used within the last twenty years for women moving closer to menopause.

These stages can be very confusing for women, especially those under the age of 45. Some women may still be having periods, although these may be lighter or less regular as the hormones begin to reduce. Symptoms can be broad ranging, depending on the individual, and can often be confused with other conditions. For this reason, it is important to seek medical advice to receive a diagnosis.

During your perimenopause, the levels of the hormones oestrogen and progesterone fluctuate significantly. It is the imbalance of these hormones that causes many of the symptoms. Symptoms are very similar to those of the menopause and include irregular and/or heavy bleeding, insomnia, night sweats and/or hot flashes, worsening PMS, migraine, vaginal dryness and abdominal weight gain. These physical symptoms are often accompanied by emotional issues such as anxiety, depression, irritability, mood swings, palpitations or even chest pains.

Women whose ovaries stop functioning fully before the age of 40 may have a condition called Premature Ovarian Insufficiency (POI). With POI, hormone imbalance can fluctuate drastically and cause ovaries to stop working normally. In many cases, the ovaries do not completely fail, and in this way it differs from menopause. In POI, the ovaries often work differently at different times, depending on the levels of hormones in the system at that time. There can be occasional menstrual periods, and even ovulation or pregnancy. This can even happen several years after the initial diagnosis at times when the hormone levels in the ovaries temporarily increase, allowing conception, and is a possibility for 5-10% of women with POI who have been previously unable to conceive.

The blood test FSH (Follicle Stimulating Hormone) can be used to measure hormone levels and determine whether POI is present, although other blood tests may be needed as well. These are the same tests that are used to diagnose the menopause

When POI is diagnosed, treatment in the form of hormones is usually prescribed to counter the risk of conditions such as osteoporosis and heart attack. Hormone treatment is required to replace any missing hormones between diagnosis of POI and the time when the woman reaches the age when her menopause is normal. None of the risks normally associated with Hormone Replacement Therapy should be an issue for women under the age of natural menopause.

Symptoms can be eased by healthy lifestyle choices, and natural supplements produced to treat menopause symptoms will help too. It is advisable to speak to a wellbeing specialist or pharmacist for recommendations to find out which supplements are suitable for you.