What is Perimenopause?

What is the Perimenopause?

The perimenopause is really the start of the menopause transition. When our periods start at puberty, estrogen levels flow up and down rhythmically during each month to give a regular period. In the perimenopause, at that start of that transition, the mechanism, the feedback keeping all of those systems in check, goes a bit haywire.

Your estrogen levels can fluctuate wildly, and what this means is your periods might change. They can become:

• Less frequent
• More frequent
• Lighter or heavier
• They can go away for a few months and then come back again

You can start to experience symptoms of the menopause transition. Women often don’t realise that the creeping up of anxiety that they’re starting to feel, that sort of feeling of being a bit frazzled, that they’re not coping so well, flat or low mood even, is to do with the menopause transition.

You might experience a few hot flushes and then they might just go away again, this is usually to do with the fluctuation and ultimate drop of oestrogen that happens in the run-up to your ovaries completely stopping producing estrogen in the menopause.

At what age will women typically go through the perimenopause?

This is really another big surprise for a lot of women. The perimenopause can last up to 8 or even 10 years, so that means that if the average age of the menopause is 50-51 in this country, symptoms can start in your early 40s, that’s the bit that often takes people by surprise – “Am I having hot flushes? I’m only 41.”

If you’re going to have an earlier menopause, then actually your symptoms can start in your 30s. One percent of women will go through the menopause under the age of 40, and so symptoms can even start earlier. This shows how important that increased awareness of symptoms of the menopause is.

Perimenopause Symptoms

During perimenopause, estrogen and progesterone levels fluctuate, leading to a wide range of symptoms. Common signs include:

• Irregular Periods: Menstrual cycles may become erratic—shorter, longer, lighter, or heavier.
• Hot Flushes: Sudden feelings of heat, usually in the upper body, can last from a few seconds to several minutes.
• Night Sweats: Episodes of intense sweating during sleep, often accompanied by hot flushes.
• Mood Changes: Increased irritability, mood swings, or episodes of depression.
• Sleep Problems: Difficulty falling or staying asleep, often due to night sweats or anxiety.
• Decreased Fertility: Ovulation becomes irregular, which can affect fertility.
• Vaginal and Bladder Changes: Vaginal dryness, discomfort during intercourse, and increased risk of urinary tract infections.

Click here to see a full list of all of the 34 potential perimenopause symptoms

Diagnosing with a perimenopause test?

As hormone levels fluctuate there aren’t hormone tests which are reliable at diagnosing perimenopause and are therefore not required. A healthcare provider or GP may tell you that you are starting perimenopause based on an examination as they will take many things in to consideration, as no one test or sign is enough to say for sure that you’ve started perimenopause.

Tests like FSH (Follicle-Stimulating Hormone) serum, may be useful and a persistently high level of FSH could be an indication of perimenopause but these tests can be misleading due to hormone fluctuations, as well as medications or pother health conditions causing the FSH fluctuation.

The best way is to listen to how you are feeling, take note of any symptoms you are experiencing or changes you are noticing, arm yourself with information from trusted sources and work with your healthcare provider so you manage your symptoms.

Preparation and Management

Research shows that the more prepared the woman is for the menopause, the better her experience of it will be. Awareness is key – understanding where your symptoms are coming from and recognising them for what they are is really super important.

While perimenopause is a natural process, its symptoms can significantly impact quality of life. Managing these symptoms involves a combination of lifestyle adjustments, medical treatments, and alternative therapies. Common strategies include:

• Lifestyle Changes: Regular exercise, a balanced diet, and stress-reduction techniques can help alleviate symptoms.

• Medical Interventions: Hormone replacement therapy (HRT) or other medications may be prescribed to balance hormone levels and relieve symptoms.

• Natural Remedies: Some women find relief with herbal supplements, acupuncture, or dietary adjustments.

All of the standard ways of managing the menopause are completely relevant in the perimenopause, but preparation is key. As our research showed, if you understand where something is coming from, it can be much easier to deal with – it causes much less angst and anxiety.

Menopause Questionnaire

You can take our menopause questionnaire – we designed it to help women through the menopause transition. It’s a really useful tool, it only takes a few minutes to complete, and it provides you with a more personalized assessment of if and where you are in the menopause transition.

Very often women don’t realize that some of the symptoms they’re experiencing are actually menopause-related, and so the questionnaire is a great free tool for anyone to use.

Knowledge really is power.