Being a woman is tough! We all know about adolescence – girls get their periods, acne and fight with their parents. We all know about the reproductive years – women get pregnant, have children and breast feed. However, we are not as well informed about the next stage – perimenopause and menopause and we’ve therefore had a chat to Dr. Jennifer Kasirsky, MD, FACOG – Head of Obstetrics & Gynaecology at Mediclinic Parkview Hospital to get some factual information for the British Mums community.

The definition of menopause is no period for one year. The average age worldwide is 51 years old and perimenopause are the years leading up to this change. It can take 10 or more years to get to menopause so the perimenopause can last from about aged 40 to 51!

What to expect in the perimenopause?

  1. Irregular periods. Your ovaries are not as responsive to the hormones that come from your brain to signal ovulation. There are wide fluctuations day to day, hour to hour, minute to minute. This results in an irregular period. What you might experience, instead of the normal 28–35-day cycle is that your periods get closer together, every 21 days. Then you might skip a period. So, 21 days becomes 42 then 63 then 6 months might go by and you don’t get a period. But do remember, you can still get pregnant!
  2. Premenstrual syndrome (PMS). It’s not just adolescents who get moody and have emotional lability, so do women in the perimenopause. Feelings of anger, anxiety, sadness, as well as the physical symptoms of PMS: bloating, breast tenderness and food cravings.
  3. Hot flashes. Feelings of intense heat that can result in sweating, and whilst this is more common at night, it can happen in the middle of the day as well.
  4. Vaginal dryness. You might not get as lubricated as you need to be during sex, and you might experience a vaginal burning either during sex or afterwards.

What to do?

Talk to your doctor! These are what I call “quality of life” issues not “quantity of life” issues. They aren’t going to kill you, but they can make you quite uncomfortable or even miserable. And there is a solution for each one of them.

  1. Irregular periods. They do not need to be treated unless they are coming more frequent than every 21 days. If they are very annoying speak to you doctor about regulating them with the birth control pill, progesterone in the form of a pill or the Mirena IUD.
  2. PMS. The birth control pill can help with this as can antidepressants taken when you have the symptoms. Natural remedies can also be evening primrose oil, St. john’s wort, vitex.
  3. Hot flashes. Again, birth control pills can help or natural remedies like black cohash, yam or soy.
  4. Vaginal dryness. Lubrication with a water-based lube or even coconut oil can help or again, hormones like vaginal estrogen cream.

So how does the menopause differ?

Well, the good news is that you won’t have a period, so no irregular bleeding. And you can’t get pregnant. But the hot flashes tend to be worse and more consistent. You will also need to start thinking about bone health as women lose a significant amount of bone in the first 5 years of menopause. You also need to think about cardiovascular disease as you will no longer have the heart protective benefits of estrogen.

My best advice is to find a doctor who has knowledge about this stage of life and discuss strategies for making this the best stage of your life! The saying goes life begins at 40, everything before then is just practice!

Thank you to Dr. Jennifer Kasirsky and the entire team at Mediclinic Parkview Hospital for pulling together important information on this part of the women’s journey. For more information or to make an appointment, simply call 800 1999 or visit


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