Perimenopause
The years leading up to menopause
Perimenopause, often referred to as “pre-menopause,” is the transitional phase before menopause. It can begin several years before a woman’s final menstrual period, commonly in the early to mid-40s, though for some it may start earlier. During this time, hormone levels — particularly oestrogen and progesterone — fluctuate unpredictably.
Periods may become irregular, heavier or lighter, closer together or further apart. Ovulation may not occur every cycle, which can contribute to symptoms such as:
- Hot flushes and night sweats
- Sleep disturbance
- Mood changes, anxiety, or low mood
- Brain fog or difficulty concentrating
- Breast tenderness
- Headaches
- Changes in libido
- Joint aches
Because hormone levels can swing dramatically during perimenopause, symptoms may feel inconsistent or confusing. Many women are unsure whether what they are experiencing is “normal,” especially if blood tests appear within standard ranges. Education, reassurance, and individualised care are often key during this stage.
Menopause is a natural and unavoidable life stage that every woman will experience if she reaches midlife and beyond. While it is a normal biological transition, the experience is highly individual. Some women move through it with minimal disruption, while others notice significant physical, emotional, and cognitive changes. Understanding what to expect — and knowing that effective support and treatment options are available — can make this transition far more manageable.