What is the perimenopause?

When does perimenopause start?

The perimenopause is a natural stage of life. In most people it will happen naturally between the ages of 45 and 55 and last for a few months to several years. It can even last a decade or more.

During the perimenopause, your hormone levels change and your ovaries start to produce fewer eggs. Once you haven’t had a period for 12 months or more, you’ve officially reached the menopause.

Some people start experiencing the perimenopause before they are 40. This can be as a result of medical treatments, such as surgery to remove the ovaries, but sometimes there’s no cause. If you think you’re experiencing the perimenopause before you’re 40 then you must speak to your doctor.

What are the signs of the perimenopause?

Perimenopause symptoms are caused by the hormonal changes happening in your body. Some people won’t have any symptoms, but most will. For some people symptoms can be very severe and affect their daily lives. Everybody’s experience will vary, but physical perimenopause symptoms commonly include:

• changes in your menstrual cycle
• hot flushes and night sweats
• headaches
• dizziness
• vaginal dryness
• incontinence and bladder problems
• weight gain
• joint and muscle pain
• difficulty sleeping

There are also other symptoms of the perimenopause that can affect your feelings and mental health. These include:

• feeling depressed
• experiencing mood swings
• problems with memory and concentration – sometimes called “brain fog”
• a loss of interest in sex

Managing symptoms of the perimenopause

The perimenopause is a natural process, but it’s not always easy to cope with. If you’re experiencing symptoms, there are some things that you can do that may help.

• Avoid alcohol and caffeine if they seem to trigger your hot flushes, or if you’re having trouble sleeping.
• Wear lighter clothing and stay in cool temperatures (for example use a fan)
• Use moisturisers and lubricants to help with vaginal dryness.
• If you smoke, try to give up as smoking can increase hot flushes.
• Do things that reduce your stress, such as practising yoga and mindfulness.
• Try to get enough sleep (to help see our six steps to a good night’s sleep (PDF, 0.3MB)).
• Eat a healthy balanced diet and take part in regular exercise . This can help manage your weight and give you more energy. Exercise can also help with low mood

There are also treatments that your doctor can prescribe to improve your quality of life. These include:

• hormones, also known as hormone replacement therapy (HRT) 
• non-hormonal medicines to ease specific symptoms
• help with your mental health, such as cognitive behavioural therapy (CBT)

You don’t need to wait for your periods to stop before speaking to your doctor or taking HRT.

Can I still get pregnant during the perimenopause?

Pregnancy is still possible if you’re experiencing the perimenopause. However, it’s much less likely because you’re not ovulating as frequently.

If you don’t want to become pregnant, you should use contraception until your doctor says it’s safe to stop. The right contraceptive for you depends on your age, symptoms and needs. Talk to your doctor about your options.

Preparing for the menopause

Experiencing the perimenopause is a signal that your body is changing. After the menopause you’re more likely to develop heart disease and osteoporosis than you were before. The good news is that there are some things you can do to help support your health.

• Eat a heart healthy diet, with at least five portions of fruit and vegetables a day. Also eat plenty of fibre, and healthy fats from fish, nuts, and seeds.
• Have two to three portions of calcium-rich foods in your daily diet, such as cheese and yoghurt. Calcium helps support your bones.
• Consider taking a daily supplement of 10 micrograms of vitamin D to help support your bone health.
• Do some moderate exercise for half an hour, five days a week, including strength exercises on at least two days a week.
• Maintain a healthy weight, limit alcohol and stop smoking, as this can reduce your risk of heart disease.