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What is the perimenopause?

General Practitioner at Bupa UK
25 August 2020

Often when people talk about ‘going through the menopause’ they’re actually talking about the perimenopause. The perimenopause is when your hormone levels start to change, but before your periods stop for good. It can cause a wide range of symptoms, both physically and mentally. Here I’ll talk about what the perimenopause is, ways to cope with it and how to look after your body as it changes.

What triggers the perimenopause?

The perimenopause is a natural stage of life that occurs as you age. In most people it will happen naturally between the ages of 45 and 60, and last for a few months to several years. Even 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?

The symptoms of the perimenopause 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 symptoms commonly include:


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

Just because the perimenopause is a natural process, it doesn’t mean that it’s always easy to cope with. If you’re experiencing symptoms, there are some things that you can do that may help.


There are also treatments that your doctor can prescribe if you need some support to improve your quality of life. These include:

  • hormones, also known as hormone replacement therapy (HRT)
  • 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.

Can I still get pregnant?

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 continue using contraception until your doctor says it’s safe to stop. The right contraceptive for you depends on your age, symptoms and needs, so 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, plenty of fibre, and healthy fats from fish, nuts and seeds.
  • Include two to three portions of calcium-rich foods, such as milk, cheese and yoghurt in your daily diet to help 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 two days a week or more.
Dr Samantha Wild
General Practitioner at Bupa UK

    • Menopause – a life stage. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, accessed 20 August 2020
    • Delamater L and Santoro N. Management of the Perimenopause. Clinical obstetrics and gynecology 2018; 61(3):419-32. doi:10.1097/GRF.0000000000000389
    • Kulkarni J. Perimenopausal depression–an under-recognised entity. Australian prescriber 2018; 41:183-5. doi:10.18773/austprescr.2018.060
    • Are you going through the perimenopause? Patient. www.patient.info, published 21 December 2017
    • Menopause: diagnosis and management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk updated 5 December 2019
    • The truth about getting pregnant after 40. Patient. www.patient.info, published 1 March 2018
    • FSRH Guideline: Contraception for women aged over 40 years. Faculty of Sexual and Reproductive Healthcare. www.fsrh.org, updated September 2019
    • Menopause and diet. British Dietetic Association, www.bda.uk.com, updated May 2019

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