What is perimenopause and menopause?
Perimenopause is a time when you can experience symptoms due to changing hormone levels. The average age for experiencing these symptoms is mid to late 40s, although for some people they can start much earlier.
Menopause is when you have had no periods for 12 months (if you are over 50), or 24 months (if you are under 50). The average age of menopause is 51 but can be quite a few years earlier or later.
What causes perimenopause and menopause?
The number of eggs in the ovaries decreases as you get older, which causes the levels of oestrogen and progesterone hormones to be less predictable. This is a natural change but can cause some troublesome symptoms while hormone levels are going up and down.
What are the symptoms of perimenopause and menopause?
Most women and people born with ovaries will experience perimenopausal symptoms. For some these are mild and for others they can interfere with their daily lives. They include:
• Period changes - more or less frequent, heavier, or more painful.
• Hot flushes and night sweats
• Vaginal dryness. This can cause sex to become painful and increase the chance of urinary infections
• Mood changes, for example feeling irritable, mood swings, low mood and anxiety
• Brain fog - Poor memory and concentration
• Headaches and migraines
• Dry skin
• Muscle and joint aches and pains
How long do symptoms last?
The average duration of perimenopausal symptoms is seven years, but this can vary from months to over 10 years.
Can I do a test to see if I am perimenopausal?
Perimenopause and menopause can normally be diagnosed by talking to your doctor about your symptoms. A blood test might be helpful if you are under 45 with symptoms, or to investigate other causes of symptoms.
It is very important to investigate new symptoms such as heavy bleeding, bleeding between periods, bloating, pain etc. to rule out causes like sexually transmitted infection or cancer.
If I am perimenopausal can I still get pregnant?
Yes. Although fertility declines as you get older, you may still be ovulating (releasing eggs) until you reach menopause.
Are there any treatments for the symptoms of perimenopause and menopause?
Yes. Combined hormonal contraception or Hormone Replacement Therapy (HRT) help keep hormone levels steady. Progestogen only methods (such as the Hormonal IUS, the progestogen-only pill, the Implant and the Injection) can help with heavy and painful periods.
Many people find lifestyle changes such as healthy eating, regular exercise and mindfulness can be helpful.
There are also a wide range of other treatments that can be offered depending on the symptoms you are experiencing.
How long can I stay on a combined hormonal method?
The two-hormone pill, patch and vaginal ring all help with perimenopausal symptoms. It is safe to stay on these methods until the age of 50 if there are no medical reasons to stop.
What is Hormone Replacement Therapy (HRT)?
HRT normally consists of two hormones - progesterone and estrogen. It is the decline in oestrogen that causes most of the troublesome symptoms of menopause e.g. hot flushes and vaginal dryness. The progesterone protects the uterus from any unwanted effects of oestrogen on the womb.
Does HRT protect against pregnancy?
No. Although HRT uses the same types of hormones as contraception, they are not given at the right levels to protect against pregnancy. Read more about contraception and the perimenopause in Contraception for Over 40s.
Will taking contraception affect when I go through menopause?
No, although some methods can treat perimenopausal symptoms, they do not affect the time you go through menopause. Contraception for Over 40s. It will be difficult to know whether the perimenopause is happening if you are taking combined hormonal contraception – you’ll probably need to stop to find out whether the menopause has happened (i.e. no periods for 12 months).
Further information on Perimenopause and Menopause can be found: