From the signs to look out for to when it’s likely to start, here’s what you need to know

Most of us will have some awareness of the menopause, but what about perimenopause? If you’re at a loss, rest assured that you’re not alone. A recent Twitter poll of This Morning viewers[1] revealed that a significant proportion didn’t know what it was either, while another study, The State of Menopause[2], revealed that nearly half of women didn’t know the difference between perimenopause and menopause itself. 

There’s a sizeable knowledge gap, made worse by the fact that it’s feeding into a ‘suck it up’ mentality that’s ultimately preventing women from getting the support they need from their workplace or healthcare provider. (Indeed, a report produced by the Fawcett Society revealed that eight out of 10 menopausal women said their workplace had no basic support in place for them). 

The same report also revealed that almost half (45%) of the 4,000 perimenopausal and menopausal women surveyed said they hadn’t spoken to their GP about their symptoms, such as hot flushes and brain fog, despite the majority (77%) finding at least one menopause symptom ‘very difficult’, and 44% experiencing three or more symptoms of similar severity[3].

And of the women who did approach their surgery, 31% said it took many appointments before their GP realised they were experiencing menopause or perimenopause, leading to many remaining unaware or unsure if they’re actually going through this transition. But know that you’re not alone. As Dr Louise Newson, a GP and menopause specialist, told Holly and Phil on This Morning: "Even when I was perimenopausal, I had no idea what was going on. I thought I was working too hard. I was moody and irritable, had migraines and joint pains, I couldn’t sleep, my mood was low. Of course, these are all menopausal symptoms, but I didn’t know because I wasn’t monitoring my periods. I was 45 years old, an absolute classic age (for perimenopause), but it’s very hard to pick up."

As so many of us will experience perimenopause and menopause, it’s important we know what to look out for – especially as these signs and symptoms can often overlap as we transition from the perimenopause to menopause and then postmenopause . "We want to be empowered with information before we experience the menopause, but certainly even before the perimenopause so we know what to do," Dr Newson points out. 

So, with this in mind, here’s our perimenopausal fact sheet, so that you can spot the first signs of perimenopause and seek support if you need it.

One thing worth noting is that some perimenopause and menopause signs and symptoms can sometimes signify other underlying causes, so visit your GP if you’re concerned.

What’s the difference between menopause & perimenopause?

So, what is perimenopause and how does it differ to the menopause? 

Menopause is when your periods stop and you haven’t had a menstrual period for 12 months. It usually happens between the ages of 45-55[4], with the average age in the UK being 51 years[5].

Perimenopause is when you have menopausal signs and symptoms before your periods have stopped, due a drop in oestrogen[6]. Signs of perimenopause start months or even years before periods stop, but perimenopause most commonly occurs when women are in their 40s[7].

If you find your periods have stopped before the age of 45, it could be early menopause. It can happen naturally or as a side effect of some treatments. If you’re under 45 and have noticed your periods becoming infrequent or stopping altogether, speak to your GP.

What are the signs & symptoms of perimenopause?[8]

Signs and symptoms can be varied and wide-ranging, but may include one or more of the following: 

• Changes to your periods, includings irregular or heavier ones

• Hot flushes (also called hot flashes)

• Difficulty sleeping 

• Mood swings 

• Anxiety 

• Depression 

• Lowered sex drive 

• Vaginal dryness (almost 20% of women will experience this during perimenopause) 

• Brain fog and forgetfulness

• Dry and/or itchy skin

• Headaches or migraines that are worse than usual

• Weight gain

As there can be so many combinations and reasons behind some of these, it can be tricky to spot if they are due to perimenopause or something else.

Keep in mind that signs and symptoms differ from person to person, as well as in severity and duration, and if you’re at all concerned, see your GP. 

What can help perimenopausal symptoms

From tweaks to your diet to hormone replacement therapy (HRT) to restore female hormone levels, there are plenty of options available to create a plan of action best suited for your needs and to help manage your symptoms. 

Here are some things that may help:

• Eat a healthy diet, which includes calcium-rich foods, such as milk, yoghurt and kale to help keep bones healthy

• Exercise regularly and incorporate weight-bearing moves into your routine, such as walking or dancing

• Get plenty of rest and stick to a regular sleep routine

• Make time for relaxation by doing things like meditation or yoga.

• Talk to friends and family going through the same things, a support network is key

• Avoid alcohol

• Don’t smoke

• Consider cognitive behavioural therapy to help with low mood, anxiety or sleep problems

• Wear light clothing and keep your bedroom cool at night

• Use vaginal moisturisers or lubricants if you have vaginal dryness

• Speak to your GP if you are still experiencing symptoms to discuss your options, including whether hormone replacement therapy (HRT) is suitable for you

• Visit Boots Online Doctor Menopause & HRT Treatment service* for advice and treatment, if appropriate

Found this useful? Here’s more advice about managing the menopause and more details on HRT.

*Access to prescription-only medicine is subject to a consultation with a clinician to assess suitability .Charges apply.

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