What is Perimenopause?
‘Menopause’ is attained once you have had no menstrual period for 12 consecutive months.
However, the phase leading up to this may last several years, as the production of oestrogen in the
body slows down and menopausal symptoms start to appear. This is known as ‘perimenopause’.
Perimenopause can be confusing, as periods are still taking place, yet common menopausal
symptoms start to present themselves, and this phase can last for years. It is common for women
not be aware of some of the changes happening, as these can be gradual, and symptoms may only
However, understanding the changes that are happening to your body is the key to managing
menopausal symptoms effectively. Here we have put together a list of some of the common
symptoms and signs for you.
Perimenopause and periods
One of the first signs that you may be entering menopausal transition can be irregular periods
(changed pattern of menstrual cycles). The cycles usually shorten initially followed by long gaps
between periods. For some women, the periods can become heavy while for others they become
lighter. All women are born with a finite number of eggs and as they enter the perimenopause, the
production of oestrogen hormone and egg activity decline.
Hot flushes during perimenopause
Another sign of entering perimenopause is having hot flushes. Many women don’t expect this until
they have achieved menopause, so it can come as a bit of a surprise. Hot flushes can start early in
perimenopause and tend to last for anything from one to five minutes. They can be pretty
disconcerting if you are having them at an inconvenient moment. See our guide to prevent hot
flushes to find out how you can try to prevent or relieve hot flushes.
Perimenopause and emotions
One of the most difficult aspects of perimenopause can be the effect this phase has on mood and
sense of well-being. Irritability, anxiety and depression may be triggered by the declining hormone
levels. Some of the symptoms may be related to a personal or family history of depression, and/or to
the life stressors and role changes that come with middle age.
While hormone replacement may help some women with these symptoms, most women should
view this as a time when they can start thinking more about themselves and their lifestyle. It is a
time when women should take the opportunity to re-evaluate their lives, jobs, and relationships,
and gather the strength to do the best for themselves.
Sex and perimenopause
As levels of oestrogen hormone decline, vaginal tissues become thinner and drier. This may cause
vaginal dryness, itching and irritation, and may also make sex painful. The declining level of
hormones can lead to loss of libido, leaving you less interested in sex than before. HRT can help to
combat these issues by replacing the lost oestrogen. HRT can be taken as tablets, patches, gels or
just local vaginal pessaries/creams. If HRT is not for you, a number of vaginal lubricant or moisturiser
preparations are available which can reduce the symptoms.