What is perimenopause and what are the symptoms?

17 Feb 2023
Perimenopause

The family of Nicola Bulley have said the missing mother-of-two suffered from symptoms of perimenopause including brain fog and restless sleep.

It comes after Lancashire Police revealed yesterday that Ms Bulley, 45, suffered from "significant issues with alcohol" in the past brought on by "ongoing struggles" with the menopause.

But what are the symptoms of perimenopause and how do they affect women?

Perimenopause and menopausal symptoms

Menopause is when your periods stop due to lower hormone levels, while perimenopause is when you have symptoms before your periods have stopped, according to the NHS.

Menopause usually happens between the ages of 45 and 55.

Perimenopause can last for up to 10 years before your periods stop altogether and it most commonly occurs in women in their 40s.

The NHS says menopause and perimenopause symptoms can have a big impact on a person's life, including their relationships and work.

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How the symptoms can affect women

Symptoms can be severe and debilitating

Common symptoms of perimenopause and menopause include: anxiety, mood swings, brain fog, hot flashes, difficulty sleeping and headaches and migraines, among others.

Whilst not all women will experience menopausal symptoms, up to 80-90% will have some symptoms, with 25% describing them as severe and debilitating, according to the British Menopause Society.

Last year, NHS England said there were around an estimated 13 million people who were currently peri or menopausal in the UK, according to Wellbeing of Women, which is equivalent to a third of the entire UK female population.

On Thursday, Ms Bulley's family said in a statement that she suffered from "significant side effects" of the perimenopause including brain fog and restless sleep.

She has been missing since 27 January after vanishing when she took her dog for a walk by the River Wyre in Lancashire.

What is HRT?

Ms Bulley's family also said she stopped taking hormone replacement therapy (HRT), which is commonly used to treat menopausal symptoms.

In their statement, they said the mother-of-two was taking HRT but this "was giving her intense headaches" which caused her to stop taking them "thinking that may have helped her but only ended up causing this crisis".

HRT is a method of managing symptoms of perimenopause and menopause and is taken by millions of women worldwide, however, it does not work well for everybody. It involves taking oestrogen to elevate the body's levels of the hormone and is often combined with progesterone.

There are different types and doses of HRT, including tablets, sprays, implants and patches.

Impact of menopausal symptoms

According to the NHS, the risks of HRT are small and usually outweighed by the benefits but HRT may worsen headaches in some people and GPs may suggest an oestrogen skin patch is used.

Symptoms of menopause can be so debilitating that a survey published last year found that one in 10 women have quit their job because of it.

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The survey, of more than 4,000 UK women aged 45 to 55, who are currently or have previously experienced perimenopause or menopause, also found that 14% of women had reduced their hours at work, 14% had gone part-time, and 8% had not applied for promotion.

Calls for greater menopause support

Campaigners and celebrities have called for better support for women experiencing symptoms including recognising menopause under the Equality Act as a protected characteristic.

They are a specific set of characteristics which it is illegal to discriminate against including age and race among others.

Last year, the Women and Equalities Committee warned in a report that the impact of menopause was causing the UK economy to "haemorrhage talent".

However, in January, ministers rejected a recommendation to make menopause a protected characteristic and also rejected calls for a trial of menopause leave for women, claiming it could cause discrimination against men with long-term medical conditions.

Diane Danzebrink, psychotherapist and menopause expert, said there is still a "lack of education" around menopause, as she urges the government to take action.

She told Sky News: "Menopause is an individual experience and is simply not the same for everybody.

"There is still such a lack of public information and education about all aspects of menopause. I would very much like to see the government back a public health campaign for menopause to bring education and information to everybody."

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