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PERIMENOPAUSE: BUSTING THE MYTHS
Perimenopause is the hormonal transition leading up to menopause. During this time, ovarian hormone levels, particularly estrogen and progesterone become increasingly variable before eventually declining.
Changes to the menstrual cycle are often an early sign, but women can still experience perimenopause symptoms while having regular periods. For many women, symptoms begin in their early forties, although some notice changes in their thirties.
Low mood, aching joints, bloating, weight changes, reduced libido, fatigue and sleep disturbance can suddenly make everyday life feel much harder. Because these symptoms can overlap with stress and burnout, many women do not initially realise that hormonal changes may be contributing.
Perimenopause can last anywhere from around one year to as long as 10 years. Menopause itself is generally reached after 12 consecutive months without a menstrual period. There is no single “normal” experience. Some women have very few symptoms, while others experience significant changes affecting their physical and emotional wellbeing.
Common symptoms can include hot flushes, night sweats, sleep problems, headaches, mood changes, brain fog, vaginal dryness, painful sex, urinary changes, bloating and changes in body composition.
Hormonal fluctuations can also affect the brain’s response to stress. As estrogen and progesterone become less predictable, some women notice increased anxiety, disrupted sleep, racing thoughts and difficulty concentrating.
Libido may also change. Lower estrogen can contribute to vaginal dryness and discomfort, while poor sleep, stress and mood can further affect sexual desire. Painful sex should not simply be accepted, effective treatments are available.
Weight changes are another major common concern. Perimenopause itself does not automatically cause weight gain, but hormonal changes occur alongside ageing, reduced muscle mass, stress, poor sleep and changes in metabolism and activity. Many women notice more fat accumulating around the abdomen.
Blood tests are not always useful because hormone levels fluctuate considerably. Assessment is generally based on age, symptoms and menstrual history.
There are a variety of treatment options varying from lifestyle changes, non hormone and menopausal hormone treatment (MHT). MHT can be an effective treatment for symptoms such as hot flushes and night sweats and can also support bone health, sleep and vaginal symptoms. Treatment should always be individualised, taking into account personal and family medical history.
FIVE COMMON MYTHS:
1. I'm too young to be in perimenopause — symptoms can actually begin years before your final period.
2. My blood test is normal, it can't be perimenopause hormones can fluctuate in early stages, diagnosis is usually clinical.
3. I just have to put up with it — you don't! There are effective lifestyle strategies and treatments available.
4. Hormones are dangerous — there are safe MHT options. Risks and benefits vary between women and different forms of treatment.
5. I can't get pregnant — the rates are lower, but ovulation can still occur, even with irregular periods.
32 SLIM-MAGAZINE SUMMER 2026/27