Understanding Perimenopause

Understanding Perimenopause


Menopause is when your periods stop due to lower hormone levels. This usually happens between the ages of 45 and 55. Perimenopause however, is when you have menopause symptoms before your periods have stopped. Symptoms can start as early as your 30s and 40s, before your periods stop. These symptoms can have a big impact on your life, including relationships and work. This article looks at the things you can do to help and manage symptoms. 

Common symptoms of perimenopause

Perimenopause symptoms can feel different for everyone. You may have a number of symptoms or none at all. Here are the most common:

  • changes to your period: a change in the normal pattern of your periods, for example they become irregular.
  • changes to your mood: low mood, anxiety, mood swings and low self-esteem 
  • problems with memory or concentration (brain fog)
  • hot flushes
  • difficulty sleeping or night sweats 
  • palpitations
  • headaches and migraines that are worse than usual
  • muscle aches and joint pains
  • changed body shape and weight gain
  • dry and itchy skin
  • reduced sex drive
  • vaginal dryness 
  • recurrent urinary tract infections (UTIs)

Symptoms may last for months or years, and can change with time. For example, hot flushes and night sweats may improve, and then you may develop low mood or anxiety. Some symptoms, such as joint pain and vaginal dryness, may also carry on when you reach menopause.

Managing symptoms

Lifestyle changes such as eating well, exercising and looking after your mental wellbeing can help with symptoms during perimenopause. Try to:

  • get plenty of rest and keep to regular sleep routines
  • eat a healthy diet
  • have calcium-rich food like milk, yoghurt and kale to keep your bones healthy
  • exercise regularly and try to include weight-bearing activities where your feet and legs support your weight like walking, running or dancing
  • do relaxing activities like yoga, tai chi or meditation
  • talk to other people going through the same thing, like family, friends or colleagues
  • avoid smoking and drinking alcohol

To ease hot flushes and night sweats try:

  • wearing light clothing
  • keeping your bedroom cool at night
  • taking a cool shower, use a fan or have a cold drink
  • trying to reduce your stress level
  • avoiding or reducing potential triggers, such as spicy food, caffeine, hot drinks, smoking and alcohol
  • exercising regularly
  • losing weight if you’re overweight

To ease vaginal dryness try:

  • vaginal moisturisers or lubricants you can get at your local pharmacy
  • using condoms if you’re having sex. Do not use oil-based lubricant as this can damage condoms, use a water-based lubricant.
  • treatments for vaginal dryness from your GP, such as hormonal treatment (creams, pessaries, gel or vaginal rings).


The main medicine treatment for perimenopause symptoms is hormone replacement therapy (HRT), which replaces the hormones that are at low levels.

There are alternative treatments if you cannot, or choose not to, have HRT, such as:

  • testosterone gel for reduced sex drive
  • oestrogen for vaginal dryness and discomfort
  • Clonidine
  • antidepressants 
  • Gabapentin
  • cognitive behavioural therapy (CBT)

Help & support

Your GP, nurse or pharmacist can give you advice and help with your perimenopause symptoms. There are also specialists who have experience in supporting anyone going through perimenopause and menopause. You can find your nearest NHS or private menopause specialist on the British Menopause Society website.

Psychological therapies like counselling or CBT (cognitive behavioural therapy) can also help with symptoms of perimenopause. You can get NHS psychological therapies without seeing your GP first. Click here to find an NHS psychological therapies service.

If perimenopause is affecting your everyday life, you can reach out to Menopause Matters for support. Queermenopause is also available to support people who identify as LGBT+