What is perimenopause?

Perimenopause refers to the year or years before your periods stop completely. It is a time of natural hormone transition towards menopause. During perimenopause, the body’s production of estrogen and progesterone, two hormones made by the ovaries, varies greatly.

It is these changing hormones that can cause symptoms to develop.


When does it start?

Perimenopause can start any time from your late 30’s, but most commonly occurs in your mid 40’s to 50’s.


How long does perimenopause last?

It can last from 3-10 years with a big variation in symptom severity.

20% of people will have no symptoms and 60% have mild symptoms. The other 20% have symptoms that interfere with their daily life, and these people may require medical help.


What are the symptoms of perimenopause?

There are many symptoms that may indicate you are in this transition time, heading towards menopause. For some people there may be a worsening of problems they already have, such as bladder or bowel control, and for others it could be the start of problems. Some won’t really notice any changes, others may have some of the following:

Neurological symptoms: – migraines, headaches, anxiety, depression, mood swings, brain fog, insomnia, sleep disturbance.

Vascular symptoms: hot flushes, night sweats, heart palpitations.

Period changes: very heavy periods and/or changes in period frequency or period pain. Others may start to notice a lighter flow.

Abdominal weight gain

Breast swelling / pain

Genito-Urinary Symptoms of Menopause (GSM): vaginal dryness, pain with vaginal penetration, loss of libido, bladder leakage, or urgency to get to the toilet.

Note: Some of these symptoms can be from other causes so please check with your doctor if you are concerned.


Bad timing!

Perimenopause often occurs at a time in your life when things can be pretty hectic! It may coincide with raising children / teenagers, when aging parents are needing more help, or when you have a more demanding job. Trying to juggle all these balls at once, as well as deal with hormone changes, can be a challenge.


What people going through perimenopause say:

“I thought I was going crazy”

“I was ashamed I was going through this”

“What the hell is going on?”

“What have I done wrong?”

“Did I not look after myself?”

By raising awareness of perimenopause we want you to know you are not alone, it is not your fault, it is normal and you are not going crazy!


For most people, thankfully, symptoms ease up and eventually pass. We like this quote from Dr Jerilynn Prior, Professor of Endocrinology, University of BC. “The turbulent time of perimenopause ends in the kinder and calmer period of menopause”.


When are you in menopause?

Perimenopause (the menopausal transition) is often referred to as “menopause”, but you’re not in true menopause until you’ve had a full year without a period. Menopause can also be triggered by a hysterectomy or removal of the ovaries.

After menopause, you are more vulnerable to heart disease and osteoporosis, so it’s important to eat a healthy diet, remain active and get enough calcium for optimal bone health.


Further help

Click here for information on how to ease the transition to menopause.


Click here to find out how pelvic health physiotherapists can help with bladder, bowel and sexual health.