For many women in their 40s, the perimenopause – before the menopause kicks in – can bring about what feels like endless changes to their bodies. So what should you expect and how can you get through it in one piece?

Whether it’s tracking your periods on an app or sharing horror stories about your sex life with your mates over a glass of fizz, the discussions we have now about women’s health and hormones are certainly more honest than ever before. And thank goodness, right? It means natural stages of life such as the perimenopause are no longer taboo subjects … and we’re so here for that.

WHAT IS THE PERIMENOPAUSE?

Just as the word implies, the perimenopause happens in the run-up to the menopause when your ovaries gradually stop working. For most women, this is in their mid to late-40s and can last up to five years before the menopause takes over; periods become erratic as your oestrogen and progesterone levels decrease, and you may start to experience those pesky hot flushes.

Not wanting to bring down the mood, the list of common symptoms may sound frightening. While no two women will go through it with a carbon copy of issues, the most likely things you’ll experience include mood swings, weight gain, vaginal dryness and loss of sexual desire, skincare issues (yes, those teenage spots may make an unwelcome return), trouble sleeping, emergency dashes to the loo and night sweats.

Now, none of that sounds like much fun, we get it. But it’s important to remember that the perimenopause is completely natural and will be experienced by 50% of the population at some point or other. And that’s exactly why it needs to be talked about, recognised and accepted – both by society and medical professionals.

HOW DO I KNOW I’M PERIMENOPAUSAL?

The average age of the last period for women in the UK is 52; but you’ll find that you’re in the midst of your perimenopause in the years running up to that. So the first obvious sign to look out for is changes to your monthly cycle – this may mean periods come sooner than expected and are heavier, as progesterone levels fall.

You can have blood tests to measure your hormone levels, while your age and symptoms will also be taken into account. Our advice? If you are going to see your GP, write down any questions you want answered beforehand, and make a note of what treatment can be prescribed, how it will help and if there are any side-effects you need to be aware of.

DO I NEED HRT?

Every year, an estimated 13 million women in the UK experience perimenopause and a growing number will rely on Hormone Replacement Therapy to get them through. HRT uses oestrogen or combined oestrogen and progestins to even out hormone levels. While there has been much debate over the years, The North American Menopause Society, the American Society for Reproductive Medicine, and The Endocrine Society take the position that “most healthy women can use hormone therapy for relief of their symptoms if they so choose”. However, you should consider your quality of life priorities and personal risk factors and discuss these with your doctor or a healthcare expert before deciding whether it’s for you.

“Unfortunately a scientific publication 20 years ago suggested that HRT might be more harmful than beneficial, but recent evidence suggests that the opposite is true for the majority of healthy women, all things considered,” explains women’s wellness advocate Dr Julia Sen. “Sadly many women still struggle through this difficult transition without hormonal support, believing that this to be the safer option.”

WHAT ELSE CAN I DO?

Eat well and move more. Simple! A healthy diet high in fruit, veggies, unsaturated fats, lean meat and fish ensures you’ll be benefitting from countless nutrients, protein and fibre, while exercise will boost your emotional and physical wellbeing. Sign up for a local Pilates class or running club to improve energy levels, sleep, mental health and bone density.

Keep a diary of your symptoms and see if there are any triggers. For example, alcohol and smoking can intensify the issues associated with perimenopause, including hot flushes and problems getting a good night’s shut eye. So what better time to ditch a few bad habits.

And, if possible, re-focus on the positives. “Far from being the end, the perimenopause and menopause herald new beginnings and opportunities,” adds Dr Sen. “Years of juggling family and career has often meant putting ourselves last. It’s a time to reflect on what’s important in our lives going forwards, perhaps focusing on professional goals, enjoying hobbies or simply taking better care of ourselves. With our mature status comes self-knowledge, letting go of the insecurities of youth and leaving us free to enjoy what we have achieved and look forward to the next exciting chapter.”

Please note, the above is not intended as official medical advice. Please discuss your perimenopausal issues with a medical professional to understand the best course of action and treatment for you.