Perimenopause: what's happening and how to cope

Perimenopause is the natural transition leading up to menopause — the point when periods stop for good. It often begins in the forties, though it can start earlier or later, and it can last several years. During this time, hormone levels rise and fall less predictably, which is what causes the familiar symptoms. It is a normal life stage, not an illness, though it can certainly feel disruptive.

Symptoms vary widely — some women barely notice the change, while others find it challenging. You may experience:

• Periods becoming irregular, lighter, heavier, or further apart
• Hot flushes and night sweats
• Disrupted sleep
• Mood changes, irritability, or anxiety
• Trouble with memory or concentration ("brain fog")
• Vaginal dryness or changes in sexual comfort
• Aches, or changes in skin and hair

If any of this feels familiar, you are not imagining it — these are real, recognised parts of the transition.

• Keep moving. Regular activity supports mood, sleep, bone health, and weight.
• Eat to support bones and heart. Include calcium and vitamin D sources, plenty of vegetables, and enough protein.
• Manage hot flushes. Light, breathable clothing, a cooler bedroom, and noticing your triggers (such as spicy food or stress) can help.
• Protect your sleep. A steady routine and a calm wind-down make a difference.
• Tend to your mind. Stress care, connection, and rest are not extras during this phase.

It is worth speaking to a doctor if symptoms are affecting your quality of life, if bleeding is very heavy or returns after stopping, or if you simply want to understand your options. There are effective approaches — including lifestyle support and, for some, medical treatments — that can ease this transition. You do not have to grit your teeth and bear it.

For a fuller guide to managing this stage, visit the perimenopause & menopause guide.