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Menopause & Perimenopause

Am I perimenopausal? 8 common signs and symptoms of perimenopause

04/04/20246 min read

Written byLaura Harcourt

Reviewed byMs Roopa Navani

Group of 5 women walking through a field with happy expressions

Discover the most common symptoms of perimenopause and learn how to ease them with our top tips and advice.

Summary

1What is perimenopause?

The time before you transition into menopause (when you’ve not had a period for 12 months) is known as perimenopause.

Jump to details below

2What's the average age to start perimenopause?

For most people who still get periods, the build-up to menopause will usually start somewhere in the mid to late-40s

Jump to details below

3How to reduce the symptoms of perimenopause

Combining lifestyle changes and natural menopause remedies, you can ease your symptoms and feel happier and healthier during this transition.

Jump to details below

Jump to section

What is perimenopause?
What's the average age to start perimenopause?
Common symptoms of perimenopause
How to reduce the symptoms of perimenopause
The lowdown
A final ‘note to self’
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Explore related topics

Menopause & Perimenopause

Feeling off balance? You’re not alone.

Going through perimenopause can be a confusing time, bringing with it symptoms like hot flushes, poor sleep and joint pain, ultimately disrupting your day-to-day life. But don’t sweat it (literally!) – we’ve got your back.

With our top tips and advice, you’ll soon be able to spot and combat the telltale signs of perimenopause and get back to feeling your best every day.

What is perimenopause?

The time before you transition into menopause (when you’ve not had a period for 12 months)¹ is known as perimenopause. This is when your hormone levels start to change and shift, which can cause a range of symptoms that go on for several years.

What's the average age to start perimenopause?

Perimenopause can not only start at different times for different people but can also last varying lengths of time too.

For most people who still get periods, the build-up to menopause will usually start somewhere in the mid to late-40s, with full menopause kicking in by 51 on average in the UK.²

But hey, life’s full of surprises! So while most women go through this natural transition at the expected time, some may start the process earlier. Things like chemotherapy or a hysterectomy (a surgical operation to remove all or part of the uterus), for example, can both speed up the process.³

Common symptoms of perimenopause

Everyone's experience of perimenopause is unique. Some of us have many symptoms, while others only have a few, and their severity can range widely too. There are over 30 perimenopause symptoms that may affect you, but the eight listed below are some of the most common.

If you experience any of the symptoms mentioned below or aren’t sure about your symptoms, you should speak to your GP or healthcare practitioner for further advice.

1. Irregular periods

Your body's preparing for a big shift!

As your hormones adjust during perimenopause, your periods might become a little less predictable. They could show up more or less often, last longer or shorter, and vary in intensity. You might even skip a few altogether. It's all part of the journey!

During early perimenopause, for instance, your cycle length may change by seven days or more. Whereas, in late perimenopause, there could be 60 days or more between your cycles.²

2. Hot flushes and night sweats

A sudden heat spreading through your body and face, a red flush rising from your chest, beads of sweat on your brow… there’s no mistaking a hot flush.

With more than eight in ten women experiencing hot flushes during perimenopause, this is one of the symptoms you’re most likely to experience.⁴ They can also strike both while you’re awake and asleep, and are a common cause of night sweats.⁵

But it's important to remember that you're not alone when experiencing these symptoms. Many women will be going through the same as you and there are plenty of ways to help reduce the impact they have on your day-to-day life.

3. Mood changes

If you’re going through perimenopause, you’ve probably noticed more changes in your mood than usual. This is common. In one study, researchers discovered that irritability was the main mood reported during perimenopause, affecting as many as 70% of women. Other emotions like sadness and anxiety were also found to be especially common.⁶

This is all down to hormonal changes – as your oestrogen levels drop, levels of the happy hormone, serotonin, do too, leading to various emotional symptoms.7

The good news? By understanding these shifts, you can find healthy ways to navigate them and feel your best throughout this transition.

4. Sleep problems

With night sweats being a regular occurrence, getting a good night’s rest isn’t always straightforward during perimenopause.

In fact, according to one study, almost half of women approaching menopause experience sleep disturbances, including poor-quality sleep and insomnia.⁸

However, with the right support, lifestyle adjustments and self-care practices in place, it can be perfectly possible to reach the land of nod and get a great night's kip!

5. Loss of libido and vaginal dryness

Oestrogen is one of the main hormones affected during perimenopause.

As your levels decrease, symptoms like uncomfortable vaginal dryness, night sweats, and poor sleep can occur. Combined, these symptoms can cause pain, fatigue, and low self-esteem, which can all reduce your sex drive and desire to be intimate.⁹

But it's not all bad news. By seeking support, exploring various treatment options and prioritising self-care, you can easily take back control of your body and retain a healthy sex drive throughout this phase of life.

6. Memory lapses and brain fog

Forgetting names, misplacing keys and struggling to remember what you went upstairs for are all common problems associated with perimenopause-induced brain fog. In fact, many people feel as though their brain is like ‘cotton wool’ during this time.¹⁰

However, the one thing you mustn’t forget is that you’re not alone. By reaching out for support and implementing simple memory-enhancing techniques, you can navigate through this foggy phase with clarity and confidence, emerging stronger on the other side.

7. Joint pain

Oestrogen helps to keep the connective tissue in our joints healthy. So when it’s in low supply during perimenopause, you might start to feel some pains in your fingers, elbows, and neck.¹¹ This can make you feel stiff and achy, especially when you first wake up.

Fortunately, there’s an effective way to combat those aches and pains: maintain a healthy, active lifestyle.

Performing exercises that are good for joints, like walking or yoga, and eating balanced nutritious meals can not only support your overall health but also help keep joint pain at bay.

8. Sore breasts

Thanks to the hormonal shifts that take place during our menstrual cycles, we’re all very much used to tender breasts already and these will continue with perimenopause.

In fact, as highlighted by the National Cancer Institute, menopause (and perimenopause) can cause symptoms like breast tenderness, lumpiness, and potentially a reduction in size.¹²

How to reduce the symptoms of perimenopause

Unfortunately, the symptoms of perimenopause can’t be cured with one miracle potion. But it’s not all bad news. With a combination of lifestyle changes and natural menopause remedies, you can ease your symptoms and feel happier and healthier during this transition.

Here are some of our top tips:

Embrace regular exercise

Performing regular gentle exercises like resistance training, swimming, dance, yoga, and walking has been found to help boost mood, improve sleep, improve joint mobility and may even reduce hot flushes.^13,14

Enjoy a nutritious diet

According to the British Dietetic Association, a healthy diet could help reduce perimenopause symptoms like night sweats, irritability, and joint pain.¹⁵

They recommend eating at least five portions of fruit and vegetables, plenty of fibre-rich cereal foods, like muesli, shredded wheat, and bran flakes, and two portions of calcium-rich foods, such as cheese, milk, and green leafy vegetables every day.¹⁵

It can also help to up your intake of fish, plain nuts, peas, and beans – and research has shown that cutting back on caffeine and alcohol can help manage hot flushes too.¹⁵

Clean up your sleep routine

Sleepless nights can take their toll.

However, adopting good sleep habits, like following a regular sleep schedule, developing a bedtime routine and avoiding napping can all help you get a better quality of sleep. This can also help reduce feelings of irritability, improve your memory, and reduce the severity of hot flushes.¹⁶

What’s more, cognitive behavioural therapy (CBT) can also help you learn new techniques to tackle sleep problems.¹⁷

Dive into supplements

Many people turn to supplements and herbal remedies due to their potential to help support your overall health and wellbeing.

Here are a few of our go-to's:

Black cohosh

Black cohosh has long been used in history as a treatment for hot flushes, with small studies finding that it may improve the severity of symptoms and reduce the number of hot flushes. But the evidence for this is unconcluded.^18,19

However, while there’s some supportive evidence that black cohosh may be beneficial, many of these studies were small, the quality and safety of these products may be unknown and different versions may vary. Black cohosh is also not recommended for treating menopausal symptoms in women with breast cancer.²⁰

It’s recommended to check with your doctor before trying any new herbal remedies.

Sage leaf

Sage leaf is a traditional herbal remedy historically and anecdotally used to relieve excess sweating and hot flushes.

During one study in 30 women with menopause, for example, researchers found that using sage leaf significantly improved the severity of hot flashes, night sweats, panic, fatigue, and concentration before and after consumption.²¹

However, this was a relatively small study and other pieces of research have since found that sage leaf makes no significant difference when compared to a placebo. So the true benefits of whether sage leaf helps with sweating and hot flushes remains unclear.

Evening primrose oil

Like black cohosh, in a small study of 80 women, evening primrose oil has been found to reduce the severity of hot flushes. As there’s not much research on evening primrose oil, the jury is out regarding its effectiveness, but these results are promising.¹⁹

To learn more about how these supplements could potentially help you, take a look at our article investigating eight of the best perimenopause supplements.

If perimenopausal symptoms are affecting your quality of life, and you find healthy lifestyle changes aren’t enough on their own, speak to your GP about further treatments. Likewise, always seek your GP’s advice before trying any herbal supplements.

The lowdown

Perimenopause affects everyone differently. But no matter how mild or severe your symptoms might be, there are plenty of things you can do to feel better and more like yourself.

Whether that’s taking yourself out for a walk in the local park or eating nutritious meals, small lifestyle changes like these can make a big difference.

A final ‘note to self’

Wherever you are in your menopause journey, Holland & Barrett is here to support you.

While we’re sure our advice and tips will help you feel more confident as you move into this next stage of life, we recommend you talk to your GP if you’re struggling to manage any of your symptoms.

Disclaimer

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.

Sources

NHS. Menopause [Internet]. [cited 2024 Feb 8] Available from: https://www.nhs.uk/conditions/menopause/
Santoro, N. ‘Perimenopause: from research to practice’. J Womens Health (Larchmt). 2016;25(4):332–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834516/.
NHS. Early menopause [Internet]. [cited 2024 Apr 11]. Available from: https://www.nhs.uk/conditions/early-menopause/.
Bansal, R., et al. ‘Menopausal hot flashes: a concise review’. J Midlife Health. 2019;10(1):6–13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/.
Sleep Foundation. Night sweats: causes and tips to prevent sweating at night [Internet]. 2020 [cited 2024 Feb 8]. Available from: https://www.sleepfoundation.org/night-sweats.
Born, L., et al.‘A new, female-specific irritability rating scale’. U.S. National Library of Medicine, 2008;33(4):344–354. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440789/.
Barth, C., et al. ‘Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods.’ Front Neurosci. 2015;9:37. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335177/.
Zhao, M. et al. ‘Effects of exercise on sleep in perimenopausal women: A meta-analysis of randomized controlled trials.’ EXPLORE. 2023;19(5):636–45. Available from: https://www.sciencedirect.com/science/article/pii/S1550830723000307.
The North American Menopause Society. Decreased desire, sexual side effects of menopause [Internet]. [cited 2024 Feb 8]. Available from: https://www.menopause.org/for-women/sexual-health-menopause-online/sexual-problems-at-midlife/decreased-desire.
The Menopause Charity. Brain fog [Internet]. 2021 [cited 2024 Feb 8]. Available from: https://www.themenopausecharity.org/2021/10/21/brain-fog/.
NHS. Menopause - Why do my joints and muscles ache? [Internet]. [cited 2024 Feb 8]. Available from: https://www.nhsemployers.org/system/files/2022-03/MSK_Menopause%20Leaflet.pdf.
National Cancer Institute. Understanding Breast Changes and Conditions [Internet]. [cited 2024 Feb 8]. Available from: https://www.cancer.gov/types/breast/breast-changes/understanding-breast-changes.pdf.
Dąbrowska-Galas M., et al. ‘High physical activity level may reduce menopausal symptoms.’ Medicina (Kaunas). 2019;55(8):466. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722698/.
The Menopause Charity. Exercise advice for women in perimenopause and menopause [Internet]. 2021 [cited 2024 Feb 8]. Available from: https://www.themenopausecharity.org/2021/04/24/exercise-advice/.
BDA. Menopause and diet [Internet]. [cited 2024 Feb 8]. Available from: https://www.bda.uk.com/resource/menopause-diet.html.
National Institute on Aging. Sleep problems and menopause: what can I do? [Internet]. [cited 2024 Feb 8]. Available from: https://www.nia.nih.gov/health/menopause/sleep-problems-and-menopause-what-can-i-do.
NHS. Menopause - Things you can do. [Internet]. 2022 [cited 2024 Feb 8]. Available from: https://www.nhs.uk/conditions/menopause/things-you-can-do/.
Shams T., et al.‘Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis’. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews Centre for Reviews and Dissemination (UK); 2010 [cited 2024 Feb 8]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK79338/.
Mehrpooya M., et al. ‘A comparative study on the effect of ‘black cohosh’ and ‘evening primrose oil’ on menopausal hot flashes’. J Educ Health Promot. 2018;7:36. [cited 2024 Feb 8]. Available from: https://pubmed.ncbi.nlm.nih.gov/29619387/.
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Dadfar F., et al. ‘The effect of Saliva officinalis extract on the menopausal symptoms in postmenopausal women: An RCT’. Int J Reprod Biomed. 2019 Jun 13;17(4):287–92. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686654/.