Perimenopause: What It Is and How to Recognise It
Sleeping less well, quicker to feel irritable, a less sharp head and an irregular cycle. On their own they seem like nothing. Together they are often the start of perimenopause.
What Is Perimenopause?
Perimenopause is the transitional phase before your final period, in which your body's production of the sex hormones oestrogen and progesterone gradually declines and becomes increasingly irregular. That fluctuation is the heart of the story: your ovaries do not stop from one day to the next, but wind production down slowly, with peaks and dips that differ from month to month. It is these swings that cause a large part of the symptoms in this phase.
Perimenopause - your hormones fluctuate and you can develop symptoms, while you are still menstruating.
Menopause - a single moment: twelve months after your last period.
Postmenopause - all the years that follow, with consistently low hormones.
Perimenopause vs Menopause: the Difference
The difference is a matter of timing. Perimenopause is the run-up: your hormones are declining and fluctuating, but you still have a cycle. Menopause is one specific moment, twelve months after your last period, which can only be confirmed in hindsight. That distinction is clinically relevant: during perimenopause a blood value such as oestrogen is still variable and a single measurement says little, while after menopause hormone levels are structurally low.
Common Perimenopause Symptoms
Because hormones play a part in so many places in your body, symptoms can be physical, mental and emotional. Many women recognise a combination that shifts from month to month, not a single isolated symptom.
Hot flushes and night sweats
Poor sleep
Mood swings
Brain fog
Irregular periods
When does perimenopause start and how long does it last?
There is no fixed age. For most women perimenopause begins somewhere in their forties, and because the duration varies so much, there is no way to say in advance exactly how long your phase will last. What you can do is track your symptoms and take them seriously.
What you can do yourself: lifestyle
Lifestyle is not a replacement for medical care, but it is the foundation everything rests on. The steps below can help ease your symptoms and contribute to your health in this phase.
Sleep
A fixed sleep rhythm, a cool bedroom and moments of calm before bed can help if you sleep poorly.
Movement
Regular exercise, and strength training in particular, matters. From the menopause transition onwards your muscle and bone mass decline faster, and strength training works against that.
Nutrition
Enough protein, fibre and a stable blood sugar can contribute to more energy and a steadier mood.
Stress and relaxation
Prolonged stress works through on your hormonal balance. Cutting back on alcohol and caffeine can also ease hot flushes and sleep problems. Relaxation is not a luxury but part of the approach.
Experiences from other women
Free guide: The Menopause Transition, a broader view
Understand how your hormones, sleep, mood and energy connect. In our free guide we explain the transition from the whole system, not from one isolated symptom.
Other possible symptoms
Beyond the familiar symptoms, hormones play a role in many more places in your body. These symptoms can also belong to perimenopause and often shift along with your hormones.
Vaginal dryness and a changed libido
Joint pain
Heart palpitations
Weight gain
Changes to skin and hair
Why perimenopause symptoms are often missed
Perimenopause symptoms are broad and irregular, and they appear while you are still menstruating. Poor sleep, irritability and brain fog look, in isolation, like stress or a busy life. On top of that, a single blood test says little: your oestrogen can be low one week and normal the next. In practice we see that women are therefore sometimes told nothing is wrong, or that the symptoms “come with the territory”. If you recognise the pattern on this page, that in itself is valuable information, regardless of what a single blood result shows.
What a care programme at Menovia looks like
We are a digital clinic specialised entirely in menopause care. Online, without a referral and without a waiting list. Our approach looks at the whole system, not at one isolated symptom.
Diagnostics
We map out your symptoms and your hormones with extensive blood testing. Blood does not tell the whole story; it is one part of a broader puzzle.
Treatment
Where appropriate, hormone therapy with bio-identical hormones can ease symptoms. Our BIG-registered doctors decide together with you what fits, with a tailored dose and monitoring of your blood values.
Guidance
A care programme lasts at least six months with a monthly consultation, because hormone levels move and fine-tuning takes time.
About perimenopause
What is the difference between perimenopause and menopause?
At what age does perimenopause begin?
How long does perimenopause last?
Can you still get pregnant during perimenopause?
Can a blood test determine if I am in perimenopause?
What are the symptoms of perimenopause?
Should I start hormone therapy immediately?
Do I need a referral from my GP?
Want to know whether this is right for you?
Request an introductory consultation with no obligation. Every treatment choice is made together with a doctor, who takes your personal situation into account.
