All you need to know about perimenopause - signs, symptoms and ...

17 Feb 2023

The lesser-known term refers to the time leading up to menopause - and most often strikes women in their early to mid 40s

A middle-aged woman on a sofa

Perimenopause can begin in some women in their 30s, but most often affects those from 40 to 44. (

Image: Getty Images)

Most of us will be familiar with the term menopause - but perhaps less so with perimenopause.

Menopause is when your periods stop due to lower hormone levels and usually happens between the ages of 45 and 55.

Perimenopause is when you have symptoms before your periods have stopped and most often affects those aged 40 to 44. It's often marked by changes in menstrual flow and in the length of the cycle.

According to the NHS, menopause and perimenopause can cause symptoms like anxiety, mood swings, brain fog, hot flushes and irregular periods. These symptoms can start years before your periods stop and carry on afterwards.

The NHS also highlights how these symptoms can "have a big impact on your life, including relationships and work" and advises visiting your GP for help dealing with them.

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Perimenopause symptoms

Some lesser-known early warning symptoms of perimenopause may include:

Menstrual flooding Vaginal flora issues Urinary tract infections Anxiety, low mood or depression Cognitive challenges Disturbed sleep Energy issues Thyroid issues Heart symptoms such as palpitations or shortness of breath Skin changes such as dryer skin with more pimples, itching or rashes Exercise feels like a chore Joint issues More prone to illness and infections Libido and sex drive is affected

Other symptoms include:

Hot flushes Headaches and migraines that are worse than usual changed body shape and weight gain

According to the NHS, symptoms can last for months or years, and can change with time.

They explain: "For example, hot flushes and night sweats may improve, and then you may develop low mood and anxiety.

"Some symptoms, such as joint pain and vaginal dryness, can carry on after your periods stop."

Effects of stress need to be combatted

Unfortunately, perimenopause symptoms may appear sooner if a woman has experienced a lot of stress.

Stress hormones are known to disrupt the normal ovulatory pattern which produces oestrogen and progesterone.

This can further lead to irregular or missed periods - something which may already be an issue when entering perimenopause.

As a result, experts say it's important to find ways to help reduce stress, as this is known to further impact perimenopause symptoms.

Nutritional therapist, author and founder of Wild Nutrition, Henrietta Norton explained: “Fluctuations and declines in hormones oestrogen and progesterone make women more susceptible to symptoms such as thrush or strange discharge because the change in hormones affects the natural environment of the vaginal ecosystem.

“It’s a sign of this life stage if you find you keep getting these symptoms despite repeated treatments.”

Discussing urinary tract infections, Norton added: “This can be common because again, the fluctuation and drop in hormones affects the urinary tract.

“The vagina itself can feel more delicate and ‘burny’ because the skin tissue can be thinner as oestrogen declines but this is more common at the later stages of perimenopause than the earlier days.”

What to do if you have perimenopause symptoms

Some women seek medical attention for their perimenopausal symptoms - but most either don’t notice or simply tolerate them.

As the symptoms come on gradually, many may not even twig that they’re connected to the same overall umbrella of hormone fluctuations of the menopausal transition.

If the symptoms are beginning to affect your life in a negative way such as severe mood swings or major changes to sexual function, it's strongly advised to speak to your GP about the best way to deal with this.

Along with visiting your GP, the NHS advises you eat well including calcium-rich food like milk and yoghurt, exercise regularly, talk to other people going through the same thing and look after your mental health.

They also advise women not to smoke and to not drink more than the recommended alcohol limit.

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