Our Live Well series, in partnership with W-Wellness, explores the pressing topics at the intersection between women, wellbeing and work.

As the world changes and becomes more sensitive and considered around the issues affecting women, the subject of menopause has become a more open discussion. But there is still a lot of work to do. One subject often left unexplored, is the perimenopause and the issues facing the women experiencing it. We’re here to change that narrative. 

We sat down with Author, and Immunologist and member of the W-Wellness expert community, Dr Jenna Macciochi on what the perimenopause truly is, the signs to look out for, and why there should never be a stigma around talking about it openly. 

So, what is the perimenopause exactly?

Meaning ‘before menopause’, it’s the transitional period, lasting up to several years, leading to the menopause. It’s usually marked by changes to our menstrual cycles, mood, and bodies. Typically, a woman experiences perimenopause in her 40’s, but it can happen earlier. 

A challenge of the perimenopause is the difficulty around defining the symptoms.

 Dr Jenna explains that “women may experience a wide variety of symptoms that wax and wane during perimenopause”.  These can be physical, including “heart palpitations, difficulty in sleeping, feeling tired or lacking in energy, headaches, dry skin, mouth, vagina and eyes, muscle and joint pains, but also emotional, including low mood, anxiety, memory problems, panic, or feeling unhappy and depressed”. But whilst this list sounds exhausting, it’s unfortunately not exhaustive. 

Do my genetics play a role? 

Our genetics play a role in almost every aspect of our health. Women whose mothers experience severe symptoms and early perimenopause are also likely to have the same experience. But whilst genetics cannot be changed, we can learn from those experiences and can plan for a different outcome. 

If perimenopause is prevalent in your family DNA, Dr Jenna recommends developing awareness around the subject. Ask family members about their experiences, make good lifestyle choices through diet, exercise, and stress management techniques and avoid smoking. Whilst these tips won’t stop perimenopause from happening, they can ease symptoms and improve our general health span too. 

 What symptoms should we be looking out for? 

Dr Jenna explains that women experience perimenopause differently. This makes it difficult to keep a track of symptoms and keep in tune with what your body is trying to tell you. Several other health complaints can also present the same or similar symptoms, including thyroid issues, depression, anxiety and Chronic Fatigue Syndrome.

This further complicates a potentially distressing or frustrating conversation with healthcare providers, with a 2019 parliamentary survey revealing that only 36.7% of women were likely to discuss perimenopausal symptoms with a GP or nurse. Dr Jenna further clarifies “perimenopause tends to be less discussed because its symptoms can be subtle… this can lead to a lack of understanding among healthcare providers”.

So, why are we not talking about it? 

Dr Jenna puts this down to societal norms, with “cultural attitudes towards ageing and women’s health” contributing to the silence. Menopause itself is often emphasised to ‘the change’, which feels like the wrong language to use too. Nothing about who we are as people is changing, and it implies some level of control. So, why do we not like to speak about it plainly either?  “Many women may feel embarrassed or reluctant to talk about their symptoms, fearing judgements or misunderstanding. Furthermore, the medical community has historically focused less on women’s health issues related to ageing”. It’s a stigma we need to break away from. Dr Jenna believes it’s a fight we will win, if we keep talking about the issue and remain firm when talking to healthcare providers. 

The lack of conversation around perimenopause also creates a vacuum in terms of role models. If no one is speaking about it online or otherwise, there is no natural expert to turn to. But that is changing. Instagram accounts devoted to the subject are gaining bigger followings, and education around the topic is improving. 

How can perimenopause affect our careers and day-to-day lives?

The perimenopause is shown to impact on productivity, concentration, energy levels, and emotional wellbeing. 

Dr Jenna explains it is up to our workplaces to provide relief for women experiencing symptoms and to create an open, supportive environment, “workplaces can support women by providing flexibility and options to work from home to help manage symptoms”. Workplaces will also foster this more inclusive space recognising the needs of women going through perimenopause with open conversations, providing resources, healthcare, and education around the subject. 

How should perimenopause be managed? 

Dr Jenna agrees, those suffering with severe symptoms may find Hormone Replacement Therapy (HRT) most beneficial, “these treatments replenish declining hormone levels and can have an impact on symptoms. There are many different approaches with HRT, and the right approach should be decided with your healthcare provider”. 

 Whilst some women do find relief with natural remedies- you’ve probably heard of taking Evening Primrose Oil to manage symptoms- Dr Jenna points out that the scientific evidence base for them is smaller, again recommending discussing remedies with a healthcare professional before relying on them. She explains that some women do find relief from hot flashes and night sweats using black Cohosh, whilst research on red clover, sea buckthorn, and evening primrose oil is promising. 

Unfortunately, it is not a one-size-fits-all solution, and medicating symptoms should be decided with a nurse or GP for a more “personalised approach”. This is something that W-Wellness are able to support you through, book a demo to talk through which supplements could help you feel your best. 

What are Dr Jenna’s top tips on managing perimenopause? 

- Seek Support: You’re not alone in the struggle. Talk to friends, family, your healthcare provider or other professionals to get the help and advice you deserve.

- Stay Informed: Educate yourself to understand what is happening to your body and how to manage it. But be careful of ‘meno-washing’, don’t be sold on products just because they mention aesthetic-based relief. They’re often not grounded in genuine research.

- Practice Self-Care: Engage in activities that promote holistic wellbeing e.g., healthy diet, exercise, lifestyle.  Irrespective of menopause these become much more important as we age.

- Try supplements for comprehensive support: DrJenna’s Perimenopause Edit has been designed to address the diverse needs of the body and mind during the transformative period of perimenopause.

See and hear Dr. Jenna speak on the Penthouse stage, powered by W-Wellness at Live Well Festival 2024.