Perimenopause is the time leading up to menopause. A woman will still have periods – although they may be different from usual – and many have physical and mental symptoms caused by their changing hormone levels.
Menopause occurs when a woman has her last period. If you have not had a period for 12 consecutive months, you are post-menopausal.
Because many symptoms of perimenopause also occur in dementia, some women worry that they are showing signs of young onset dementia, particularly if they have a family history of dementia.
For example, ‘brain fog’ is a very common symptom of menopause, with many women saying their brain feels like cotton wool. They may have difficulties with:
mood and emotions
However, while people with young onset dementia do experience memory and concentration problems, these are not usually early symptoms; changes in vision and spatial awareness, language problems and changes in behaviour are more common in the initial stages.
Because it can be difficult to tell if these symptoms are related to perimenopause/menopause, young onset dementia or both, it is important to see a GP if you have any concerns.
Before your appointment, spend some time thinking about your symptoms, what treatments are available, and what outcomes you would like to achieve.
If you are supporting someone with young onset dementia, you can help by:
working with them to keep a record of their periods and possible symptoms
doing some research into menopause symptoms and what treatment may suit the person best, especially if they may need support to manage their treatment
attending the appointment with them
helping them explain the changes you and/or they have noticed and why you think they may be due to hormonal changes
At your appointment, your doctor should discuss the stages and symptoms of menopause, lifestyle changes that may help, possible treatments and how menopause may affect your future health.
Women over 45 do not need tests to diagnose perimenopause, however, if a woman is under 45, her GP may run some tests to rule out other conditions.
Be aware that some healthcare professionals are not fully aware of the variety of menopause symptoms and might put changes down to the person’s dementia. Be patient but persistent – it may take several appointments to agree on a treatment plan.
The most common and effective treatment for perimenopause/menopause is hormone replacement therapy (HRT), which can be prescribed by a GP. HRT replaces or tops up the hormones that fall during this time.
It also reduces the risk of future health problems, including:
type 2 diabetes
There are different types and doses of HRT, and different ways of taking it.
This is the main hormone in HRT and is usually taken through the skin via a patch, gel or spray. It also comes in tablet form, but this may increase the risk of blood clots.
Women who still have a womb will need to take progesterone to keep the womb lining thin and healthy. The safest types of progesterone are Utrogestan, which comes in capsule form, or the Mirena coil: a small plastic T-shaped device that is inserted into the womb.
Taking a testosterone replacement alongside oestrogen and progesterone may help improve energy levels, sex drive, bone and muscle strength, brain fog and sleep. It comes as a cream or gel.
Although HRT is a very effective treatment, it may not be the right choice for everyone.
There are many other things that may help manage symptoms – either alongside HRT, or as an alternative. These include:
other prescription medicines, eg antidepressants
cognitive behavioural therapy (CBT)
herbal medicines: scientific evidence is mixed on how effective they are, and they may also have side effects or interfere with other medicines you might be taking, so it is important to speak to your GP or another healthcare professional before using these remedies
massage, acupuncture or aromatherapy
prioritising good sleep
relaxation techniques eg meditation or mindfulness
To speak to a dementia specialist Admiral Nurse about young onset dementia and perimenopause or menopause or any other aspect of dementia, please call our free Helpline on 0800 888 6678 (Monday- Friday 9am-9pm, Saturday and Sunday 9am-5pm, every day except 25th December) or email firstname.lastname@example.org If you prefer, you can book a phone or video appointment at a time to suit you at dementiauk.org/closer-to-home
We’ve created a section of content about young onset dementia (dementia symptoms under 65) to bring together information and resources that have been created specifically for younger people, that cover the key issues that you may face