Perimenopause is the phase before menopause when your hormones start to change. Perimenopause is the transition towards menopause, lasts on average 4-5 years Often progesterone drops first, estrogen can fluctuate between high and low before dropping significantly and testosterone gradually decreases over time. For many women, this begins in their early 40s but it can happen earlier. It is not a single moment. It is a gradual shift and it can show up in different ways. You might notice anxiety, poor sleep, brain fog, changes in your weight or irregular periods. These symptoms are often explained away or missed altogether. If you feel like something is not quite right, perimenopause could be part of the reason. Understanding that is often the first step towards feeling better.

You are likely in perimenopause if you are aged 40-50 and experiencing perimenopause symptoms.

Many women are told they are too young to be in perimenopause, especially under 45. In reality, symptoms can start in your late 30s or early 40s. Age alone is not a reliable guide. If you are noticing changes in your mood, sleep, energy or cycle, it is worth paying attention. Start writing down or using an app to track your symptoms. You know your body best.

In most cases, blood tests are not the best way to diagnose perimenopause despite advice from many doctors. Hormone levels fluctuate throughout the cycle and from month to month, so results can appear “normal” even when symptoms are very real. A good understanding of your symptoms and patterns is often more helpful than a single test result. According to OBGYN and Menopause Specialist Dr. Sharon Malone, “You don’t need a blood test because the reality is that every woman – 100 percent of people with ovaries – will go through Menopause. Most women between the ages of 40 and 50 will be in Perimenopause. If you are having any of the 34 symptoms of menopause, and you are in this age range, you are in Perimenopause.”

In perimenopause, it is common for women to start noticing changes. Your period may be shorter or longer, blood flow may be heavier or lighter. As perimenopause progresses, cycle length may vary by 7 days or more. In the beginning it may be an occasional skipped period, but in the late menopause transition women may skip 60 days or more.  One in three women still menstruating at age 45 reported unpredictable periods. By age 52, 1 in 10 reported that they still had predictable cycles.

Menopause is a point in time when a woman has had 12 consecutive months without a menstrual period. It begins on average at age 51 in UK/US with about 4 in 10 women reaching menopause by age 50 and 9 in 10 by 55.

I will listen your perimenopause symptoms and establish clear goals so that you get what you need. I'll share proven nutrition, exercise, stress-reduction and sleep strategies, as well as evidence-based facts on hormone replacement therapy (HRT). Then we will put together a customised plan that addresses your symptoms and goals and is doable for your real life. As you implement your plan, I will provide accountability and support so that you reach your goals. You don't have to do it alone!

There are many symptoms associated with perimenopause. The constellation and severity is very specific to each woman. Vasomotor Symptoms • Hot flashes: Sudden sensations of intense heat, often accompanied by sweating • Night sweats: Hot flashes during sleep Genitourinary symptoms: • Vaginal dryness: reduced lubrication and vaginal tissue thinning • Urinary incontinence: leakage of urine, especially with coughing, sneezing, jumping • Urinary urgency and frequency: sudden and frequent urges to urinate • Painful intercourse: due to vaginal dryness and tissue changes • Vaginal itching or irritation: discomfort in the vaginal area Psychological Symptoms • Sadness/Depression/Mood Swings. Estrogen stimulates serotonin, a major mood neurotransmitter, that brings on feelings of happiness. When estrogen levels drop, it can cause a drop-in serotonin in the brain, causing feelings of sadness or depression. • Anxiety/Stress/Panic. Estrogen and progesterone are involved in the production of the stress hormone cortisol. Thus, feelings of panic, stress and anxiety may be heightened as hormone levels change. • Brain fog. Difficulty concentrating, memory lapses, and impaired cognitive function Physical Changes • Sleep disturbances: difficulty falling asleep or staying asleep • Low libido • Weight gain: especially around the abdomen • Heart palpitations: feels like heart is racing/skipping beats • Fatigue: unexplained tiredness, constant or periodic • Digestive problems • Joint pain and muscle aches, frozen shoulder • Headaches and migraines • Skin and hair changes: drying, thinning, texture changes • Body odor changes • Breast tenderness/pain

There are many things that women can do to get relief from their symptoms, including nutrition, exercise, sleep and stress reduction strategies and hormone replacement therapy (HRT).