Women's symptoms 'overlooked' in menopausal stages

Perimenopause is a transitional period before menopause, where levels of oestrogen begin to decrease, bringing with it a range of symptoms.

A first of its kind study of more than 5500 women by Monash University published in The Lancet Diabetes and Endocrinology examined the similarities and differences in symptoms across the stages of menopause.

Almost 40 per cent of perimenopausal women in the study experienced debilitating vasomotor symptoms (VMS) such as hot flushes and night sweats.

While it was already known that VMS symptoms were typical in menopause, the study showed a new onset was highly specific to perimenopause, senior author Susan Davis said. 

Other symptoms such as poor memory and low mood were found at various stages, but vaginal dryness was the most distinctive symptom from pre-menopause to perimenopause, she said.

Other symptoms such as poor memory and low mood were found at various stages, but vaginal dryness was the most distinctive symptom from pre-menopause to perimenopause, she said.

"While other symptoms might emerge in the perimenopausal stage, they lack specificity to that stage as these other symptoms are also common in pre-menopausal women."

A major finding in the study was that women with regular cycles but changed menstrual flow and VMS who are classified as pre-menopausal have a similar severity of symptoms as perimenopausal women. 

"This finding supports the likelihood of perimenopause commencing before menstrual cycles vary by at least a week, and that women whose periods have become much heavier or much lighter and who also have VMS should be considered as having entered their perimenopause," Professor Davis said.

The research was expected to transform women's health treatment, particularly in menopause, which had been overlooked for too long, Monash Women's Health Alliance chair Jill Hennessy said. 

"Too many go untreated for debilitating symptoms like hot flushes and night sweats," she said.

"By defining the symptoms that truly mark this transition, this study empowers women and clinicians alike with better knowledge and tools to improve women's health and wellbeing."

The study authors hoped the findings would improve how medical professionals identified and managed transitions in menopause.

Many women were overlooked in being classified within a menopausal stage if they had regular cycles or no longer menstruated due to a hysterectomy, first author Rakib Islam said.

"Our findings support a more symptom-based approach, enabling earlier recognition of perimenopause and more timely care," he said. 

Australian Associated Press