Researchers call for better support for women during perimenopause

Women going through perimenopause need better education and support about how their periods might change towards the end of their reproductive life, a new study led by UCL researchers has concluded.

The research, published in Post Reproductive Health, highlighted how, as women approach the menopause, their periods may become unpredictable, heavy and cause worse premenstrual symptoms, including mood swings, breast tenderness and headaches.

The team of researchers from the UCL EGA Institute of Women’s Health and Centre for Reproductive Health, University of Edinburgh, interviewed 31 perimenopausal women aged between 40 and 55.

They found that almost all of the women spoke of having unpredictable periods that accompanied the perimenopause, including changes in cycle length and period duration. This was the case even if their periods had been regular throughout the rest of their lives.

The researchers said most women stated that due to constant and unpredictable changes during perimenopause, it was challenging to commit to plans, in case they coincided with a period that would leave them unable to cope either emotionally or physically.

Additionally, many participants talked about the increased heaviness of their periods during the perimenopause which, they said, often resulted in them being caught off-guard or having low iron levels.

Premenstrual symptoms were also described as being more intense and lasting much longer than before. This ranged from new feelings of anxiety, to uncontrollable mood swings and longer periods of premenstrual syndrome (PMS).

Senior author, Professor Joyce Harper from the UCL EGA Institute for Women’s Health, said: “We need to be sure that perimenopausal women understand how their periods might change at this time in their lives and that we need to be supporting perimenopausal women as their periods become unpredictable, heavy, or have worse premenstrual symptoms.

“All of these factors can affect the working life and mental wellbeing of women going through the perimenopause.”

All of the women involved in the research described numerous ways they needed support in managing their periods. Suggestions included extra support in the workplace, such as working from home to reduce anxiety around unpredictable periods, greater sympathy from managers and colleagues, as well as mandatory managerial training and better education in schools.

Many of the participants also desired emotional support as they navigated mood swings and other bodily changes, particularly from their husbands, children and friends.

While the women said that having friends or mothers that they could confide in was comforting, many also desired additional help from support groups where they could meet people with similar experiences.

Experts at UCL, including Professor Harper, have recently announced plans for the UK’s first menopause education and support programme.

The project aims to provide education and support for women across the UK experiencing menopause to help them gain a greater understanding of what is happening to their bodies.

Professor Harper said: “This study offers valuable insight into the impact of periods on the wellbeing of perimenopausal women.

“Most negative menstrual experiences stem from a lack of education about what is and isn’t normal and when to seek medical care. Early, inclusive, and comprehensive menstrual education is vital for everyone, alongside specialised women’s health training for healthcare professionals.

“Empowering women with knowledge aids self-advocacy and informed treatment choices. We have conducted a similar study in schools with 49 15-year-old girls and they felt they needed more education and support around menstruation.”

She added: “Accessible support is essential for each woman’s perimenopause journey. We hope to make this possible for more women through our plans for the UK’s first menopause education programme.”