Here’s your guide to navigating perimenopause and menopause

Loretta Dignam founded The Menopause Hub in the hopes that it would dispel myths and bring clarity to a topic shrouded in confusion. Her mission is to empower Irish women to understand and manage their menopause journey on their own terms – whether at home, at work, or in any aspect of life.

We spoke with the founder on how to distinguish between perimenopause and menopause, identify common symptoms, and effectively manage and navigate this transformative stage of life.

What is perimenopause and how is it different from menopause? 

Menopause comes from the Greek words – ‘mens’ for month and ‘pausis’ for cessation. So it’s cessation of monthly periods. However, the term menopause itself can be confusing and is often used as a catch-all word for the various phases and stages of menopause. Officially menopause is confirmed retrospectively after a woman has had 12 consecutive months of no periods. Therefore, menopause refers to the ‘anniversary’ of when your periods stopped first. The typical age for this is 51. Once a woman has had no periods for 12 consecutive months, she becomes postmenopausal and remains postmenopausal for the rest of her life.

The phase before that is referred to as perimenopause, and the typical age is 45 years. This can be a rollercoaster stage, where women’s hormones are declining, but are also erratic. Periods may remain regular or become irregular and symptoms associated with those hormonal shifts can be difficult to recognise

Is there a typical age or age range at which it starts? How does this differ for various women? 

Every woman is different, and so too is her menopause. The average age of menopause is 51 and perimenopause is 45, but these are averages and women can experience menopause earlier or later than this. However, 80% of women will experience menopause symptoms and there are over 40 symptoms. I had 26 symptoms and because my symptoms were mostly physical and genitourinary, I would describe my menopause as moderate. However, 25% of women would describe their menopause as ‘severe’ or debilitating.

What are some common symptoms of perimenopause? What about not-so-common ones? 

The symptoms we hear about most are ‘hot flushes’ or ‘flashes’, but they are not always present. Insomnia, anxiety and mood issues, weight gain and skin changes are also common. Women report relationship issues – 61% said that menopause negatively impacted their relationship with their significant other (partner, wife, husband) and 74% said that their sex life was negatively impacted by menopause/perimenopause. Other symptoms include Urinary Tract Infections (UTIs) and urge and stress incontinence. Then less common symptoms include burning mouth/tongue, frozen shoulder, development of asthma, sinusitis, IBS, digestive problems, and allergies.

Any widely believed misconceptions about perimenopause you’d like to dispel? 

Yes, that Hormone Replacement Therapy (HRT) or Menopause Hormone Therapy (MHT) as it is better referred to, is not suitable for women who are peri/menopausal. We have heard from many patients that they have been told by their doctor that they are not suitable for HRT/MHT as long as they are still having periods. This is not the case. 

When will free HRT become available in Ireland?

Free HRT will be introduced in January 2025. This is fantastic news. Women bear a disproportionate economic burden associated with their hormonal health. I typically spend €70 per month on my HRT prescriptions. This is from my disposable income. Not everyone can afford that. Menopause can’t just be a middle-class condition. 

What are a few ways we can help manage these symptoms? Any lifestyle changes that can help? 

Absolutely. At the Menopause Hub, we believe that diet and lifestyle are the cornerstone of treating peri/menopause. Women need to approach this phase of their lives with their weight under control, with an active lifestyle that includes moderate weight-bearing exercise for bone strength, a more Mediterranean diet, more protein, a reduction in alcohol and quitting smoking. In addition, it is important to take supplements with vitamin D3 and K2 for bone health. 

Are there any supplements or prescriptions that you’ve seen work first-hand for your patients?

We are evidence-based and our values at the Menopause Hub are ‘Education, Empathy and Empowerment’. We want women to have the best evidence-based information possible so that they can decide how best to manage their menopause. 

After listening to patient feedback and doing our research among the team, women tell us Sisterly – The Elevator works to improve their energy levels among other things. We also hear good things about Fabu supplements, particularly the Shrooms. In addition, we also believe that women should focus on vaginal health in peri and postmenopause. The decline in estrogen results in vaginal dryness for many women, with lots of associated symptoms, and it continues to get worse as we age. Therefore vaginal moisturisers are recommended as well as local oestrogen pessaries, gels or creams. 

Delivering expert advice in a friendly and professional way, Meaghers Pharmacy have redefined the role of the pharmacist in the communities they serve and offer accessible and affordable healthcare solutions to patients in need of expert advice.

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