SHAH ALAM, Oct 7 — Perimenopause is not just about irregular periods, as hormonal changes during this phase can also be linked to women's long-term health risks.
Femma Clinic medical director Dr Alia Zafira Zaferi said perimenopause can begin as early as age 40 and last between eight and 10 years before menopause.
She said the hormones oestrogen and progesterone play an important role in cardiovascular protection and help regulate cholesterol levels.
As levels of these hormones decline, women may become more susceptible to health problems including high cholesterol, high blood pressure and diabetes.
"It is very common in our practice to see women in their 40s and 50s beginning to develop problems with cholesterol, high blood pressure and diabetes as their hormone levels decline.
"However, I want to remind all women that they need to understand these changes will happen," she said during Media Selangor's ‘Bicara Semasa’ programme.
Recognising the early signs
Dr Alia said early signs can include sleep disturbances, irritability, sudden feelings of heat, night sweats and changes in weight.
"Perimenopause is actually the phase before menopause and can begin as early as age 40.
"In the earliest stage of perimenopause, we may notice sleep disturbances, such as being unable to sleep soundly and waking up frequently," she said.
She said emotional changes, difficulty sleeping and weight gain are not necessarily due to ageing alone, but can also be linked to declining progesterone levels.
"Progesterone is a hormone that helps us relax and sleep at night. So when progesterone levels fall, one of the first symptoms we may experience is poorer-quality sleep.
"We may also become irritable more easily because our hormones are changing," she said.
Protein, strength training helps
Besides health screenings, Dr Alia stressed the importance of consuming sufficient protein and fibre, as well as staying physically active, to help women navigate hormonal changes.
She said protein is important for building and maintaining muscle, while strength training helps preserve physical function and bone health as women age.
"Protein is number one. As a guide, aim for one gram for every kilogram of body weight each day.
"When we consume more protein, we also need plenty of fibre, so we should eat more vegetables," she said.
She also encouraged activities such as walking on an incline and strength training with weights.
"We want to focus on building muscle and making sure we have enough muscle to support our bones and body.
"You can do incline walking and lift weights. You don't need to lift 10 or 15 kilogrammes — even five kilogrammes is enough, as long as there is some resistance," she said.
Hormone therapy should be understood, not feared
Dr Alia said hormone replacement therapy (HRT) is one option for managing symptoms and reducing certain cardiovascular and metabolic risks.
She explained that the treatment is not intended to prevent menopause but to replace hormones that are declining.
"We are not saying that we want to stop menopause from happening. Menopause will still happen. What we are doing is managing the symptoms and reducing cardiovascular and metabolic risks, as well as cholesterol-related risks," she said.
However, she advised women against taking HRT without medical supervision, as not everyone needs the treatment.
"I recommend consulting a doctor first because some patients may not need HRT at all.
"Before starting HRT, we need to understand the risks and side effects before making a decision," she said.
Health screenings after 40
Dr Alia also recommended that women, particularly those aged 40 and above, undergo a health screening at least once a year.
She said regular screenings are important for monitoring blood sugar and cholesterol levels, as well as organ function.
"I recommend a full health screening. We look at blood sugar, cholesterol, kidney and liver function, and heart health.
"This should be done at least once a year, particularly once you reach 40," she said.
Dr Alia said perimenopause and menopause are natural processes that all women will experience.
However, she said a healthy diet, physical activity and regular health screenings can help women navigate the transition more effectively.
"Perimenopause and menopause are transitions that all women will go through. To navigate them better, eat well, reduce sugar, increase protein intake and keep moving.
"Don't wait until you are sick or have a health problem before going for a health screening," she said.
