Peri Menopause

Perimenopause banner

Perimenopause is the stage where your body is slowly transitioning to menopause. Perimenopause begins several years before you reach the menopause stage. Usually, you start experiencing the symptoms in your 40s. However, in some women, the symptoms may begin in their 30s. 

Studies show that on average, a woman experiences the symptoms of perimenopause for about 4 years. Nevertheless, in some women, it can last only for a few months. 

Perimenopause continues until you hit menopause and your ovaries stop releasing eggs and you can no longer have periods or become pregnant.

What Are the Causes of Perimenopause?

The leading cause of perimenopause is hormonal imbalance. Specifically, there is a drop in oestrogen, a chief female sex hormone, produced by the ovaries. During perimenopause, the oestrogen levels can occasionally be high and low, and thus, resulting in irregular periods and other symptoms. 

As you age and near the last phase of perimenopause, your ovaries produce lesser oestrogens. Even at this stage with little oestrogen production, you can still become pregnant. Your reproductive era ceases after you fully transition to menopause and do not get periods for over 12 months continuously. 

Reasons that may contribute towards early menopause are:

  • Family history
  • Hysterectomy (removal of the uterus) or Oophorectomy (removal of ovaries)
  • Cancer treatment
  • Smoking

What Are the Symptoms of Perimenopause?

Some of the commonly experienced symptoms of perimenopause are:

  • Irregular periods
  • Heavy or light periods than usual
  • Severe premenstrual syndrome (PMS) before periods
  • Fertility issues (you can still become pregnant with the help of treatments)
  • Hot flashes
  • Sleep trouble
  • Mood swings
  • Vaginal dryness
  • Urinary Tract Infections (UTIs)
  • Loss of sex drive
  • Weight gain
  • Bone loss
  • High cholesterol
  • Tender breasts 
  • Hair loss/ changes
  • Heart palpitations
  • Headaches
  • Muscle ache
  • Difficulty in concentration 
  • Forgetfulness

When to See a doctor? 

According to Mayo Clinic, see your doctor in case you experience any of the following symptoms:

  • Spotting or bleeding after your periods
  • Heavy bleeding – changing sanitary napkins every 2 hrs
  • Heavy bleeding – changing sanitary napkins every 2 hrs
  • Bleeding for over 7 days
  • Getting periods in less than 21 days
  • Bleeding after sex

How to Diagnose Perimenopause?

Your doctor will diagnose perimenopause based on the symptoms you are experiencing, and by recommending a blood test to check the thyroid function and hormonal levels.

What Are the Treatments to Reduce the Symptoms of Perimenopause?

Most of the women may get swift relief from perimenopause symptoms by taking prescribed or over the counter medications. You may be recommended:

  • Low-dose contraceptive (birth control) pills for a short duration
  • Vaginal rings
  • Progesterone injections
  • Birth control skin patches

However, in some cases, birth control pills are not recommended. So, discuss with your doctor and choose an ideal treatment to reduce hot flashes and other symptoms. 

Hormone therapy 

Hormone (oestrogen) therapy is recommended to normalise the sudden spikes and fall of oestrogen levels. This therapy may reduce osteoporosis risk, a symptom of perimenopause. 

Oestrogen therapy with progesterone is suggested in the form of:

  • Creams
  • Gels
  • Oral pills
  • Skin patches

Non-hormonal dietary supplements

Your gynaecologist may recommend non-hormonal dietary supplements, such as Femarelle® to immediately relieve the symptoms. This is an alternative therapy used in women who do not wish to undergo hormone therapy. 

Vaginal oestrogen

Vaginal creams, rings or tablets are directly administered into the vagina to ease vaginal dryness, UTI problems and pain during sex.


Anti-depressants belonging to the Selective Serotonin Reuptake Inhibitors (SSRIs) group of drugs alleviate mood swings and reduces hot flashes. This is a good treatment option in women who cannot undergo hormone therapy for health reasons. 

Other tips to relieve the perimenopause symptoms:

You can take care of general well-being to reduce the perimenopause symptoms: 

  • Regular exercises 
  • A healthy diet including calcium, vitamins, carbohydrates, fibres and minerals 
  • Healthy lifestyle – avoiding tobacco, alcohol and drugs 
  • Maintaining a healthy weight
  • Maintaining a regular pattern of sleeping and waking up

Consult with your doctor if you notice any symptoms and get through the perimenopause stage comfortably with one of the available treatments. 

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