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Are you in perimenopause?

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.

What are the symptoms of perimenopause?

There are over 30 symptoms but some of the most common include:

  • changes in the menstrual cycle – you might skip periods, find they are lighter or much heavier
  • 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

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Reduce the symptoms of perimenopause

You can tackle perimenopause symptoms in two ways; by fooling the body into forgetting that your hormones are changing, or by directly targeting the symptoms themselves. Here are three remedies that have been shown to help:


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.2 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.3

Black cohosh

Black cohosh is another traditional herbal medicinal product used for the relief of menopause symptoms, which is now being backed by science. The root of this plant contains compounds which bind to oestrogen receptors throughout the body,4 which may reduce the hormone’s effects. 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.5

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Soy-based foods

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.

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.6

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Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies.
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1. NHS Choices. Menopause. Available from:
2. Kargozar R, Azizi H and Salari R. A review of effective herbal medicines in controlling menopausal symptoms. Available from:
3. Bommer S, Klein P, Suter A. First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Available from:
4. As Source 2
5. Mehrpooya M, et al. A comparative study on the effect of ‘black cohosh’ and ‘evening primrose oil’ on menopausal hot flashes. Available from:
6. Data presented at North American Menopause Society Annual Meeting. Equol-Producer Status Of U.S. Women Influences Soy Food Effects On Menopause Symptoms. Available from:

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