What Are Menopause and Perimenopause?
Menopause marks the end of menstrual cycles, but perimenopause is the transition many experience first. Understanding both helps you navigate symptoms and embrace this life stage confidently.
What Is Perimenopause?
- Perimenopause is the hormonal transition before menopause—usually starts in mid-40s.
- Oestrogen and progesterone levels fluctuate, causing irregular periods.
- This phase can last 4–8 years—sometimes even a decade.
What Is Menopause?
- Menopause is defined by 12 consecutive months without a period.
- Average age in the UK is around 51.
- Post‑menopause begins after that 12‑month mark and lasts the rest of life.
Common Perimenopause Symptoms
- Irregular bleeding—lighter, heavier, unpredictable cycles.
- Hot flushes, night sweats and disrupted sleep.
- Mood swings, low mood or anxiety.
- Breast tenderness and bloating.
- Vaginal dryness or reduced libido.
Common Menopause Symptoms
- Continued hot flushes and night sweats.
- Thinning bones and increased osteoporosis risk.
- Weight gain—especially around the abdomen.
- Changes in skin elasticity and hair density.
- Memory issues ("brain fog") and reduced concentration.
How to Know You’ve Entered Menopause
If your periods stopped and you’ve had no bleed for 12 months, you’re considered menopausal. Hormone tests (FSH, oestradiol) are sometimes used, but often aren’t necessary unless you’re under 45.
Health Considerations Across the Transition
- Bone health: Oestrogen drop increases fracture risk—consider calcium and vitamin D.
- Heart health: Cardiovascular risk rises—regular activity and a Mediterranean-style diet help.
- Mental wellbeing: Mood and sleep disruptions can trigger anxiety or depression in sensitive individuals.
Treatment & Symptom Relief
- Hormone Replacement Therapy (HRT): Effective for hot flushes, mood and bone health—speak to your GP.
- Non-hormonal options: SSRIs, SNRIs and gabapentin can ease symptoms.
- Vaginal moisturisers and lubricants: Help with dryness and intimacy.
- Lifestyle: Cool clothing, paced exercise, balanced nutrition and good sleep—foundation of relief.
Lifestyle Strategies to Support You
- Stay active—strength, cardio and balance exercises at least 150 min weekly.
- Eat whole foods, limit processed sugar and maintain healthy weight.
- Reduce caffeine, alcohol and spicy foods to ease flushes.
- Practice mindfulness, relaxation, social connection and hobbies for stress relief.
When to See Your GP
- If you’re under 45 and suspect perimenopause or menopause.
- If bleeding continues after 12 months of no period.
- If symptoms severely affect sleep, mood, work or quality of life.
- If you have a family history of osteoporosis or cardiovascular disease.
Real‑Life Example
At 48, Sarah had erratic periods, night sweats and mood swings. Her GP prescribed HRT, plus a referral for a DEXA scan. With support, her symptoms eased and she felt confident navigating early menopause.
FAQs
1. Can perimenopause start in your 30s?
Yes—early perimenopause can begin in the late 30s. Seek medical advice if symptoms occur before 40.
2. Is menopause the same for everyone?
No—some women have mild symptoms; others experience severe hot flushes, mood issues and health effects requiring treatment.
3. How long do hot flushes last?
Usually 3–7 years—but can last longer. Effective treatments are available to manage them.
4. Will HRT cause weight gain?
Not directly—HRT may help with metabolism, but weight shifts are best managed through diet and exercise.
5. Can I get pregnant during perimenopause?
Yes—ovulation still happens. Use contraception until 12 months after your last period if you wish to avoid pregnancy.
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Final Thought
Perimenopause and menopause are life chapters, not illnesses. Understanding your experience, seeking support, and making health-positive choices makes this transition smoother. You’re not alone—help is available and change is possible.