I enjoyed and appreciated the frank, candid and sometimes sweary expression of the author (although this may not be to everyone’s taste). I also appreciated the forthright manner in which she makes recommendations about lifestyle choices as you navigate peri menopause and menopause (although other readers may find her preachy). The blood test often used measures the levels of follicle stimulating hormone (FSH). It is advisable to do 2 tests at least 4-6 weeks apart. This test is unreliable if a woman is using combined hormonal contraception at that time. If the level is over 30 IU/L, it is in the menopausal range. I thought perimenopause was just the run-up to the menopause and not a treacherous passage in itself. I had no idea it would make me so furious – or give me surprise periods like tsunamis. In the kitchen at various times during my deranged perimenopausal mood swings I threw: 1) a butternut squash, 2) Nigella Christmas, 3) broccoli, 4) a full butter dish, and 5) blue poster paint at the wall. No one was injured. Indeed, the missiles actually released family tension – and at least the dog began to treat me with more respect. I had no idea that progesterone and oestrogen drained erratically but inexorably away over the course of years in perimenopause, and that symptoms could be mental as well as physical. I started my periods when I was 10, and so while I'm only in my mid 30s now, I really wouldn't be surprised if I started perimenopause early too - based on what I've learned about perimenopause recently (and what I've unlearned because what I thought I knew isn't true) I may already be experiencing it. The book is full of useful information, and while the thought of menopause might fill you with dread, knowledge really is power.

Perimenopause Power by Maisie Hill | Waterstones

Perimenopause may last months or years; it may be more or less drastic; but one day it will be over. On the other side, we’ll be different – perhaps more focused on what’s most important to us and almost certainly calmer. Psychotherapist Amy Jordan Jones told me: “This is the time of life when we learn we don’t have to be pleasing; the work now is just to become more ourselves.” Three-quarters of women reaching menopause experience symptoms such as mood changes, insomnia, hot flushes, and night sweats, but there is little in the way of evidence-based information out there to help them presented in a way that's engaging and helpful.

Changing hormones

Maisie Hill, the highly qualified women's health expert, best-selling author of Period Power and founder of The Flow Collective , takes us through the physiological changes of perimenopause and menopause, step by step, with calm positivity. In this invaluable guide she shares tips and advice to support women through the challenge of wildly fluctuating hormones. Treating hot flushes can help alleviate some of the sleep disturbances. Having a slightly cooler room to sleep in often helps. Turn the radiator setting lower, or let in some cooler air through the window before bedtime. Otherwise following good sleep hygiene advice is sensible. Use a lubricant Mood swings, irritability or increased risk of depression may happen during perimenopause. Sleep changes Women need to recognise that it’s a time of vulnerability, and there are some things that they can do to help.”

perimenopause: ‘I was overwhelmed and full of rage Surviving perimenopause: ‘I was overwhelmed and full of rage

Mom,” I said. “Did you just call the Bounty paper-towel company to complain about these teddy bears?” Symptoms of the perimenopause can also be caused by some medical procedures that will affect how the ovaries work. These include some medications (such as tamoxifen, which is used for breast cancer), chemotherapy or radiotherapy to the pelvic area, also to treat cancer. And of course, having your ovaries removed surgically, possibly as part of a hysterectomy operation, will also cause these symptoms. What are the symptoms and signs of the perimenopause?

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Perimenopause on the other hand is the timeframe before you go through menopause when you still experience a cycle but you start to notice a difference with your cycle in terms of length and experience, perhaps your cycle shortens by a few days and your period changes in volume, things like that. New symptoms might emerge or existing symptoms might worsen. And perhaps this might be happening just around the time that you start your period to begin with. Staying active and eating healthy foods are beneficial for every phase of perimenopause. Aim for 30-60 minutes each day - five days a week - of both aerobic and strength training exercise. This will also help reduce the raised risk of osteoporosis that comes with the menopause. Eat healthy foods Dr Pinkerton gave me an example: “A woman came into my office and said, ‘I hate my husband. I hate my marriage. I need to get out of this.’ The husband had called me earlier and said, ‘I’ve noticed that my wife is really having exaggerated responses to things around the time of her periods.’ There was a hitch in this: WHI had been looking at what the hormones did in women aged 50 to 79. The aim was to figure out if this type of hormone treatment could help protect these women from heart disease and other illnesses. It was not about short-term hormone therapy for treatment of symptoms in women in their 40s and 50s. But many midlife women heard only “cancer” and went off HRT immediately.

Perimenopause is a window of opportunity for Maisie Hill: ‘Perimenopause is a window of opportunity for

The average age of the menopause is 51 years. However, perimenopause or menopausal transition occurs in the years before periods stop so is usually from the 40s into the early 50s.One answer is: denial. We have had incentives for a long time to pretend we are the same as men in every way. For decades, women have had to argue that they could still work and function through those messy period, pregnancy and menopause-related symptoms, and as a result we’ve minimised them, both to others and to ourselves. So as not to call attention to ourselves as women, we pretend it’s not happening. Boomer women arguably started this, entering the work world in shoulder-pad armour. It makes sense that they felt they had to hide the inconvenient fact of their womanhood, particularly in middle age. So this woman read the guidelines and when her GP suggested more blood tests she was able to say, “Look, I think I meet the criteria, this is what the NICE guidelines say.” And because of that she was just referred to a menopause clinic. And I will link to the NICE guidelines in the show notes so that you can read them too and perhaps take them into your appointments if you’re having any discussions with GPs or other healthcare professionals. stating a naturopath is the best person to help you reverse insulin resistance in the context of PCOS It also helps simply to understand what’s happening, which is why those delineated phases of perimenopause can be a light-bulb moment. ‘I think it’s helpful when we can name something, and say, “Maybe you’re in this phase, these are the common things that can happen, and this is what’s going on.”’ Why are young girls and women still shamed about periods? Why are older women shamed about menopause? And why is a uterectomy still referred to as a hysterectomy? It's about time all of this stigma was broken down, and society changed. After all, anything you can do, we can do bleeding.

Maisie Hill

A year or so ago, I began to think I was possibly losing my mind. I was feeling anxious, tired, and finding that I was forgetting even the simplest of things - people's names, things I'd promised to do at work, something somebody had literally just told me. I started googling early onset dementia, but it was when I was chatting with another friend about the menopause that she mentioned early symptoms like brain fog and forgetfulness and suddenly all the clues started to point in that direction. Women also benefit exponentially from sleeping more, Dr Pinkerton added. “It’s often the first thing to go, but it’s absolutely one of the things that can help you navigate this time. Then, stress reduction.” It is important that you keep up to date with the national cervical screening programme (smear tests) and breast cancer screening (mammogram) programme, if appropriate. How do I manage perimenopausal symptoms? Low levels of oestrogen can lead to many joints feeling stiff and aching. Vaginal dryness and changes in sexual functionI know the newspapers tend to say that HRT increases your risk of cancer and they’re often very dramatic in that reporting. But the research studies that they’re referring to were flawed, the actual studies were flawed. And the data that they collected was then analysed incorrectly, and I would say reported irresponsibly. They also used forms of HRT that tend not to be used these days. You can read all about this in the book. Hill says that while some may be able to get through the menopause without hormone replacement therapy, it’s important to take the perimenopause as a window of opportunity. “Scientific literature refers to it as a time we can have lasting influence over our future, and HRT not only helps to manage symptoms in the here and now, but it can also help fend off everything from osteoporosis and cardiovascular disease to neurodegenerative diseases like Alzheimer’s and Parkinson’s,” she says. Nowadays, body identical hormones are used, and they’re identical to the hormones we naturally produce – a fun fact is that they’re also made from yams. Whether you take it in a pill or as a topically-applied gel, Hill is emphatic that HRT can make a huge difference to quality of life, both at the time of use and in the future. It isn’t all doom and gloom!