You’ve probably heard about the menopause, but the perimenopause is the period before it and can last for up to 10 years,
Brace yourself – while most of us are aware of the menopause and the symptoms to expect, the perimenopause still remains a bit of a mystery.
Technically, it’s the period just before menopause and can affect your body from head to toe, for up to 10 years.
It pays to prepare for the perimenopause, so here’s what you need to know.
Perimenopause vs menopause
Many of us mix up these two terms but in the medical world they have two clear definitions:
- Menopause is the point when your periods actually stop. You’re defined as being menopausal one year after your last actual period
- Perimenopause is the years preceding menopause, when you experience a number of hormonal and body changes, and the symptoms that occur
Perimenopause can begin in your early 40s, while the average age of true menopause in the UK is 51.1
Every woman goes through this hormonal upheaval but not all of us will notice its effects.
That’s because the symptoms of perimenopause are often dismissed as natural signs of ageing, or as being caused by other health issues.
If you’re uncertain if it could be menopause or perimenopause that you’re experiencing, please speak to your GP or HCP, or use this article for some extra guidance.
What is the typical age you start perimenopause?
We've mentioned when true menopause begins on average for people in the UK, but when is the typical age you start perimenopause?
GPs here in the UK state that the average perimenopause age is 45 years old, but it can begin for some people in their 30s.2
What are the symptoms of perimenopause?
There are over 30 perimenopause symptoms but some of the most common include:
- Changes in the menstrual cycle Breast discomfort
- Hot flushes and night sweats
- Mood swings, irritability and anxiety
- Sleep problems
- Loss of libido and vaginal dryness
- Memory lapses and brain fog
- Joint pain
While these are listed as some of the most common signs of perimenopause, we’ve explained a couple of the slightly vaguer symptoms below:
Diving into a little more detail, you may be wondering what to expect when it comes to your periods during perimenopause. It could be different in a number of ways, including missed periods, changes to your flow (e.g., lighter or much heavier), changes to the length of your cycle or spotting/bleeding in between periods.3
However if you’re concerned about changes to your menstrual cycle, speak to your GP or a specialist for advice tailored to you and your body.
Ah that old familiar feeling. Breast discomfort is something we may experience throughout our lives, thanks to hormonal shifts during our menstrual cycle.
And many can experience it during perimenopause, too. In fact, the National Cancer Institute highlights menopause (and perimenopause) as a potential reason for changes in your breasts, such as tenderness, lumpiness and potentially a reduction in their size.4
If you are concerned about these symptoms, it’s incredibly important to speak to your GP and to attend regular breast cancer screenings.
Considered the most common symptom of perimenopause (and full menopause), hot flushes describe the sudden feeling of heat rushing through the upper body.
The scientific name for this is vasomotor symptoms (VMS), which refer to the temperature dysfunction which takes place during this time, due to changes in gonadal hormones.5,6 These are the hormones produced in the testes or ovaries.
On a similar note, the Sleep Foundation states that hot flushes are one of the most common causes of night sweats, showing that the two often go hand in hand.7
If you’re going through perimenopause right now, you might be familiar with the mood swings. From feeling full of rage, to sadness, to general irritability - you’re not alone. In fact, one study discovered that 70% of women experienced irritability as their main symptom.8
And there is a scientific reason for these changes too, as oestrogen (which declines during perimenopause) has an impact on happy hormones like serotonin.9
How to help reduce the symptoms of perimenopause
You can manage your perimenopause symptoms in a number of ways, but one of the most common is by directly targeting the symptoms themselves.
Here are three perimenopause remedies that have been shown to help, alongside altering your diet and lifestyle habits:
A traditional herbal medicine used to relieve excess sweating and hot flushes, based on traditional use only.
Sage binds to receptors in the brain believed to be involved with temperature control.10
A 2011 trial involving 71 women who experienced a daily average of five hot flushes found that taking sage every day could cut their flushes by 50% in four weeks, and 64% in eight weeks.11
Black cohosh is another traditional herbal medicinal product used for the relief of menopause symptoms.
The root of this plant contains compounds which bind to oestrogen receptors throughout the body, which may reduce the hormone’s effects.12
A study published in the Journal of Education and Health Promotion in 2018 comparing black cohosh to evening primrose oil, another remedy known to offer perimenopause support, found both reduced the severity of flushes within eight weeks but black cohosh could also reduce the number of flushes.13
Although, it’s important for us to point out that while there is some evidence to suggest black cohosh may help with these symptoms, the quality and safety of these products may be unknown and different versions may vary.
Additionally, black cohosh is not recommended for the treatment of menopausal symptoms in women with breast cancer.
These contain substances called phytoestrogens that mimic oestrogens in the body, so it’s thought that they can help moderate the symptoms of perimenopause.
The evidence so far is mixed but some research does show they may reduce hot flushes, and anxiety and depression associated with menopause.14,15
Exactly why the studies are so varied isn’t completely understood but a 2012 trial led by the University of Washington found women who can convert soy into a substance called equol were more likely to get positive effects from it – so the effects could be highly individual.16
For more advice on what you can take to help manage perimenopause symptoms, head to our article on the 12 best supplements for perimenopause.
What are the stages of perimenopause?
So, to recap on what you might experience and when, here’s an overview of the stages of perimenopause:
- From your late thirties to forties, your cycle will still be pretty regular, although some small changes may be happening
- During this time, your oestrogen and progesterone levels will go up and down, but generally your oestrogen levels start to decrease which throws off the balance with progesterone
- Because these two hormones are responsible for ovulation and menstruation, as time goes on, your periods will become more and more irregular
- Eventually, you will have your last ever period17,18
After a year has passed, you’ll be classed as being in true menopause
The final say
Perimenopause is the transitional stage before menopause, and everyone’s experience of it can be different. So, we hope you’re feeling a little bit more confident about the various stages and signs of perimenopause, and whether it’s what you’re experiencing or not.
The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.
Last updated: 15 December 2022