What is the perimenopause?
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 it’s before your periods stop completely. 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.
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).
- 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.
Worried you have perimenopausal symptoms? With a personalised Bupa Menopause Plan, you don't have to face these problems alone. Get advice from a specially trained GP, and a personalised care plan based on your needs.
-
Sources Sources
- Menopause - a life stage. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, accessed July 2023
- Menopause practice standards. The British Menopause Society. thebms.org.uk, published July 2022
- Delamater, Lara, and Nanette Santoro. "Management of the Perimenopause." Clinical obstetrics and gynecology 61.3 (2018): 419. doi: 10.1097/GRF.0000000000000389
- Menopause: diagnosis and management. NICE guideline [NG23]. National Institute for Health and Care Excellence (NICE). www.nice.org.uk updated 05 December 2019
- The truth about getting pregnant after 40. Patient. patient.info, published March 2018
- Menopause – Causes. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated September 2022
- Menopause and its Management- Menopause Symptoms. patient.info, last updated November 2022
- Kulkarni, Jayashri. "Perimenopausal depression–an under-recognised entity." Australian prescriber 41.6 (2018): 183. doi: 10.18773/austprescr.2018.060
- Menopause. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised September 2022
- Gynaecology. Oxford Handbook of General Practice (5 ed, online). Oxford Academic. academic.oup.com, published June 2020. doi:10.1093/med/9780198808183.003.0020
- Hamoda H, Mukherjee A, Morris E, et al. Joint position statement by the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on best practice recommendations for the care of women experiencing the menopause. Post Reprod Health. 2022;28(3):123-125. Doi:10.1177/20533691221104879
- FSRH Guideline: Contraception for Women Aged Over 40 Years. Faculty of Sexual and Reproductive Healthcare. fsrh.org, last updated July 2023
- Menopause and its Management- Associated diseases. patient.info, last updated November 2022
- Menopause and diet: Food Fact Sheet. British Dietetic Association. bda.uk.com last updated May 2019
About our health information
At Bupa we produce a wealth of free health information for you and your family. This is because we believe that trustworthy information is essential in helping you make better decisions about your health and wellbeing.
Our information has been awarded the PIF TICK for trustworthy health information. It also follows the principles of the The Information Standard.
More general health advice articles
Bupa menopause plan
Not sure if you're going through the menopause? Need help dealing with symptoms? Talk to a specially trained Bupa doctor and get a personalised plan.
Bupa menopause plan
Did you find our advice helpful?
We’d love to hear what you think. Our short survey takes just a few minutes to complete and helps us to keep improving our healthy lifestyle articles.
Legal disclaimer
This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
Any information about a treatment or procedure is generic, and does not necessarily describe that treatment or procedure as delivered by Bupa or its associated providers.
The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.
