First Signs of Perimenopause – What Exactly Is Perimenopause?

There’s a lot of focus on menopause itself, but where’s the dedication to perimenopause and the first signs of perimenopause? The answer? Right here!

Perimenopause is a transition period, acting as the middle-woman between pre-menopause to menopause.

This is a turbulent time with a significant amount of changes, which can cause you to feel unsettled. Knowing as much as you can about perimenopause allows you to prepare, as well as know the first signs of perimenopause and what’s considered ‘normal.’ And, most importantly, you’ll learn how to manage your perimenopause at home.

No one should be doomed to suffering in silence. So, let’s dive into everything you need to know about perimenopause!

What is perimenopause?

Perimenopause is a transitional period where your body makes the shift towards menopause. At this point, your ovaries won’t produce as many hormones which is why your periods can become more erratic and irregular.

Essentially, perimenopause is the period of time where your body is reaching the end of your reproductive years.

When the first signs of perimenopause show themselves and perimenopause begins

Everyone is different and every body is different. Perimenopause can start at different stages for everyone. Perimenopause can begin as early as your mid-30’s. On the other hand, you might transition into perimenopause as late as your mid-50’s.

Typically, perimenopause starts 8 to 10 years before you reach menopause. Generally, you’re likely to embark on perimenopause in your mid-40’s. Although, as mentioned before, you could start earlier.

If you’ve reached menopause before 40, it’s classed as premature menopause. This can happen because of various medical conditions or surgery. However, if no medical intervention or condition has contributed toward reaching menopause before 40, this is called primary ovarian insufficiency.

When perimenopause ends

Perimenopause ends when you have officially reached menopause. Menopause is official once you haven’t had a period (or spotting) for 12 consecutive months.

Why does perimenopause happen?

Perimenopause happens because of a change to your hormones (which is responsible for a bunch of your symptoms, too!).

In perimenopause, your oestrogen levels, produced by your ovaries, fall. Oestrogen is really important when it comes to your reproductive system. As your oestrogen levels decline, the balance between oestrogen and progesterone levels are no longer balanced.

During perimenopause, your hormone levels will fluctuate: going up and down frequently.

Even a slight change to your levels can result in symptoms, so you’ll spot the change when you recognise the first signs of perimenopause.

What’s the difference between perimenopause and menopause?

Menopause is, essentially, one day. Perimenopause is the period of time leading up to that day.

Perimenopause literally means “around menopause.” This is when you’ll have symptoms linked to menopause during perimenopause but your periods have not yet stopped.

Remember, menopause is official once you have had no periods or spotting for 12 months in a row.

How is perimenopause diagnosed?

Because perimenopause is a process and a transition, there isn’t a test to “diagnose” you with being perimenopausal.

Your GP will take a number of factors into consideration such as your age, history of your menstrual cycle and the symptoms you’re experiencing.

What perimenopause feels like

It’s really important to note that perimenopause should never feel like you’re dying.

Perimenopause can feel different for everyone. Some women experience a wide range of symptoms while others can go through the entire transitional period without feeling any different.

There’s no “right” way to feel during perimenopause. There’s such a range of perimenopause symptoms, from physical ones to emotional and mental ones. Some women feel like they’re going crazy during perimenopause. Others feel totally fine.

No one journey is identical to another in perimenopause. That’s why everyone’s first signs of perimenopause are unique.

How do I know when I’m no longer perimenopausal?

Once you reach menopause officially, you’re no longer perimenopausal. Menopause is official when you have had no periods (or spotting) for 12 consecutive months. That’s why it’s so important to track your periods.

There are a heap of period tracking apps out there, from Flo to Clue. Some apps also allow you to track your symptoms, which is exceptionally helpful during perimenopause.

Signs of perimenopause

So, what are the first signs of perimenopause? Remember, perimenopause is unique for every woman. You may experience zero symptoms whatsoever or you might live through a handful of them.

Let’s take a look at the most common symptoms of perimenopause.

1. Perimenopause and periods

Because your hormones are fluctuating, your periods during perimenopause might feel very different to what you’re used to. Again, this could vary from women to women in terms of how periods differ.

Perimenopausal menstruation could mean a heavier or lighter flow, changes in colour, or you could even experience cramping without the presence of a period.

2. Perimenopause and night sweats

Night sweats are extremely common side effects of perimenopause and menopause and are some of many women’s first signs of perimenopause. Sometimes, night sweats can become so severe that your clothing and bedding is soaked through and your sleep is disturbed. Naturally, your body sweats so that your body can cool down. Your body does this as a safety (and comfort) technique.

With night sweats, though, that comfort disappears. You might feel an intense and sudden wave of heat spread over your body. This could then be followed by your skin reddening, sweating and a faster heart rate. If you’re sleeping, this may wake you up and disrupt your sleep. This often leads to exhaustion, with so many women tying a link between perimenopause and fatigue.

3. Perimenopause and fatigue

Sleep disturbance is a super common perimenopause symptom. It involves finding it tricky to fall asleep, waking up sporadically throughout the night, waking up exceptionally early or a combination of all of these. It’s not difficult to see why so many women experience perimenopause and fatigue at the same time.

Sleep problems can hinder your mental and emotional health and cause your physical symptoms to feel more extreme.

You can mainly thank the falling levels of oestrogen, progesterone and testosterone for being unable to get your full 40 winks. With such drastic changes and fluctuations in hormone levels, it’s unsurprising that physical symptoms – particularly sleep disturbance – happens so frequently.

While the link between perimenopause and fatigue is undeniable, it’s not inescapable.

Insomnia and perimenopause

Insomnia and perimenopause are, unfortunately, highly related. There are two main types of insomnia:

1. Chronic insomnia Defined when you’re struggling to sleep for 3 days per week for at least 3 months.
2. Short-term insomnia This is diagnosed when you’ve been struggling to sleep for three months.

But how common is insomnia in perimenopause and menopause? Up to 60% of women in perimenopause and menopause experience some type of insomnia, which is why there’s a lot of focus on insomnia and perimenopause.

Remember, there is a difference between sleep disturbance and insomnia. If you are finding it challenging to fall asleep or stay asleep during menopause, do not suffer in silence. While insomnia and perimenopause are strongly linked, it’s not something you have to put up with.

4. Perimenopause and anxiety

Anxiety can crop up at any point, from pre-menopause to perimenopause anxiety and menopause anxiety. As your oestrogen levels fluctuate, you could be left feeling more overwhelmed and anxious than usual, connecting the dots between perimenopause and anxiety.

Perimenopausal anxiety symptoms can include:

• Feeling irritable, more restless, panicky and more nervous
• Finding it challenging to relax
• Worrying about the smaller things
• A lack of focus and struggling to remember things
• Feeling tense
• Sweating more
• Sleep disturbance
• Panic attacks (which can bring along with them dizziness, pain in your chest, rapid heart rate, and a deep sense of fear.)

Perimenopause and anxiety both come with their separate challenges. When experienced together, some women find it extremely tricky to cope with.

5. Perimenopause and bladder issues

Bladder weakness is actually exceptionally common as women transition through perimenopause to menopause. However, it’s one of the least talked about symptoms due to the shame that comes along with it.

It’s really important that we talk about it because it’s a natural part of life and this transition can feel isolating enough without us piling on self-shame!

In fact, bladder issues are key reasons why perimenopause and anxiety and perimenopause and fatigue are connected (amongst others.)

While some women believe that urinary incontinence is just part of aging, it’s not always the case. And it’s not something you’re doomed to live with. There are ways to prevent and treat it (which we’ll get to shortly).

Weakening bladders tend to start in perimenopause as your oestrogen levels begin to fall. Oestrogen plays a key role in making your urethral and vaginal tissues thin out, and as women age, our pelvic floors start to relax. In combination, this can cause urinary incontinence. Hi, perimenopause anxiety!

6. Perimenopause and a decrease in fertility

As you edge closer to menopause itself, you’re ovulating less frequently. That’s why periods during perimenopause can be so erratic and irregular. And when you do ovulate, you may release a “lower-quality” egg. Or the hormones used for ovulation may not be able to support a pregnancy efficiently.

For all of those reasons, it’s less common to fall pregnant during perimenopause. That said, it absolutely can happen. So, if you don’t want to conceive during perimenopause, it’s best to make sure you use a form of birth control and protection. Pregnancy is completely possible until you’ve reached menopause.

7. Perimenopause and sex

Perimenopause can alter your sex life, libido and sensations. For some women, their libido increases. However, for many, sex drive decreases. This is often due to vaginal dryness and irritation, which can cause sex to feel uncomfortable or even painful in extreme cases.

Unfortunately, a loss of libido can add pressure, often contributing to the tie between perimenopause and anxiety. However, there are certainly things you can do to improve your sex drive during perimenopause, which we’ll take a look at shortly.

8. Perimenopause and hot flashes

Hot flashes are the most common symptom of perimenopause and menopause. Your GP will likely refer to hot flashes as “vasomotor symptoms” or “VMS.”

Hot flushes feel like an intense wave of heat spreading through your face, neck and chest accompanied by redness. You may also sweat excessively, feel your heart rate increase, experience panic and anxiety and feel cold afterwards. Sometimes, hot flashes can be the result of perimenopause and anxiety. Other times, the hot flashes are triggered by anxiety. It can be a vicious cycle. However, you can experience hot flashes without anxiety.

9. Perimenopause and cholesterol levels

Cholesterol is found in every cell of our bodies. It’s made by our bodies or we can absorb it from our diet. We need cholesterol so that our body can make steroid hormones: oestrogen, progesterone, and Vitamin D. Plus, it’s needed to help repair our cell membranes. Not to mention, cholesterol also works to create bile acids in your liver, aiding with fat absorption when digesting our food. So, as you can see, some cholesterol is good.

But what about the bad cholesterol?

Bad cholesterol is made up of LDL cholesterol and triglycerides. When you have high levels of LDL cholesterol in your bloodstream, you may notice inflammation and plaques may form in your arteries. When this happens, it could lead to something called atherosclerosis – where your arteries harden. This is a huge root cause of heart attacks and strokes.

The risk of heart disease increases in perimenopause and menopause. So, it’s important to be aware of cholesterol levels at this time. A lot of perimenopausal women don’t check their cholesterol levels frequently, and might be unaware of rising levels prior to menopause.

That’s why so many women take perimenopause vitamins and perimenopause supplements.

10. Perimenopause and weight gain

Studies have proven that women’s body compositions change through perimenopause. Fat mass increases as well as waist circumference, plus a decrease in muscle mass. It’s common for fat to gather around the abdomen, which is where the term “meno belly” can come to fruition.

Oestrogen is a huge player in the world of energy metabolism. As your oestrogen levels fluctuate during perimenopause, the way your body works to metabolise fat will change.

It’s important to note that genetics also play a role in weight gain during perimenopause, as well as lifestyle factors and diet.

11. Perimenopause itchy skin and spots

Spots can crop up in perimenopause for the same reason it makes an appearance in puberty. (Who invited her either time?!)

The changes and fluctuations in hormone levels have a direct impact on our skin’s natural defences, which can trigger acne or other skin conditions. Skin changes can begin during perimenopause and last throughout menopause itself and beyond.

Additionally in perimenopause itchy skin is pretty common. There’s a huge shift in the oils we produce which can lead to dehydrated skin, resulting in dryness and itchiness.

If you’ve been searching for solutions to perimenopause itchy skin, take a look at our deep-dive that focuses on the changes to skin in perimenopause and menopause.

How to know if perimenopause is ending

Perimenopause will officially end one year after your final period (which also includes spotting.) Then, you’ve reached menopause.

Your symptoms may vary in terms of the actual symptoms you’re displaying as well as the severity of them throughout, so symptom spotting isn’t always a reliable way to know if perimenopause is ending.

Instead, take notice of your menstrual cycle regularity. It is well worth using a period tracking app.

Remember, menopause is reached when you go for 12 months without a period or spotting. If your menstrual cycles are varying by a week or so, you’re likely in early perimenopause. The longer they are separated, the later in perimenopause you tend to be.

How to manage perimenopause symptoms

Repeat after me: perimenopause should not feel like dying.

There are ways to manage your perimenopause symptoms at home. So, let’s break it down symptom by symptom.

How to manage perimenopausal periods

Periods: regardless of when they take place, kinda suck.

But before perimenopause, we get used to them, learning first-hand how to manage our periods. But when perimenopause comes and our periods start to differ, it’s like we have to learn all over again.

If you’re noticing your periods during perimenopause are more uncomfortable, you can:

• Engage in light exercise to help with bloating and reduce cramps
• Speak with your GP about pain relief if you’re struggling with cramps
• Use meditation to help with stress, pain and/or mood changes
• Use a hot water bottle, applying it to your stomach or back to help with muscle pain and cramps
• Make sure your diet is rich, varied, nutritious and healthy. Recent studies suggest that foods like meat, sugar, salt and oil can actually cause your period pains to be worse. Instead, opt for anti-inflammatory foods like fruits, vegetables, whole grains, nuts and legumes.
• Swap tea and coffee for peppermint tea. This helps to relieve cramps, diarrhoea and nausea.

How to manage perimenopause and night sweats

Remember to always speak with your GP if your perimenopausal night sweats are too difficult to cope with. No one should suffer in silence.

There are also some ways you can manage perimenopausal night sweats at home, too:

• Bring a glass of cool water to bed with you. Sip on it throughout the night.
• Invest in temperature control cooling bedding
• Wear pyjamas that are loose on your skin, lightweight and made either of cotton or linen
• Make sure you are exercising daily. A walk, swim, dance or cycle can make all the difference if you’re struggling to sleep.
• Swap your duvet for a lighter blanket
• Go to bed as stress-free as possible. Meditate, journal, do those breathing techniques and have a bubble bath! Whatever you need to do to enter your bed in a state of calm, do it.
• Keep your fan on, even in the winter. Sleep with your windows open if you can, too.
• Stay clear of night sweat triggers like booze, spicy foods, caffeine or cigarettes before bed
• Don’t exercise directly before bed. Give yourself enough time to unwind.

How to manage perimenopause and fatigue

Sleep disturbance is such a common perimenopause symptom and it can be extremely damaging to your physical, emotional and mental health. As mentioned before, don’t suffer in silence. If a lack of sleep is impacting you severely, please make an appointment with your GP.

There are ways to better the chances of a solid night’s sleep that you can do at home, including:

• Make sure you’re exercising daily Routine exercise can help perimenopausal women (and menopausal women) to fall asleep and stay asleep throughout the night. Just make sure you don’t exercise directly before bed time as your body needs time to unwind.
• Keep your room cool According to the National Sleep Foundation, you should try to keep your bedroom at a temperature of 15.6 – 19.4°C. If you suffer with night sweats, this is especially important.
• Create complete darkness Of course, we switch the lights off when we go to sleep. But sometimes we simply adjust to lights from your phones, alarm clocks, TVs or lamps. If you’re struggling to sleep during perimenopause, make sure all blinking lights – no matter how small – are switched off before you fall asleep. Make sure your phone is on Do Not Disturb so flashing screens don’t cause sleep disturbance.
• Create a relaxation routine Everyone relaxes differently. Some find serenity in calming music. Some find their troubles drift away in a bubble bath. Whether your way is yoga and meditation or writing in a journal before bed, do what you need to do to enter your bedroom in a relaxed state. Stress is a strong contributor to sleep disturbance in perimenopause, so make sure you’re prioritising your peace at this stage of your life.
• An hour phone-free every night If you use your phone directly before going to bed, you may find it harder to fall asleep and stay asleep throughout the night. When practicing your relaxation routine, make sure your phone is on Do Not Disturb for at least an hour before bedtime.
• Eat earlier In 2021, a study concluded that eating within an hour before going to bed will increase your chances of waking up. If you go to bed on a full stomach, you might get heartburn or acid reflux, which is difficult to sleep through.

How to manage perimenopause anxiety

Anxiety can be triggered at any point in life, but during perimenopause it can increase your chances of experiencing anxiety. With so much change going on inside your body, anxiety can then trigger hot flashes and night sweats, weight gain, vaginal dryness, sleep disturbance and even impact your periods.

I sound like a broken record here, but I’m going to say it again: perimenopause shouldn’t feel like dying. Do not suffer in silence with perimenopausal anxiety. Speak with your GP if your symptoms can’t be managed with these natural methods:

• Prioritise your sleep A lack of sleep could heighten existing anxiety. Everything is harder when we’re tired. Make sure you avoid caffeine and alcohol later in the day and follow the tips above to protect your sleep during perimenopause.
• Routine exercise does help with perimenopause anxiety If you’re suffering with perimenopausal anxiety, experiment with aerobic exercise. Aerobic exercise is activity that elevates your heart rate, and includes activities like dancing, walking (so long as it’s brisk) or jogging.
• Mindfulness-based stress reduction (MBSR) Mindfulness-based stress reduction is used to manage and improve physical symptoms that have been caused by long-term illnesses, including stress and anxiety (and a range of other perimenopause symptoms.) It consists of a variety of exercises such as breathing exercises, meditation, yoga and guided imagery.
• Quit (or cut down) on alcohol and caffeine Alcohol is a depressant by nature. Caffeine elevates the heart rate and can trigger panic attacks. Unfortunately, so many women think “I’ll have a glass of wine to take the edge off,” which might seem a good idea in the moment. In reality, though, it often makes things worse. I’m not a believer in extremes and I believe you should do the things that bring you joy. However, it is absolutely worth cutting down (or quitting altogether) to aid with perimenopause anxiety.

How to manage perimenopause bladder issues

Thanks, falling oestrogen levels: you strike again at being the absolute worst. But here’s the good thing: there are a bunch of techniques you can implement to avoid perimenopausal bladder problems.

• Don’t go for a wee “just in case.” It might sound like a good idea to go for a wee before you leave the house “just in case.” In actuality, though, it can work against you. Your bladder stretches to store more urine, sending you signals that you need to head to the toilet. When you do the whole “just in case” thing, you’re essentially training your body to respond to these signals before your bladder is full. In short, you’ll think you absolutely have to go even if your bladder isn’t even half full. Then, over time, your bladder will actually shrink, leading to the need to wee more frequently. Make sure you go for a wee when you need to go and don’t go “just in case.”
• Don’t push when you pee If you add extra pressure by pushing, you are hindering your pelvic floor muscles, which can lead to other issues. Instead of pushing when you wee, breathe deeply and just let yourself wee as naturally as possible.
• If you absolutely have to, suppress the urge to wee If you need to go to the toilet, go. That’s the healthiest method for your body. But sometimes, we’re in situations where that’s not possible. As such, in the short term, you can suppress the urge to pee by:
  • Distracting yourself
  • Breathing exercises
  • Be still (either sitting or standing)
  • Perform 5 – 10 Kegels to calm your bladder

How to manage low sex drive and vaginal dryness in perimenopause

If you’re finding your libido has fallen during perimenopause, know that you’re not alone. Many women report a change to their sex drive and, while some women experience a higher sex drive, most do report a lower one.

To help increase libido, you can try:

• Getting routine exercise
• Avoid caffeine and alcohol
• Quit smoking if you’re a smoker
• Avoid products that irritate the vagina. Bin the scented soaps and bath products.
• Ensure you’re following a balanced and nutrient-dense diet
• Manage your weight to boost wellbeing and confidence
• Do pelvic floor exercises
• Take time to become aroused – engage in more foreplay to raise moisture levels and avoid painful sex
• Take the pressure off of the orgasm: commit to pleasure with or without an orgasm

How to manage hot flashes in perimenopause

Hot flashes are among the most common symptoms of perimenopause and menopause itself. They can vary in severity, and some can be entirely debilitating. However, there are ways you can manage hot flashes yourself so you can remain cool, flash-free and collected:

• Keep a tracker of your hot flashes Tracking when you have a hot flash is the first step in banishing them from your life. By tracking them, you can identify any potential triggers and patterns. It could be, for example, your hot flashes are worsened when you have a coffee or a spicy meal. Keep a tracker for a few weeks, writing down what you’ve eaten, what you’ve been doing, when you had the hot flash and how long it lasted. Then, reflect – perhaps after a month – and try to spot patterns, links and triggers.
• Dress in light layers Even in the colder months, make sure you’re dressing in light layers. Should a flash occur, you can remove clothing if you have enough layers and still remain warm once you’ve cooled off. You should opt for natural, breathable fabrics. Cotton, soft wool or silk all work to help keep you cool. Clothing that is loose will be far better for temperature control than anything tight.
• Sleep in light layers Just as you should wear loose layers, the same applies to bedding. Ditch the double duvet and replace it with lighter blankets. Invest in some 100% cotton sheets that can keep you cool and comfortable. Keep your room cool, too, by having your windows open and using a fan.
• Carry a cooling spray with you There’s nothing fancy or expensive here. All you need is a small spray bottle. Then, fill it with water, pop it in the fridge over night, and store it in your bag as you’re out and about. That way, you can spritz yourself with some cool water when a hot flash begins.
• Lukewarm showers and baths rather than piping hot When showering or having a bath, avoid using very hot water. Instead, you want to opt for a lukewarm shower or bath to decrease the likelihood of having a hot flash or night sweats.

How to lower cholesterol during perimenopause

You can lower your cholesterol levels during perimenopause to keep your heart healthy by dedicating yourself to making some lifestyle changes, particularly by focusing on your diet.

• Increase your intake of soluble fibreby consuming particular foods
  • Legumes (beans, chickpeas, peas, lentils and edamame)
  • Whole grains (barley and oats)
  • Fresh fruits and vegetables
  • Fibre supplements
• Include foods high in omega-3 fatty acids
  • Salmon
  • Walnuts
  • Olive oil
  • Avocado
• Be careful of your saturated fat intake, limiting your intake of:
  • Meat
  • High fat dairy
  • Butter
• Routine exercise helps with cholesterol.
  • 150 minutes at least per week of moderate-intensity aerobic activity and strength training. Two days per week at the minimum.
• Quit smoking
  • Smoking is a huge risk factor when it comes to heart disease. It’s 100% worth quitting.

How to manage weight gain in perimenopause

Perimenopause can cause a wide range of symptoms and it’s different for everyone. That said, weight gain is pretty common. You’re not doomed to gain weight, though. You can, absolutely, lose the added weight.

• Focus on nutrition It’s not exactly surprising that eating well will help with weight loss. But you’d be surprised at the number of people who know it but ignore it.
  • It’s important to have a healthy and diverse diet with a focus on fresh produce. You’re going to want to consume a range of fruits, vegetables, whole grains, beans, seeds, nuts and pulses.
  • Make sure you’re consuming foods high in fibre, which will help support your gut and keep you fuller for longer.
  • Stay hydrated, preferably drinking lots of water. Avoid fizzy drinks as much as possible.
  • Avoid highly processed foods, restricting high-fat foods or meals with excessive sugar and salt.
• Physical exercise: create a routine and stick to it
  • You don’t always have to join a gym to add physical activity to your routine. Instead, you should make sure you’re doing a form of exercise that is manageable and sustainable for your body and your unique routine.
  • Choose an activity that you enjoy. Yoga is great for stress relief, too. Or perhaps a dance class, horse riding or swimming is more up your street. Even a daily walk counts towards physical activity.
  • Aim for 150 minutes of exercise per week
  • Mix up aerobic and strength-based exercise because these will help with other perimenopause symptoms such as hot flashes, night sweats and perimenopause anxiety.
• Protect your sleep
  • Sleep is crucial at every stage of life! Everything’s harder to cope with when you’re tired. You snack more when you haven’t slept well, too, contributing to weight gain. If you can, on average you should aim for 7 – 9 hours of sleep per night.
  • Avoid napping as this can impact your sleep quality through the night
  • Do not exercise directly before bed time.
• Take perimenopause supplements
• Take perimenopause vitamins
• Join our Menopause Midsection Makeover programme
  • There are a lot of weight management programmes out there. However, the problem with these programmes are that they’re generalised. Every body is different. The way you gain weight and the way you lose weight is independent to you. That’s why my **Menopause Midsection Makeover®** programme is completely bespoke and rooted in science.

How to manage perimenopause itchy skin and spots

Skin changes are often a hard pill to swallow and can be frustrating. However, there are ways you can manage perimenopause itchy skin and spots yourself:

• Wash your face daily Use a mild soap that won’t dehydrate your skin.
• Moisturise your face with facial cream, avoiding harsh products
• Don’t scrub too hard when exfoliating
• Use a cleanser that contains salicylic acid to help clear clogged pores
• Don’t pick or pop spots as this can cause scarring or a further breakout
• Avoid sun beds and use sunscreen whenever you’re outside

Perimenopause and your menstrual cycle

A change to your menstrual cycle is often one of the first signs of perimenopause. However, this “change” is open to your body’s interpretation.

“Change” could mean longer or shorter in duration, further or closer apart, heavier or lighter in flow and colour: it’s totally unique to you.

That said, it’s always recommended to speak with your GP about changes to your menstrual cycle. That way, you can rule out any other potential causes of these changes.

Perimenopause: can you get pregnant?

You can absolutely get pregnant during perimenopause. So long as you’re still ovulating and having periods, you can conceive.

The chances of conception are lower the longer you’re in perimenopause, but not impossible. If you don’t want to conceive, make sure you’re using birth control throughout perimenopause until you haven’t had a period or spotting for 12 months in a row.

Perimenopausal periods: how do they change?

As your body produces less of the hormones that work together to help you ovulate, your periods can become erratic and irregular. As such, your menstrual cycle could become longer or shorter in duration to what you’re used to. Also, your flow could be lighter or heavier. Some women have reported that their PMS symptoms get worse during perimenopause.

Are perimenopause symptoms worse during ovulation?

Symptoms of ovulation during perimenopause can be, essentially, the same as those you’ve experienced before you reach perimenopause. The difference, though, is that they may crop up less frequently or when you’re not expecting it. This is due to having erratic and irregular menstrual cycles.

In terms of intensity, you may experience that your ovulation symptoms are more or less so, particularly having tender breasts and pelvic pain. Again, every woman is unique and will experience perimenopause differently.

Perimenopause and birth control

If you’re perimenopausal, you might be wondering whether you should use birth control to avoid conceiving a baby. If pregnancy isn’t something you want, speak to your GP about suitable birth control until you’ve reached official menopause.

Perimenopause: when to see a doctor

Remember that your GP is there to help you through this transition. You shouldn’t suffer in silence. If any of your perimenopause symptoms become too much for you to handle, book an appointment with your GP to assess a suitable support strategy.

In terms of your periods, though, there are certain red flags that indicate you need to see a doctor. While changes to your periods is natural and to be expected in perimenopause, keep an eye out for any of the following and make sure you see a healthcare professional should any arise:

• You are experiencing exceptionally heavy bleeding or you’re bleeding for a long time
• You haven’t had a period for a year and then you start bleeding
• You’re bleeding after sex
• You have PCOS (polycystic ovarian syndrome)

Perimenopause in a nut shell

Perimenopause is a transition phase that is different for everyone. From duration to symptoms, it’s all unique to each woman. That’s why there’s no set list of first signs of perimenopause.

What you must remember is that perimenopause should never feel unbearable. With so many women Googling “perimenopause is making me crazy,” it’s clear that the taboo still exists. The most important thing is to talk about your experience with the people you trust. Having support is one of the most crucial ways to get through this period.

One of the best ways to cope with perimenopause is to be prepared, knowing as much as you can and the indicators for when you need to seek medical assistance.

Remember that perimenopause doesn’t last forever. And there are ways to lighten the load throughout this transitional period just by making some swaps to your lifestyle and diet. Don’t underestimate the power you have to reshape your experience of perimenopause!