Perimenopause Symptoms and What Actually Helps
Perimenopause often arrives uninvited and unannounced. One day you are fine. The next you are lying awake at 3am wondering why your body suddenly feels unfamiliar.
What Is Perimenopause
Perimenopause is the transition phase before menopause. It typically begins in your mid 40s but can start earlier. During this time, oestrogen levels fluctuate unpredictably before eventually declining.
This hormonal turbulence causes the symptoms that make perimenopause so challenging to live with.
The Symptoms Nobody Warns You About
Hot flushes and night sweats get all the attention. But perimenopause affects far more than your temperature regulation.
Brain fog makes you forget words mid sentence. Concentration becomes difficult. You walk into rooms and cannot remember why.
Sleep disruption goes beyond night sweats. Many women experience insomnia, early waking, or unrefreshing sleep regardless of sweating.
Mood changes can be dramatic. Anxiety appears from nowhere. Irritability flares. Some women experience their first depressive episodes during perimenopause.
Joint and muscle pain surprises many women. Oestrogen affects joint lubrication and muscle recovery. As levels drop, aches and stiffness increase.
Weight distribution shifts. Even without gaining weight, you may notice changes in where fat is stored, typically moving to the abdomen.
Skin and hair changes include dryness, thinning, and changes in texture. Your regular skincare routine may suddenly seem inadequate.
Urinary symptoms like increased frequency, urgency, and recurrent infections become more common as oestrogen levels fall.
Why Symptoms Vary So Much
Every woman's perimenopause is different. Some sail through with minimal disruption. Others find daily life significantly affected. The difference relates to how quickly hormones fluctuate, individual sensitivity to hormonal changes, and overall health.
What Actually Helps
Lifestyle adjustments make a genuine difference for many women. Regular exercise, particularly strength training, helps with weight management, mood, sleep, and bone health. Reducing alcohol and caffeine often improves sleep and reduces hot flushes.
Hormone replacement therapy remains the most effective treatment for most perimenopause symptoms. Modern HRT is safe for most women and can be transformative. Your GP can discuss whether HRT is appropriate for you and which type suits your situation.
Non hormonal medications can help specific symptoms. Certain antidepressants reduce hot flushes. Vaginal oestrogen treats urinary and vaginal symptoms with minimal systemic absorption.
Cognitive behavioural therapy has evidence for helping women manage hot flushes and the psychological aspects of menopause.
Getting Proper Support
Many women struggle unnecessarily because they do not realise what they are experiencing is perimenopause, or because they cannot access proper care.
A women's health GP can assess your symptoms, discuss your options, and create a treatment plan that addresses your specific concerns. You do not have to simply endure this transition.
Frequently Asked Questions
How do I know if it is perimenopause or something else? Your GP can assess your symptoms and may arrange blood tests. However, hormone levels fluctuate significantly during perimenopause, so tests are not always definitive. Diagnosis often relies on symptom pattern and age.
Is HRT safe? For most women under 60 or within 10 years of menopause, the benefits of HRT outweigh the risks. Your GP can discuss your individual risk factors.
How long does perimenopause last? Typically four to eight years, though some women experience symptoms for longer.
Can I still get pregnant during perimenopause? Yes. Contraception is needed until 12 months after your last period if over 50, or 24 months if under 50.
Perimenopause is challenging but treatable. The right support makes this transition far more manageable.