The transitional years leading up to menopause — what to expect and how to manage symptoms.
Perimenopause is the transition phase before menopause, typically starting in a woman's mid-40s but sometimes as early as the mid-30s. During this time, oestrogen levels fluctuate unpredictably, causing irregular periods, hot flushes, sleep disturbances and mood changes. This phase can last 4–10 years.
Symptoms include irregular periods, hot flushes, night sweats, vaginal dryness, mood swings, brain fog, weight gain (especially around the abdomen), decreased libido, and sleep problems. Every woman's experience is different — some have mild symptoms while others find them debilitating.
Perimenopause is diagnosed based on symptoms and menstrual history. FSH blood tests can be helpful but are not always reliable during perimenopause due to fluctuating hormone levels. Your doctor will consider your age, symptoms and cycle changes.
Lifestyle changes (diet, exercise, stress reduction), hormonal contraception to regulate cycles and manage symptoms, and in some cases, early HRT. Calcium and vitamin D supplements support bone health. Discuss options with your GP or gynaecologist.