Perimenopause Symptoms: What are they and how can I manage them?

Perimenopause is something most women will go through as they age. However, it can cause significant symptoms that wreak havoc on your daily life.

Perimenopause can be different for each woman. Some women may experience worse symptoms than others and some may only have a handful of mild symptoms develop.

At The McIndoe Centre, we understand the difficulties that perimenopause can bring. That’s why we’re here to explain what perimenopause is in more detail, highlighting its associated symptoms and how to manage them effectively.

Understanding perimenopause

Perimenopause is the name for the transition a woman’s body goes through before reaching menopause (when your periods have stopped for 12 months or longer). Lasting between four and eight years, it represents the time before your periods stop altogether and can lead to problematic symptoms for some women.  

Biologically speaking, perimenopause is the time when your ovaries gradually stop releasing eggs. 

The reason your body stops ovulating is due to hormonal changes. As you age, you naturally decrease the amount of oestrogen and progesterone you produce, signalling the end of your reproductive years and transitioning your body into menopause. 

Perimenopause can occur at any time from your mid-30s to your mid-50s. If you go through perimenopause and menopause before the age of 40, it is known as ‘premature menopause’. 

Premature menopause can sometimes be caused by premature ovarian failure – a condition which stops your ovaries from working as they should before the age of 40 years old.  

However, it may also be caused by other factors such as:  

  • Genetics (premature ovarian failure can run in families) 
  • Cancer treatments (such as chemotherapy or radiotherapy) 
  • Autoimmune conditions 
  • Chromosome abnormalities  

Decreased oestrogen levels and how they affect perimenopause

Perimenopause is caused by decreased levels of oestrogen. This leads to symptoms like hot flushes, vaginal dryness and brittle bones (osteoporosis) that are more prone to fractures or breaks. 

It may also contribute to changes in your blood cholesterol levels. For instance, low oestrogen levels can increase your level of ‘bad’ cholesterol (low-density lipoprotein) which could lead to an increased risk of heart disease 

Common perimenopause symptoms 

Symptoms of perimenopause can vary and may be more severe in some people than others. Generally, the first sign of perimenopause is changes to your menstrual cycle.  

The most common perimenopause symptoms include:  

  • Heavier or lighter than usual periods 
  • Skipping periods or shorter or longer periods 
  • Hot flushes 
  • Vaginal dryness 
  • Night sweats 
  • Urinary incontinence or urgency 
  • Problems sleeping (insomnia) 
  • Mood swings 
  • Low mood or depression 
  • Low libido (sex drive) 

Some symptoms can be more severe, and you may experience a high number of symptoms or only a few.  

Menopause Management at The McIndoe Centre

Fast access consultations with a GP and Menopause Specialist who can provide advanced hormonal testing and bespoke HRT prescriptions tailored to each patient.

Managing perimenopause symptoms 

Managing perimenopause symptoms can require a multi-faceted approach. 

Some symptoms may be manageable with lifestyle changes and certain medications. Insomnia and low moods, for example, could be alleviated with regular exercise. Vaginal creams and lubricants can also help manage vaginal dryness symptoms, but won’t treat the root cause.  

However, sometimes hormone replacement therapy (HRT) may be used to help menopause symptoms. 

Hormone replacement therapy  

Hormone replacement therapy, or HRT, is one of the most common ways for women to manage perimenopause symptoms. It will often be recommended by your doctor within the first ten years of experiencing perimenopause symptoms.  

Oestrogen and progesterone are vital hormones your body needs during your reproductive years. However, when you go through perimenopause, both of these decrease naturally in your body as you get older and head into perimenopause.  

These low levels of hormones can lead to a myriad of symptoms but with the help of HRT, they can be effectively managed.  

Using HRT in this way could help you manage symptoms like:  

  • Hot flushes 
  • Night sweats 
  • Insomnia 
  • Mood swings 
  • Mood changes  
  • Vaginal dryness 

HRT is a prescribed medication that contains either oestrogen and progesterone (combined HRT) or oestrogen only to replace the hormones you’ve lost. Combined HRT uses progesterone to prevent the lining of your womb from getting too thick and reduces your risk of endometrial and uterine cancer.  

If you no longer have a uterus, then you will be prescribed oestrogen-only HRT as you won’t need progesterone to mitigate uterine cancer risks.  

Types of HRT 

HRT is available in many different forms such as tablets, patches, creams and gels. The right choice for you will depend on your personal preferences and your likelihood of remembering to take tablets over having an injection every three to four weeks. 

Finding the right HRT dose can also take a bit of trial and error. For this reason, you’ll normally start at a lower dose and work your way up if you need something stronger to help alleviate your symptoms.  

Who is HRT suitable for? 

HRT isn’t right for everyone, so you’ll need to undergo a thorough consultation with your doctor before starting it. 

Some of the reasons HRT might not be right for you can include:  

  • A history of breast cancer, ovarian cancer or uterine cancer 
  • A history of blood clots  
  • Untreated high blood pressure 
  • Liver disease 
  • Pregnancy 

Coping strategies for perimenopause symptoms 

While HRT can be useful for managing perimenopause symptoms, taking care of your overall wellbeing can be a good way to support a further reduction in your symptoms.   

Here are a few coping strategies than can be used to help with perimenopause symptoms:  

  • Maintaining a healthy weight through a nutritious diet and regular exercise 
  • Wearing light clothing to manage hot flushes 
  • Keeping your bedroom cool to reduce night sweats 
  • Avoiding triggers like caffeine and alcohol (these can increase hot flushes and anxiety) 
  • Practising mindfulness techniques or meditation to help manage anxiety 
  • Wearing layers of clothing you can easily remove if you experience a hot flush 

If you’re struggling with your mental health during perimenopause, always make sure to reach out for help. A loved one can provide you with a supportive shoulder and a licensed therapist or counsellor can offer professional advice.  

Undergoing a women’s health check can also provide you with further information on how to cope with your symptoms and ensure there are no underlying problems.  

Book a consultation with The McIndoe Centre

Managing symptoms of perimenopause can take time and neither coping strategies nor HRT will provide immediate relief. HRT can take weeks or even a few months to have the full effect, so you need to be patient when trying to cope with your symptoms.  

At The McIndoe Centre, we offer menopause management. Our GP-led service provides you with access to a personalised consultation, HRT prescriptions, lifestyle and complementary therapy advice and follow-up appointments.  

If you’re trying to alleviate symptoms of perimenopause, get in touch with our team today.

Patient story: Sarah Jenner

It was September 2023 when Sarah began to experience a change in her mood and not feel like herself, all common signs of perimenopause.  Follow her journey after she discovered the Menopause Management Service and found an HRT treatment that suits her active lifestyle.

News and articles

We offer a range of news and blog articles to enable people to make more informed decisions when it comes to the treatments we have at The McIndoe Centre.