- Perimenopause is the transition phase before your periods stop completely.
- Symptoms often start in your 40s and include irregular periods, mood swings, and poor sleep.
- Diagnosis is usually based on your symptoms, not blood tests.
- Perimenopause is a normal life stage, and support is available.
What Exactly Is Perimenopause?
Perimenopause, meaning "around menopause," is the transitional time before your periods stop for good. It's a natural process where your ovaries' production of oestrogen and progesterone starts to fluctuate and decline. This hormonal shift is what causes the symptoms many women experience.
This stage can begin in your 40s, or sometimes earlier. For many women I see, the unpredictability is the hardest part. Unlike menopause itself, which is a single point in time, perimenopause is a journey that lasts for several years on average.
Common Early Signs to Look For
The most well-known sign is a change in your menstrual cycle. Your periods might become lighter, heavier, longer, shorter, or the time between them might change. This irregularity is a classic hallmark of perimenopause.
But it's not just about periods. You might also notice mood swings you can't explain, increased anxiety, or feeling low. Disrupted sleep is another very common complaint, often due to night sweats, leaving you feeling exhausted. Brain fog, vaginal dryness, and a lower libido can also be early indicators.
How Is Perimenopause Diagnosed?
If you're over 45, your GP can usually diagnose perimenopause based on your symptoms alone. With long NHS waiting lists for specialist care, having a clear list of your symptoms can help you get the right support from your GP faster.
A blood test to check hormone levels isn't generally recommended because your hormones fluctuate so much day-to-day that the results can be misleading. The next step is to discuss how to manage your symptoms, which could involve lifestyle adjustments or exploring options like Hormone Replacement Therapy (HRT).
Frequently asked questions
Can I get pregnant during perimenopause?
Yes, it's possible. Your ovulation is irregular but it can still happen. If you do not want to become pregnant, you must use contraception until you have gone 12 full months without a period (or two years if you're under 50).
How long does perimenopause last?
The duration varies significantly between women. The average length is around four to five years, but it can be shorter or much longer for some. It ends when you have not had a menstrual period for 12 consecutive months.
Do I need a blood test to confirm perimenopause?
Usually, no. For women over 45, the National Institute for Health and Care Excellence (NICE) guidelines state that a diagnosis can be based on your symptoms alone. Blood tests are typically only used for younger women or if the picture is unclear.
What's the difference between perimenopause and menopause?
Perimenopause is the transition period leading up to menopause, when your ovaries gradually begin to make less oestrogen. Menopause is the point in time 12 months after your last period. Post-menopause is the stage after that.
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