'I'd never even heard of the perimenopause'
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Margaret*, a 37-year-old woman with two teenage children, has been experiencing irregular periods for more than six months.
"Sometimes I have two periods a month and, if I only have one, it's extremely heavy and goes on for longer than usual," she says.
"One day, while I was in a meeting, I also felt extremely hot and started to sweat, even though I wasn't nervous. I asked a friend and she said it could be hot flushes so I went to my GP.
"He says the signs point to me being peri-menopausal -- I'd never heard of that term."
Cathy thought she was too young to be facing the menopause but in reality it can begin as young as 30, although typically it begins in the mid-40s.
Peri-menopause is the transitional phase preceding the menopause, whereas the menopause proper is when periods have completely stopped for one year or more.
The menopause occurs when the ovaries have stopped releasing eggs entirely, whereas the peri-menopause is the decline in oestrogen and the slowing down of egg release.
"For some women, as they get older, their periods will naturally get heavier," says Dr Rachel Mackey, gynaecologist at the Women's Health Clinic in Dublin.
According to former 'Charlie's Angel' Cheryl Ladd, who has publicly spoken about her experiences of the peri-menopause and menopause, one of the most crucial aspects is that the symptoms are discussed more openly, so women don't feel alone or frightened.
"It is an amazing thing in our culture that so little of this has been talked about," she says. "We've been locked away for so long in this sort of weird closet of embarrassment that even the doctors don't have the information they need."
In a youth-focused culture, it's no surprise that this topic has been driven underground. With the onset of erratic or diminished periods, many women perceive this as the first official sign of ageing and the ebbing away of their femininity.
Although one woman's experience of the peri-menopause can be very different than the next (with some women experiencing irregular periods but not much else), the most common symptoms tend to be: irregular or heavy periods, longer periods, spotting or cramping, post-coital bleeding, dyspareunia (painful intercourse), insomnia, vaginal dryness, mood changes, fatigue, loss of sex drive, loss of concentration, weight gain, night sweats and/or hot flushes.
*not her real name
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