Perimenopause
The years before menopause, when your hormones start to change. Here's what to look out for, and how we can help you feel like yourself again, now and in the years ahead.
What is perimenopause?
Perimenopause is the time leading up to menopause. Your hormone levels start to rise and fall unevenly, and you may notice changes in your body, mood and periods.
It usually starts in your 40s, but for some women it begins in their late 30s. It can last several years, and symptoms often come and go. You reach menopause when you haven't had a period for 12 months.
Many women don't realise they're perimenopausal, because the signs aren't always hot flushes and can start earlier than expected.
Symptoms
Every woman is different, and you may only notice a few of these.
Mind and mood
- Anxiety or low mood
- Irritability
- Brain fog and poor memory
- Loss of confidence
Body
- Hot flushes
- Weight changes
- Joint aches and headaches
- Dry skin
- Heart palpitations
Sleep and energy
- Trouble sleeping
- Night sweats
- Tiredness and low energy
Periods
- Irregular periods
- Heavier or lighter periods
- Worse PMS
- Breast tenderness
Intimate health
- Low libido
- Vaginal dryness or discomfort during sex
- Needing to wee more often
These symptoms can have other causes, so we always look at your full health picture. If you have bleeding after sex, between periods or after your periods have stopped, see a doctor promptly.
Why now matters for your future health
Perimenopause isn't only about getting through the symptoms. It's the best time to build strong foundations for the rest of your life. Falling estrogen affects your bones, heart and brain, and the habits and care you put in place now can protect you for decades.
That's why your plan looks at five areas together, not just your hormones:
- Hormones
- Nutrition
- Movement
- Sleep
- Stress
How we can help
We bring medical care and nutrition together in one plan. Nutrition isn't an extra here, it's an essential part of your care, because what you eat fuels how you feel today and protects your health for the decades ahead.
Medical care
From our doctor
- A full review of your symptoms and history
- HRT options, if right for you
- Testosterone, where appropriate
- Blood tests when they'll genuinely help
Nutrition support
From our nutritionist
- Fuel your body for steadier energy all day
- Find and fix gaps in key nutrients, such as iron, vitamin D and B12
- Support your mood and sleep through food
- Realistic help with weight changes
- Protect your bones and heart for the future
Your first appointment
An unhurried 60 minute consultation, online or in person. We'll listen to your story, explain what's happening in plain English, talk through your options, and give you a written plan so you know exactly what happens next.
“My mum was told it was just her age for years. We started Menopause Angels so that you're listened to the first time.”
“I'd seen my GP three times and kept being told it was stress. In one appointment, the team explained exactly what was going on and gave me an eating plan I could actually stick to. Six months on, I'm sleeping through the night and finally feel like me again.”
Common questions
Do I need a blood test to know if I'm perimenopausal?
Not always. If you're over 45, perimenopause is usually recognised from your symptoms, because hormone levels can change from day to day and one test rarely gives a clear picture. Blood tests are still helpful in some cases, for example if you're under 45, or to check for things that cause similar symptoms, such as thyroid problems, low iron or low vitamin D. If you still have periods, the timing of the test usually doesn't matter, and we'll tell you if it does.
Can I have HRT while I'm still having periods?
Yes. Many women start HRT during perimenopause. If you still have a womb, you'll take progesterone alongside estrogen to protect the womb lining, and the type is chosen to suit you while you're still having periods. Our team will explain the options, benefits and risks so you can decide what feels right for you.
Can changing my diet really help?
Yes, and it's a key part of your plan, not an extra. During perimenopause your body's needs change. Getting enough protein, fibre and healthy fats, along with the right vitamins and minerals, such as iron, vitamin D, B vitamins, magnesium and calcium, helps fuel your body, lift your energy and steady your mood. It also protects your bones and heart as estrogen levels fall. Our nutritionist looks at what you eat now, spots any gaps, and builds simple changes that fit your life, working hand in hand with your medical care.
Do I need a referral from my GP?
There's no need. Just book directly with us, online or in person. With your permission, we'll share your plan with your GP so your care stays joined up.