Perimenopause is a period of our lives that on average starts around 45 years of age. It is
the start of the decline of our female hormones that culminates in menopause at around 51
years of age in the UK.
Women can be in this phase for up to 10 years. That is to say that you may be experiencing
all or some of the perimenopausal symptoms for a long time before periods cease. It is a
difficult prediction to make and varies from one woman to another. If symptoms of
perimenopause start under 45 years of age, then this may be heralding an earlier
menopause.
During the perimenopause we may still be having regular, irregular, frequent or infrequent
periods associated with up to 100 other signs and symptoms. All of these can be due to
hormonal imbalance.

Symptoms of Perimenopause

  • Tiredness and fatigue
  • Poor motivation
  • Mood swings, irritability and low mood
  • Anxiety
  • Dry skin
  • Reduced immunity
  • Increased facial hair
  • Hair thinning and frizziness
  • Night sweats
  • Hot flushes
  • Chills
  • Cystitis /Recurrent UTI
  • Symptoms of vaginal prolapse
  • Bladder problems
  • Urinary Tract Infections (UTI)
  • Vulval Dermatitis/Lichen Sclerosus
  • Bowel sluggishness
  • Vaginal dryness
  • Lack of or increased libido
  • Erratic, infrequent light or heavy periods
  • before ceasing

Treatment of Perimenopause

Perimenopause can be treated with Hormone Replacement Therapy. Treatment will depend on
what symptoms of perimenopause you are experiencing. If it is heavy bleeding or irregular periods
for example, then the first aim is to regulate periods or reduce bleeding. This is because increase in
menstrual blood loss can make women anaemic. Anaemia can have serious health sequelae such as
breathlessness, tiredness, lack of concentration and thinning of the hair. At the same time, we may
also need to address any other symptoms of hormone imbalance that you may be experiencing.
These could be hot flushes, night sweats, vaginal dryness and anxiety. The management of your
symptoms is likely to include estrogen replacement therapy.

It is important to understand that treatment options will need to be tailored to an individual
woman’s symptoms and needs. Your doctor will assess and advise you about the treatment options
available to you. Both Hormone Replacement Therapy (HRT) and Bioidentical Hormone Therapy (BHRT) perimenopause treatments can provide effective relief of symptoms.