When the actual timing of perimenopause comes before the expected timing we call it an “off-time” experience.
Does being “off-time” have an impact on one’s experience of perimenopause? If so, how? These are the things we explored in a recently published paper.
Anticipated age of perimenopausal experiences, stress, satisfaction, and health and well-being: Observations from The Women Living Better Survey Woods NF, Coslov N, Richardson M. Menopause. 2023 Aug 1;30(8):807-816. doi: 10.1097/GME.0000000000002206. Epub 2023 Jun 6. PMID: 37279510.
As we’ve noted before there are many reasons why we don’t expect changes associated with menopause to begin before age 45.
The expected timing of perimenopause
To better understand when changes associated with menopause are expected, we asked a question in the Women Living Better Survey.
We asked: Think back to when you were 30. In which of the following age ranges (35-39, 40-44, 45-49 and 50+ years) did you assume the changes associated with the lead up to menopause would begin?
Here are the results:
Almost 60% of our survey participants expected changes associated with menopause (the timing of perimenopause) to begin at 50 or later.
People’s expectations about the timing of developmental events such as our first period (menarche) and menopause (our last), that is, the ages at which they will occur, are defined by social and cultural ideas. In this research, we hypothesized that the ages at which people go through these reproductive transitions versus their expectations about timing may influence their experience, including the associated degree of challenge, concern, distress, and possibly how they appraised their health.
To study this, we used the age categories at which participants indicated anticipating changes related to menopause (the graph above) and grouped their current ages into the same categories. We calculated the difference to see who was experiencing changes at an age before they expected them. We called this group “off-time” that is having perimenopause-related menstrual cycle changes or symptoms sooner than they expected them.
We thought being “off-time” would lead to more negative outcomes on items we asked participants about like health stress, satisfaction with life roles and activities, and perceived health. However, “off-time” was only associated with worse perceived health.
The most surprising finding was that those who were “off-time” and experiencing more bothersome volatile mood symptoms reported greater health stress, lower satisfaction with life roles and activities, and poorer perceived health.
Volatile mood symptoms include new irritability, sudden anger/rage and mood swings. Perhaps because these aren’t expected symptoms of perimenopause, they are more a cause of concern when they arise. Paricualrly when the timing of perimenopause is early than expected.
This interactive effect of being “off-time” and experiencing volatile mood suggest a need for greater research attention to volatile mood that can arise during perimenopause. Also, anticipatory guidance for those on the path to menopause should address the possibility of volatile mood symptoms so they aren’t a surprise and cause for concern.
This research was published online ahead of print on June 6, 2023, and published in the August 2023 issue of Menopause, the journal of The Menopause Society.
You can read the abstract here.
Learn more about the different stages of perimenopause, what the four main reproductive hormones do and what symptoms can occur as these begin to fluctuate on the path to menopause.
