Perimenopause is a phase of life that many people experience as they approach menopause, but it’s often misunderstood. It can feel like a rollercoaster of symptoms and changes, leaving you wondering what exactly is happening to your body. In this blog, we’ll break down what perimenopause is, how it’s different from menopause, and what you can expect in terms of symptoms, periods, and fertility. We’ll also share tips on how to manage the changes.
Perimenopause is the transitional period before you reach menopause. It usually begins in your 40s but can start as early as your mid-30s. During perimenopause, your ovaries gradually start producing less estrogen, leading to changes in your menstrual cycle and the onset of various symptoms. This phase can last anywhere from a few months to several years, depending on the individual. Menopause is officially reached when you’ve gone 12 consecutive months without a period.
While perimenopause is the lead-up to menopause, menopause itself is the point at which your periods stop completely. Once you’ve gone a full year without a period, you’re considered to be in menopause. After this, you move into postmenopause, the phase of life after your periods have ceased.
During perimenopause, hormonal fluctuations cause irregular periods and symptoms such as hot flashes, mood changes, and disrupted sleep. By the time you reach menopause, your hormone levels have dropped significantly, and many symptoms may ease up, although some, like hot flashes, may continue for a while.
Perimenopause usually begins in your 40s, with the average age being around 45. However, it can start earlier or later. Some people may notice changes in their mid-30s, while others might not experience perimenopause until their late 40s. For most, menopause typically happens between the ages of 45 and 55, with the average age in the UK being around 51, according to NHS UK.
The symptoms of perimenopause can vary widely, but the first signs are usually related to changes in your menstrual cycle. You might notice that your periods become less regular—sometimes they’re closer together, other times they’re further apart.
Here are some common early signs of perimenopause:
Perimenopause can come with a wide range of symptoms, and some people experience more than others. You might have heard about the "34 symptoms of perimenopause," which are commonly reported as including:
Not everyone will experience all of these symptoms, but if you’re noticing several of these signs, it could be a sign that you’re entering perimenopause.
Perimenopause is driven by fluctuating hormone levels, particularly estrogen and progesterone. Estrogen levels begin to decline as your ovaries produce less of it, but the process isn’t smooth. You might experience hormone surges and drops, which is why perimenopausal symptoms can feel so unpredictable.
The drop in estrogen affects several systems in your body, including your reproductive system, bones, and even your brain. This is why symptoms like memory problems (often called “brain fog”) and mood changes are so common during perimenopause. You can learn more about how fluctuating hormones impact your body from Women's Health Concern.
Perimenopause marks a decline in fertility as ovulation becomes less predictable. While it is still possible to get pregnant during this phase, it can be more difficult. If you’re trying to conceive, be aware that your fertility decreases as you age, and perimenopause makes it harder to predict when ovulation will occur.
However, if you’re not planning to get pregnant, it’s important to use contraception until you’ve gone a full 12 months without a period, as ovulation can still happen unpredictably.
One of the most noticeable changes during perimenopause is in your menstrual cycle. Your periods might become shorter or longer, and the flow can be heavier or lighter than you’re used to. You may also experience periods that are more frequent, or your cycle may stretch out, with missed periods in between.
For some, periods during perimenopause can come with more intense PMS symptoms and cramping, even if they didn’t have these issues before. The erratic hormone levels can make periods more painful or uncomfortable.
Dealing with unpredictable periods can be frustrating, but there are some ways to manage the changes:
Keeping a log of your periods, including the length, flow, and symptoms, can help you notice patterns. This will also be useful when talking to your doctor about any concerns. There are apps specifically designed for tracking perimenopausal symptoms, which can help you stay on top of any changes.
If you experience more intense cramps, over-the-counter painkillers like ibuprofen or paracetamol can help. Additionally, using a heating pad on your lower abdomen can soothe discomfort.
Drinking plenty of water can help with bloating and fatigue. Since hormonal changes can lead to increased water retention, staying hydrated helps keep your system balanced.
Regular exercise can improve mood, help with weight management, and reduce stress. Even gentle activities like walking, yoga, or swimming can make a difference in how you feel during perimenopause.
Eating a diet rich in whole grains, fruits, vegetables, and lean proteins can help your body manage hormonal changes more effectively. Foods rich in calcium and vitamin D are particularly important, as they support bone health during this time of declining estrogen. For more information on how diet affects your cycle, check out this NHS resource on healthy eating.
If your symptoms are severe, you may want to talk to your doctor about hormone replacement therapy (HRT). HRT can help balance out hormone levels and relieve symptoms like hot flashes and mood swings. You can learn more about HRT and its benefits through Menopause Matters.
While most symptoms of perimenopause are normal, there are some signs that should prompt you to see a doctor. If you experience:
These could be signs of other underlying health conditions, so it’s important to check in with a healthcare provider if you have any of these.
Perimenopause is a natural phase of life, but it can come with many physical and emotional challenges. Understanding what is happening in your body and knowing how to manage symptoms can make this transition easier. Everyone experiences perimenopause differently, so it’s important to find what works best for you.
