What is perimenopause, and am I going through it?

Perimenopause is a natural transition that every woman will go through, but it can sometimes feel confusing or overwhelming. It’s the phase leading up to menopause when hormone levels start to fluctuate, bringing changes in your period, energy levels, mood, and more.. 

While some women may experience only mild changes, others will have more noticeable symptoms. Understanding what perimenopause is, how long it lasts, and what influences it can help you feel more in control during this stage of life.

What is perimenopause and when does it start?

Perimenopause is the transition leading up to menopause when hormone levels begin to change, marking the end of your reproductive years. It typically occurs in a woman’s 40s, but some women notice changes as early as their late 30s. 

The timing varies due to genetics, health conditions, medication use (such as oral contraceptives) and lifestyle factors like smoking, alcohol, exercise and nutrition. It’s important to pay attention to subtle shifts in your cycle and how you feel, as these can be early signs.

During this phase, the body starts to produce less of the hormones oestrogen and progesterone. For some women, it can feel like a roller coaster ride, where your hormones are fluctuating wildly, taking you up and down with unexpected symptoms.

Two key hormones to know: Oestrogen and progesterone

Before perimenopause, oestrogen supports muscle structure and function, helps with calcium absorption, maintains bone strength, assists in blood sugar balance, and regulates cholesterol levels. 

Progesterone has a calming effect, supporting a healthy mood, promoting sound sleep, and aiding thyroid function. Because these two key hormones drop during perimenopause, women need nutrition and lifestyle strategies to support their bodies through this transition.

How long does perimenopause last?

On average, perimenopause lasts 4 to 6 years, though it can be shorter or longer. It officially ends when a woman has been without a period for 12 consecutive months, marking the start of menopause.

Symptoms of perimenopause

While every woman’s experience is unique, common symptoms include:

• Hot flushes and night sweats that can disrupt sleep
• Mood changes like irritability or low mood
• Brain fog – trouble with memory, concentration, or focus
• Sleep disturbances – difficulty falling or staying asleep
• Changes in metabolism that may affect weight
• Irregular periods – cycles may be longer, shorter, heavier, or lighter
• Breast tenderness
• Fatigue – feeling exhausted even with enough sleep
• Changes in libido – fluctuating sexual desire or vaginal dryness
• Headaches or migraines

How to manage perimenopause

Managing perimenopause isn’t about just getting through it—it’s about feeling your best during this transition. Key strategies include:

• Building balanced meals: Include protein, fibre, and healthy fats to your meals to help balance blood sugar and prevent energy crashes.
• Prioritising key nutrients: These include vitamin D, calcium and protein for bone and muscle health.
• Supporting sleep: Create a relaxing nighttime routine and reduce screen time before bed.
• Moving regularly: Choose exercises that you enjoy. Strength training supports bone and muscle health, while walking or yoga may help to manage stress.
• Tracking symptoms: Use a diary or app so you can notice patterns and discuss with your healthcare professional.
• Taking care of your mental and emotional health. Mental health symptoms are not uncommon during perimenopause. In fact, most women in this stage of life will likely experience one or more of these symptoms over time. If you’re experiencing low mood or changes to your mood, please speak to your healthcare professional to find the best treatment options for you.

Are there supplements that can help?

While food should be the foundation of good health, some supplements may help with managing symptoms:

• Magnesium: May help to support sleep, mood, and bone health.
• Vitamin D and calcium: These are key for bone health, especially as oestrogen drops. A supplement may be beneficial if your needs are beyond what you can get from food or sunlight.
• Black cohosh: A herb traditionally used in Western herbal medicine for managing hormonal imbalances and perimenopause symptoms.
• Sage :  A herb that may help with hot flushes and night sweats.
• St John’s Wort : A herb that has been traditionally used to support healthy mood balance and relieve mild anxiety.
• Shatavari :  An adaptogen traditionally used in Ayurvedic Medicine to help the body adapt to stress.

Some supplements may have interactions with other medications. Always check with your healthcare professional before adding supplements to your routine.

The bottom line

Perimenopause is a unique journey for every woman, but understanding what’s happening can make it easier to handle. By listening to your body, making healthy nutrition and lifestyle choices, and seeking guidance when needed, you can move through this transition with confidence.

Reviewed by the Healthylife health experts February 2025.