How to recognise the early signs of perimenopause

For most women, recognising menopause is relatively simple – it’s the time when you haven’t had a period for 12 consecutive months because your ovaries have stopped producing eggs and your levels of oestrogen (oestradiol), progesterone and testosterone have fallen.

Perimenopause, on the other hand, is a little more tricky to pinpoint. It’s defined as the time directly before menopause, when hormone levels start to decline. Your periods may still be regular or they can change in nature or frequency (or both).

The average age a woman in the UK experiences menopause is 51 [1], although it can occur earlier or later than this. Perimenopause can vary in length from a few months to around a decade, and often women start to have symptoms when they are in their early 40s or younger.

Like with menopause there are numerous symptoms of perimenopause – in fact the symptoms of perimenopause and menopause are the same, with the exception that you don’t have periods once you are menopausal.

What are the symptoms of early perimenopause?

Because you have hormone receptors all over your body, the fluctuating and lower levels of hormones you experience in perimenopause and menopause can have a wide-reaching effect. Yet some women do not realise their symptoms are due to perimenopause – they may put them down to stress or being busy.

Symptoms can include:

• Mind and cognition: including difficulty concentrating, memory problems
• Mood and sense of self: including mood swings, feeling low or depressed, loss of interest
• Nervous system: including low energy, migraines, loss of interest in sex, hot flushes and sweats
• Skin and hair: including dry skin, hair loss, brittle nails
• Digestive system: including weight gain, bloating, heartburn
• Menstrual cycle: including irregular periods
• Genitourinary system: including vaginal dryness, painful sex, urinary incontinence
• Musculoskeletal system: including joint pains, muscle pains.

This list is not exhaustive. Women can be surprised to learn that symptoms such as heart palpitations, dry eyes, burning mouth, altered sense of smell and worsening of existing health conditions can be due to perimenopause.

When should I see a doctor about early signs of perimenopause?

Some women mistakenly believe they need to wait for their periods to stop, or for their symptoms to become ‘bad enough’, before seeking advice from a healthcare professional. This isn’t the case.

You may experience symptoms of perimenopause over several years (or for just a few months) but there is no need to wait to get help. Some women find that they have more severe symptoms during perimenopause, when their hormones are fluctuating, than during menopause when hormone levels tend to settle down more.

We’re all different and your menopause is completely individual to you so don’t compare yourself to others and seek help or simply get more information when you need it.

If you want to talk to a Newson Clinic healthcare professional about your symptoms, book an appointment here.

References

1. National Institute for Health and Care Excellence (NICE) (2024) Menopause: what is it?