Perimenopause & Menopause
Hot flushes, broken sleep, mood swings or periods going haywire in your 40s? That's usually perimenopause — the years of hormonal change leading up to menopause. It's a natural transition, not a decline, and there's a lot that helps.
Menopause arrives at an average age of 46–47 in Indian women— Indian menopause age studies (typically 46–48 years)
Menopause arrives at an average age of 46–47 in Indian women— Indian menopause age studies (typically 46–48 years)
General education, not a diagnosis. SHELY is pre-launch — “Talk to someone” adds you to our experts waitlist; we don’t offer bookings yet.
Perimenopause is the transition phase — often lasting four to ten years — when your ovaries gradually wind down and your levels of oestrogen and progesterone begin to swing and fall. It usually starts in your 40s, though it can begin earlier. Menopause itself is a single point in time: the day you have gone 12 full months without a period. Everything after that is post-menopause.
Because hormones fluctuate rather than simply switching off, symptoms can be unpredictable — heavy then skipped periods, a sudden hot flush, a restless night, a low mood that arrives from nowhere. This is biology, not weakness, and it doesn't mean anything is wrong with you.
The years around menopause also matter for long-term health: falling oestrogen affects bone density and heart health, so this is a good moment to build habits that protect both. With the right information — and treatments like menopausal hormone therapy where appropriate — most women move through this transition feeling like themselves again.
Signs & symptoms
- Irregular periods — closer together, further apart, heavier or lighter
- Hot flushes and sudden night sweats
- Trouble sleeping or waking unrefreshed
- Mood swings, irritability, anxiety or low mood
- Vaginal dryness or discomfort during sex
- Brain fog — forgetfulness or trouble concentrating
- Reduced sex drive
- Joint aches and stiffness
- Needing to pass urine more often or urgency
What causes it
- Natural ageing of the ovaries and falling egg reserve
- Fluctuating then declining oestrogen and progesterone
- Surgery to remove the ovaries (surgical menopause)
- Chemotherapy or radiotherapy affecting ovarian function
- Early or premature menopause, sometimes running in families
When to seek help
See a doctor if symptoms are disrupting your sleep, mood, work or relationships — effective treatments exist and you don't have to simply endure them. Get checked promptly for any bleeding after you've gone 12 months without a period, very heavy bleeding, bleeding between periods or after sex, as these need investigation. Also speak to a clinician if your periods stop before age 40, as early menopause needs specific care to protect bone and heart health.
How SHELY helps
SHELY Care
Log periods, hot flushes, sleep and mood to see how your transition is unfolding and share a clear picture with your doctor.
Symptom Checker
Not sure if it's perimenopause? Check your symptoms and learn what to ask a clinician.
SHELY Varsity
Plain-language guides on managing hot flushes, protecting bone and heart health, and understanding hormone therapy.
Not sure what comes next?
Pick a topic to explore what we know about Perimenopause & Menopause. Educational only — not a diagnosis.
- Irregular periods — closer together, further apart, heavier or lighter
- Hot flushes and sudden night sweats
- Trouble sleeping or waking unrefreshed
- Mood swings, irritability, anxiety or low mood
- Vaginal dryness or discomfort during sex
- Brain fog — forgetfulness or trouble concentrating
- Reduced sex drive
- Joint aches and stiffness
- Needing to pass urine more often or urgency
- Natural ageing of the ovaries and falling egg reserve
- Fluctuating then declining oestrogen and progesterone
- Surgery to remove the ovaries (surgical menopause)
- Chemotherapy or radiotherapy affecting ovarian function
- Early or premature menopause, sometimes running in families
See a doctor if symptoms are disrupting your sleep, mood, work or relationships — effective treatments exist and you don't have to simply endure them. Get checked promptly for any bleeding after you've gone 12 months without a period, very heavy bleeding, bleeding between periods or after sex, as these need investigation. Also speak to a clinician if your periods stop before age 40, as early menopause needs specific care to protect bone and heart health.
SHELY Care
Log periods, hot flushes, sleep and mood to see how your transition is unfolding and share a clear picture with your doctor.
Symptom Checker
Not sure if it's perimenopause? Check your symptoms and learn what to ask a clinician.
SHELY Varsity
Plain-language guides on managing hot flushes, protecting bone and heart health, and understanding hormone therapy.
Symptoms
- Irregular periods — closer together, further apart, heavier or lighter
- Hot flushes and sudden night sweats
- Trouble sleeping or waking unrefreshed
- Mood swings, irritability, anxiety or low mood
- Vaginal dryness or discomfort during sex
- Brain fog — forgetfulness or trouble concentrating
- Reduced sex drive
- Joint aches and stiffness
- Needing to pass urine more often or urgency
Causes
- Natural ageing of the ovaries and falling egg reserve
- Fluctuating then declining oestrogen and progesterone
- Surgery to remove the ovaries (surgical menopause)
- Chemotherapy or radiotherapy affecting ovarian function
- Early or premature menopause, sometimes running in families
When to seek care
See a doctor if symptoms are disrupting your sleep, mood, work or relationships — effective treatments exist and you don't have to simply endure them. Get checked promptly for any bleeding after you've gone 12 months without a period, very heavy bleeding, bleeding between periods or after sex, as these need investigation. Also speak to a clinician if your periods stop before age 40, as early menopause needs specific care to protect bone and heart health.
How SHELY helps
SHELY Care
Log periods, hot flushes, sleep and mood to see how your transition is unfolding and share a clear picture with your doctor.
Symptom Checker
Not sure if it's perimenopause? Check your symptoms and learn what to ask a clinician.
SHELY Varsity
Plain-language guides on managing hot flushes, protecting bone and heart health, and understanding hormone therapy.
Frequently asked
How is perimenopause different from menopause?
Perimenopause is the run-up — the years when hormones fluctuate and symptoms appear while you still get periods. Menopause is the single point reached after 12 months with no period at all; after that you are post-menopausal.
Is hormone therapy safe?
For most healthy women under 60, or within ten years of menopause, menopausal hormone therapy is a safe and very effective option for troublesome symptoms. It isn't right for everyone, so a doctor weighs your personal history with you — it's a conversation worth having.
Can I still get pregnant during perimenopause?
Yes. Ovulation becomes irregular but can still happen, so pregnancy is possible until you have gone a full 12 months without a period. If you don't want to conceive, keep using contraception through the transition.
Will these symptoms last forever?
Most symptoms like hot flushes ease over time, often within a few years of your last period. Some, such as vaginal dryness, can persist but are very treatable. You won't feel this way indefinitely — and help is available throughout.
✔ Written from established medical guidance — independent clinical review in progress
This guide is for general education and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your health. In an emergency or crisis, see our crisis support resources.