Menopause
Perimenopause
Understand the signs, symptoms and changes that can happen in the lead-up to menopause.
You can think of perimenopause as the transitional stage that comes before menopause. If your periods have started changing, you've noticed some new physical or emotional symptoms, or you simply don't feel quite like yourself, perimenopause could be the reason.
Perimenopause is a natural part of the menopause journey where hormone levels start to fluctuate, causing a variety of symptoms and changes throughout the body.
For some women*, this can feel confusing, as symptoms can develop gradually and might come and go. Understanding what to expect during perimenopause and what the key signs are can help you navigate this new chapter.
What is perimenopause?
Although 'menopause' is the term that's used most frequently, it's actually perimenopause that most people are talking about when referring to symptoms and hormonal changes.
It's during the perimenopause stage that the ovaries naturally start producing lower levels of hormones such as oestrogen and progesterone. However, these hormone levels don't steadily decline. Instead, they can rise and fall unpredictably, which is why symptoms can sometimes feel inconsistent and seem to appear suddenly.
The perimenopause stage ends once you've gone 12 consecutive months without a period. That's your official menopause 'marker'. After that, you're considered to be postmenopausal.
The first signs of perimenopause
For many women, changes to their menstrual cycle are among the earliest signs of perimenopause.
You might notice that your periods become:
- More irregular
- Heavier than usual
- Lighter than usual
- Closer together
- Further apart
- Less predictable
Some women start noticing other changes around the same time, such as sleep disturbances, mood swings or changing energy levels.
Perimenopause vs Menopause - what's the difference?
| Perimenopause | Menopause |
|---|---|
| The transition leading up to menopause | The point at which you've gone 12 months without a period |
| Hormone levels fluctuate | Hormone levels remain consistently lower |
| Periods usually continue, although they might become irregular | Periods have stopped completely |
| Symptoms often begin during this stage | Symptoms tend to ease, although some might continue after menopause |
What age does perimenopause start?
There's no set age when perimenopause begins, but most women start experiencing changes during their 40s. However, some women might notice symptoms in their late 30s, while others only start later in life.
Timing varies from person to person, so try not to compare your experience with someone else's. If you're concerned about any symptoms you're experiencing, it's always worth speaking to a healthcare professional.
How long does perimenopause last?
Perimenopause can last for several years, and everyone's experience is slightly different. The good news is that there are numerous ways you can help manage your menopause symptoms to avoid a significant impact on your day-to-day life - this might include understanding HRT treatments.
For some women, perimenopause might be relatively short. The transition is different for everyone, and there's no 'normal' timeframe that applies to everybody.
One of the reasons perimenopause can feel frustrating is because symptoms often change over time, becoming more noticeable during some stages than others.
How to know if you're experiencing perimenopause
There's no single test that can definitively confirm whether what you're experiencing is perimenopause, but healthcare professionals will usually consider several key factors:
- Your age
- Menstrual cycle changes
- Symptoms
- Medical history
For most women over 45, common symptoms and changes to their menstrual cycle are often enough to identify the start of perimenopause.
If you're unsure whether your symptoms could be related to perimenopause, it's worth discussing them with a healthcare professional.
Pregnancy and fertility during perimenopause
Although fertility naturally starts to decline with age, pregnancy is still possible during the perimenopause stage if you're still having periods.
If you don't wish to become pregnant, it's important to continue using contraception until you've received advice from a healthcare professional about when it's safe to stop.
What to expect after perimenopause
After perimenopause comes the milestone of menopause itself, which is reached once you've gone 12 consecutive months without a period. Following this, you'll enter the postmenopausal stage permanently.
Symptoms often begin to settle once you're in postmenopause. However, the hormonal changes your body experiences before and during menopause can sometimes lead to other symptoms later on.
For example, vaginal dryness, which is a common menopause symptom, can sometimes contribute to postmenopausal bleeding. However, any bleeding after menopause should always be checked by a healthcare professional.