Perimenopause

Understanding Perimenopause

Perimenopause marks the natural transition toward menopause, typically beginning in your 40s but sometimes earlier. It’s caused by fluctuating levels of oestrogen and progesterone, which can lead to a wide range of symptoms that vary from person to person.

Common Symptoms

Common symptoms include:

• Irregular periods or changes in cycle length

• Hot flushes and night sweats

• Mood changes, anxiety, or low mood

• Brain fog or difficulty concentrating

• Sleep disturbances

• Fatigue

• Vaginal dryness or discomfort during sex

• Changes in libido

These symptoms may come and go for several years and can have a significant impact on daily life.

Diagnosis & Support

There’s no single test for perimenopause. Diagnosis is typically based on symptoms, age, and cycle changes. Blood tests may sometimes be used to rule out other conditions.

While perimenopause is a natural life stage, support is often lacking. Many women are dismissed or misdiagnosed, and it can take years before they receive the help they need.

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Quick Facts, Big Impact

Prevalence in the UK 

Most women in their 40s and early 50s will experience perimenopause.

• On average, symptoms begin 4–5 years before menopause.

• Around 13 million women in the UK are peri- or postmenopausal.

• 1 in 10 women may experience early menopause (before 45).

• Some may enter menopause early due to medical treatment, such as chemotherapy or surgery.

Diagnosis Delays 

Perimenopause can be hard to diagnose because symptoms come on gradually and mimic other conditions.

• There’s no single test – diagnosis is based on age, symptoms, and cycle changes.

• On average, women take over 4 years to recognise they are in perimenopause.

• Symptoms can be misdiagnosed as anxiety, depression, or stress.

• GPs are encouraged to consider perimenopause in women over 40 with typical signs.

Early recognition is key. You don’t have to wait for your periods to stop before seeking help. Hormonal treatments and lifestyle changes can ease the transition.

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Common Causes

Perimenopause is a natural life stage triggered by declining ovarian function and fluctuating levels of oestrogen and progesterone. These hormonal shifts lead to irregular periods and a range of symptoms. It usually begins in the 40s but can start earlier. Genetics, smoking, and certain medical treatments (like chemotherapy) may influence timing.
 

Treatment Options

Hormone Replacement Therapy (HRT) is the most effective treatment for perimenopausal symptoms. It can:

• Regulate periods and reduce hot flushes, brain fog, mood swings, and night sweats.

• Be given in several forms, including patches, gels, or tablets.

• Often be used alongside contraception like the combined pill or Mirena coil.

Non-hormonal treatments may include:

• Medication for hot flushes or low mood (e.g. SSRIs or clonidine).

• Lifestyle changes: exercise, healthy diet, reducing alcohol, and stress management.

• Complementary therapies, though evidence is mixed – always consult your GP first.

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