Perimenopause symptoms change from mental to physical as women get older, new study finds

The conversation around perimenopause (and menopause) in recent years has grown for the better, with more awareness of the symptoms and treatment options available. Yet, as a new study by Flo shows us, there's so much more to learn.

While many of us are aware of the most common menopause symptoms, a new study has found they're unlikely to all happen at the same time - and some may even begin much earlier than we expect.

The women’s health app Flo has found that there can even be a 5 to 10-year gap between the onset of psychological and physical symptoms of perimenopause. As the physical symptoms of menopause are more well-known and many women don't expect to go through menopause until their late 40s, some women may be entering this stage unknowingly, which can have a serious impact on mental and physical health.

Data from over 4,400 women aged 30 and above in the US showed that the symptoms associated with mental health or mood such as anxiety, irritability, and depression were highest in women aged 41 to 45 and lowest in those aged 56 or older.

The study, which is due to be published in the npj Women’s Health journal, found that physical symptoms of perimenopause such as hot flushes, sleep issues, excessive sweating, vaginal dryness, and low libido were more common in the cohort of 51 to 55-year-old women, compared to the younger group.

Perimenopause affects women at different ages but many begin to experience symptoms, such as irregular periods or mood swings, in their early 40s. However, as symptoms may coincide with other stressful events in life - such as parenting or work commitments - and many women don't expect to enter perimenopause until their late 40s, they may not realise it's happening.

This lack of awareness around how early perimenopause symptoms can begin, Flo suggests, is because education and research still have a long way to go. The app highlights a report from Harvard Medical School which found that fewer than 1% of published medical studies on the biology of ageing focus on menopause - yet it has a huge impact on women’s mental and physical wellbeing.

According to the NHS, in the UK the average age for menopause, which is reached when you’ve not had a period for 12 months, is 51.

The study’s co-author Dr Jennifer Payne says the findings showing the differences in menopause symptoms across age groups, have never been demonstrated before. “Knowing this type of progression of perimenopause-associated symptoms can help both women and their doctors know what to expect as women enter the perimenopausal portion of their lives,” she adds.

Suffering in silence

Flo also found that because women don’t expect to go through perimenopause until they’re 50 or older, or aren’t aware of how early symptoms can begin, they’re not seeking medical support. The data showed that 64.3% of women aged 36 to 40 experienced moderate or severe perimenopause symptoms, but only 8% of this age group went to see a doctor.

Many women may still be using contraception in perimenopause as well, which can mask the symptoms because they override the body’s natural hormonal changes. But of course, it can also be because GPs aren’t considering perimenopause as a possible cause of adverse symptoms in younger women.

Flo believes this has led to many women suffering in silence. “Physical and emotional symptoms associated with perimenopause are understudied and often dismissed by physicians. This research is important in order to more fully understand how common these symptoms are, their impact on women and to raise awareness amongst physicians as well as the general public,” says Dr Payne.