What Is Perimenopause?

Perimenopause is the stage, which precedes menopause, the time you have your last period. Perimenopause usually lasts 2-8 years and it is characterised by falling levels of oestrogen, which prepare the body for menopause and result in the last period, which occurs when eggs are no longer released by the ovaries. Most women start to develop symptoms of perimenopause in their mid-late 40's, but some women have signs a lot earlier. The duration of perimenopause can vary significantly; some women have just a few months of symptoms, while others go through perimenopause for up to 10 years; the average length is 4 years.

Premenopausal symptoms

During perimenopause, it is common to experience symptoms including:

  • irregular periods
  • hot flushes
  • tender breasts
  • loss of libido
  • tiredness
  • vaginal dryness, which may result in pain during sex
  • increased urination and reduced bladder control
  • night sweats
  • mood swings and irritability
  • disturbed sleep
  • insomnia
  • heightened pre-menstrual symptoms, such as cramps

Usually, in the last 12-24 months before menopause, the symptoms of perimenopause become more apparent, as the levels of oestrogen fall at a faster rate.

There is no specific test to diagnose perimenopause and a doctor will usually make a diagnosis based on your age and your symptoms.

Should I see a doctor?

It is normal to experience symptoms during perimenopause, but if your symptoms are interfering your day to day to day life or you are worried about problems such as very heavy bleeding, severe cramps, bleeding after sex or spotting between periods, you should seek help from your GP. There are many possible causes of irregular and abnormal bleeding and it may be best to get checked out, just in case there is an underlying cause, which is not associated with perimenopause.

Perimenopause and pregnancy

During perimenopause, fertility decreases, but as you are still having periods and your ovaries are releasing eggs, it is still possible to get pregnant. If you are having sex during perimenopause and you do not wish to conceive, you should continue to use contraception.

Treatments used during perimenopause

If you have severe symptoms during perimenopause, there are treatments out there that can help. Treatments that may be recommended for hot flushes include contraceptive pills (usually a low dose), hormone replacement therapy (known as HRT) and the contraceptive patch. Self-help techniques can also help to reduce symptoms; some examples include regular exercise, giving up smoking, keeping your fluids up, eating a balanced and healthy diet, maintaining a healthy body weight, drinking in moderation and getting enough sleep.


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