In my Pilates classes, I have lots of women that are around the perimenopause, menopause, postmenopause age. And a lot of the time our conversations end up heading towards the menopause because obviously they know that I do a lot with perimenopause, postmenopause, and we always seem to get around to that topic.

Often it's things like sleep and migraines and we have a little chat about all the things they can do that will help and what is common perimenopausal symptoms. A lot of them have joint pain and then have a little chat about what causes those.

But what are we not talking about?

There are always topics that are missed out whenever we're talking about menopause because they are seen as maybe more the embarrassing symptoms. But if you spoke to a big range of women that are going through perimenopause, they are very common and we are already getting better talking about menopause.

But there are still things that we are not talking about. And that's what we're going to talk about today. Some of those symptoms that maybe are seen as a little bit more embarrassing.

Now the things that we do talk about.

Hot flushes, now about 80% of women will be getting hot flushes.

Weight gain, that's a big topic in my classes. Those that have tried lots of different diets, they're struggling with it and a lot of people getting weight around the middle particularly. People are happy to talk about that.

And sleep as well, and the joint pain, no problem talking about it.

However, things that people are not talking about.

Incontinence.

Now I'm going to do a whole episode about incontinence next week. So listen out for that if you are struggling with incontinence or prolapses or any pelvic issues during perimenopause and postmenopause because it's really common that a lot of women have had particularly vaginal deliveries may got no problems, they may have a little bit of an issue after having babies.

But as soon as we lose that estrogen, as we head through perimenopause, then we start to get some of the pelvic health issues. But I won't go too much into that because I'm talking about that next week.

Vaginal dryness.

Now, because we are losing that estrogen, that's what keeps everything moist. And I know lots of people hate that word, but it's keeping everything lubricated vaginally, gives a little bit of scaffolding to support the vagina but as we head particularly more post menopause when we have a lot lower estrogen then we are more likely to get dryness and that just potentially gets worse as we get older and it is something that is really common.

Now that could cause discomfort all the time. It may only cause you issues with intercourse and you might have to use extra lubrication.

There are lots of things that you can do for vaginal dryness. One of which is to use some moisturiser. So there is special moisturiser such as YES, they do a vaginal moisturiser.

It is also one of the times where I am a big champion of local estrogen. So even if you're not taking general HRT, local estrogen, assuming you can take it, obviously discussed with your GP, as a cream or a small pessary that's inserted in the vagina, it has so many benefits for your vaginal health.

So not only can it help with dryness, but it also can help with incontinence, with prolapses, and just help everything around that area plump out and feel much healthier.

So if you are getting problems, then do discuss with your GP about getting some because it is really useful.

Make sure you're using lubrication with intercourse as well and make sure that it's one that's not got lots of chemicals in.

So if it's one that's meant to be tingly, probably not the best idea because that's going to irritate.

And make sure that you're not washing with anything in that area other than water. Even though there's lots of things that are made for it, it can change the pH and cause irritation.

So ideally don't use anything unless it's medicated from the GP, but water is fine.

Other things that people may not discuss or they may do, maybe not something they would relate to perimenopause, is thinning of the hair.

So a lot of women, peri and postmenopausal, are losing hair or the hair becomes drier. And that again is quite common.

So I think there are particular shampoos and things that you can use. I mean, talk to your hairdresser, but it is just being aware that that can happen.

Making sure that you've got a good diet is really useful as well to keep the hair as good as possible.

And I think it's the marine collagen that's meant to be good for hair and nails, but certainly some of the collagen is meant to be good for hair as well. So I'm not an expert in supplements, so just look into that.

Other things that people may not talk about is actually mental health wise.

Now I spoke last week about anxiety and fear and the nervous system being on edge, which is quite common, but we often lose confidence.

Now I've spoken several times on previous episodes about self confidence, self esteem, but often we don't talk about that as being a problem due to perimenopause, but it is because all our hormones are changing and our stress levels are changing, our bodies changing so we don't feel good about ourselves.

But it's these things that are often not spoken about that are the most embarrassing.

And if we were just to talk about them a little bit more, then we may actually then get help for them.

Whereas oftentimes women don't talk about them. They think it's just normal ageing. They don't realise that there is help.

Particularly things like prolapse, incontinence, obviously that's things that I treat as my bread and butter of treating, but they don't always realise that that isn't something they have to put up with.

They often go to the GP and are told, "You've had a baby, you're now menopausal, you just have to put up with it, just get some incontinence pads."

But if we could talk about it more, then it would help more people seek out help.

And also women often feel isolated.

So relationships can be a challenge in perimenopause because our moods change, our self confidence changes.

We may get a lack of libido as well. So that's another thing that we often don't talk about.

Our libido decreases because our testosterone decreases, but also because our self esteem isn't great often.

And maybe because you're getting incontinence and prolapse issues, maybe it's painful to have intercourse. So therefore, we want to avoid it.

And it therefore can feel isolating from your partner as well.

So ideally, we want to open up that conversation.

As soon as we talk about it, what's the old saying? A problem shared is a problem halved.

But as soon as we admit that there is problems or symptoms that we're struggling with, whether that is to a healthcare professional, whether that is to a friend that's going through similar things or someone that's been there and done that, making sure that you are normalising this experience.

It isn't something you have to be ashamed of because every single woman will go through menopause. They may have different experiences, but everybody will go through it at some point to one degree or the other depending on how bad they get it.

If you are struggling with particular symptoms or you're not sure whether your symptoms are normal because some symptoms actually need to be investigated further and are not related to perimenopause or postmenopause, then check out the free masterclass that I've done.

That goes through a lot of the symptoms that are present at perimenopause and it will help you distinguish whether it is to do with your hormones or whether there's something else that's going on.

But that's a good place to start. So check out the link to that in the show notes.

And knowing that actually, if we can just talk about it, it will lead to more understanding and more support.

So even if you feel that it's not really a big problem to you, but you're happy to talk about it and let other people know about it, then they may be struggling with the same problem but are too shy to talk about it.

So let's just be open with our conversations.

Not necessarily with every single person in the world, but if you've got a few trusted friends or a healthcare professional, then start talking about it, getting the support that you need or providing support to other people.

So who are you going to talk to this week about it?

Please feel free to let me know on social media, message me or email me or whatever.

If you're getting value from any of these episodes, then please do share them.

Until next week when we're going to be talking about incontinence.

Take care and I'll see you soon.