Perimenopause and Menopause

Everything you need to know.

Perimenopause and Menopause

Everything you need to know.

Navigate to the next section

Perimenopause and Menopause

While there isn’t anything you can do to stop menopause from happening, understanding more about the process and what your body needs during this transition will make it easier to manage.

Menopause marks the end of the reproductive phase of your life – the time where you could theoretically get pregnant. Menopause happens because over time your ovaries stop producing eggs, which in turn, causes your periods to stop.

No eggs or cycles means that your body stops producing the same amount of the hormones needed to support a pregnancy and your levels of estrogen, progesterone (also called progestin) and testosterone drop.

While many of us are not the biggest fans of our periods, having a monthly cycle does mean we continue to produce sex hormones associated with many important mental and bodily functions. When we produce less of these hormones, our bodies notice the difference and around 80% of us experience menopausal symptoms as a result of our hormone levels dropping.

While there isn’t anything you can do to stop menopause from happening, understanding more about the process and what your body needs during this transition will make it a lot easier to manage.

There’s no specific age at which menopause will happen, but the average age in the US is 52. However, many people experience menopausal symptoms for years before their periods completely stop. This time in your life is called perimenopause. The clue to this one is in the name, as ‘peri’ means before.

Menopause can be divided into 3 main stages:

Perimenopause: The time before menopause when you begin experiencing symptoms including changes to your period.
Menopause: The point in time when you are no longer having periods. After you experience 12 months in a row without a period you will be able to say you have ‘gone through menopause’.
Post-menopause: The remainder of your life after menopause.

When your hormone levels start to change it’s important to think about how to take care of your mind and body. Your eating habits, your activity levels, your stress levels and your quality of sleep can all influence how severely you experience menopausal symptoms. So, it’s worth making some changes to address lifestyle factors, as lower levels of sex hormones in your body can have a big impact. Adjustments can make a significant difference to the way that you feel.

The good news is there are treatments available that will help to improve your symptoms. Hormone Therapy (HT) which helps to address your shifting hormone levels, will help to ensure you don’t feel the effects of menopause as intensely. HT also offers a number of benefits when it comes to healthy aging. There are lots of options to explore when it comes to HT, so be sure to read our resource on treatment options for more information.

Interventions such as Cognitive Behavioral Therapy (CBT) have also been found to help address symptoms, particularly when it comes to the psychological shifts you may experience.

So that was a quick overview, but there’s loads more to get into – keep scrolling to find out more about how to manage menopause.

Further reading

Estrogen

Progestin/Progesterone

Testosterone

Myth Buster

Help spread the knowledge

Impact of the menopause

Menopause costs American women an estimated

$1.8 billon

in lost working time per year

Things you
should know

What is perimenopause?

As we’ve explained perimenopause is the period of time that comes before menopause. Here are some other things you should know about perimenopause:

  • During perimenopause your ovarian function will start to change.
  • Your hormone levels will shift, going up and down more than they have before.
  • Changes to your hormone levels may cause you to experience symptoms, particularly when your hormone levels are lower.
  • You will still have periods (if this is normal for you), but your periods may change:
    • you may bleed more or less heavily
    • the time between your periods may get shorter or longer
    • you may skip a period, or several periods altogether
    • you may have months where you do not ovulate and do not release an egg.
  • Perimenopause usually starts in your mid-40s, but this is different for everyone.
  • The average length of perimenopause is between 4-10 years, but there’s no set amount of time we can guarantee you will be in perimenopause for.
  • The length of time is different for everyone. Your perimenopause could last a few months, or a few years.
  • It’s common not to know that you have entered perimenopause as symptoms can be subtle at first.

What is menopause?

Menopause is the time in which your periods stop completely. After a full calendar year has passed where you have not had a period, you will be able to say you have gone through menopause. Aside from no longer menstruating, here are some other things you should know about menopause:

  • Menopause happens because eventually, your body stops producing enough of the hormones needed for you to ovulate and become pregnant.
  • The average age of menopause (experiencing a whole year without periods) in the US is 52 years, but it can happen at different ages for different people.
  • The age at when you go through menopause can depend on your heritage. For example, if you’re Black or Latina, you may enter your menopause a bit earlier than someone who is white.
  • If you’re born with ovaries you will go through menopause at some point in your life. There is no way to change when menopause starts or put it off.
  • If you have surgery where both of your ovaries are removed, or you take medication that affects how your ovaries work, you’ll enter menopause immediately, no matter what age you are.
  • If menopause happens naturally before the age of 40 years old you may be told you have a condition called Primary Ovarian Insufficiency (POI).
  • If you experience menopause between the ages of 40- 45, you may be told you’ve gone through an early menopause.
  • While menopause isn’t ‘genetic’ and all women will go through it, your experience of menopause may be similar to your mothers or other close family members. For example, if your mother went through menopause earlier than the national average, you may too.

What is post-menopause?

The post menopausal phase lasts for the remainder of your life after menopause. Here are some things you should know about the post-menopause period:

  • After 12 consecutive months have passed where you have not had a period, you will be able to say you have had your menopause and entered the post-menopause stage.
  • You may continue to have menopausal symptoms (even after your periods have stopped) for an average of 4-5 years or more.
  • You may be more prone to vaginal or vulval dryness and discomfort as well as a thinning of your genital tissue at this stage. There are effective treatments for this. See our ‘What’s up down below?’ resource for more information.
  • You will be post-menopausal for the rest of your life.
  • You may spend a third of your life as a post-menopausal woman, so it’s good to be prepared for what this is going to mean for your health and wellbeing in the future.
  • Having lower hormone levels as a result of menopause means you may be at greater risk of developing certain conditions such as osteoporosis (a weakening and thinning of the bones) or cardiovascular disease (problems with your heart). Using HT can help with this.

Did you know there are over 34 recognized symptoms of menopause?

Find out if you’re in perimenopause or menopause using our symptom checker here.

Download it here.

How hormones can change at perimenopause and menopause

Your ovaries are responsible for producing most of your sex hormones:

  1. Estrogen
  2. Progesterone
  3. Testosterone

These hormones are commonly associated with fertility and sex drive, but they also help the body function in many other ways you may not realize. Estrogen for example, has been linked to immune response as well as cognitive function.

Once your ovaries stop producing the same amount of these hormones that you are used to having, your body usually realizes that you are missing them, and this is when you may start to experience symptoms.

How to know if perimenopause has started

Symptoms of perimenopause are different for everyone and for most women, they involve more than hot flashes.

Did you know there are over 34 recognized symptoms of menopause?

Find out if you’re in perimenopause or menopause using our symptom checker here.

Symptoms can creep up on you and at first, you may not realize it’s your changing hormone levels that are to blame. Some common early symptoms of perimenopause are:

  • changes to your sleep
  • feeling anxious or experiencing quick shifts in your mood
  • feeling more tired or fatigued.

Most of us would put these things down to problems at work, relationship issues or just being too busy, right? So, watch out for changes to your periods too.

If you’re using a contraceptive that stops your periods, or you don’t know what a normal period is like for you, you can still use the symptom checker to see if you’re showing signs of perimenopause and read more about possible symptoms here.

Take control of your perimenopause and menopause

While you can’t stop menopause from happening, there’s a lot you can do, to make sure you continue to feel like yourself while navigating this period of time in your life:

  • Look at our habits and lifestyle advice to see what positive changes you could make to your eating, exercise, sleep and stress levels.
  • Focus on looking after your mind and emotions as much as your physical health. Nurture your close relationships both intimate and familial. Even if you don’t feel like being social, make sure to keep checking in with friends, and foster those community connections too.
  • Talk to others about your experience of perimenopause and menopause. Sharing what you are going through with others can really help when it comes to feeling supported during this time.
  • Consider taking HT not only to help alleviate symptoms, but to protect your future health outcomes too.

Hormone Therapy

Many women choose to use HT as it helps to alleviate the symptoms they are experiencing. HT works by adding back the hormones your body is naturally losing as a result of perimenopause and menopause. Most women use both estrogen and progestin when beginning an HT regime, but some women also opt to use testosterone as part of their HT regime too.

HT comes in many different forms and it is generally agreed that a transdermal option (HT that is rubbed onto, and absorbed through the skin) is the safest option when it comes to the estrogen component of your HT.

You may have already heard about HT. Some people think it’s dangerous and misinformation linking using HT to an increased risk of cancer means many women remain afraid to use HT. However, this claim is founded upon research findings that have been disproved. For most women, HT is not only safe to use, but it is the most effective way to treat perimenopausal and menopausal symptoms.

When taken as recommended by a clinician, HT can not only improve your menopausal symptoms, it can also help to prevent against health conditions such as osteoporosis and cardiovascular disease.
You can find out more about HT and how to access it safely here.

Managing menopause

When it comes to perimenopause and menopause, you don’t need to suffer in silence. Menopause treatments have come a long way and there is plenty you can do to address your symptoms.

Now more than ever, menopause is being recognized as something that can massively impact women’s lives. While menopause may have been a taboo topic in the past, this is changing. Hormonally, along with countless other organisations, are committed to shining a light on the need to better support women navigating their menopause.

In providing evidence-based educational information, and through fostering communities of care, Hormonally’s hope is that you will feel empowered to seek the support you deserve and manage your menopause magnificently!

We need your help

Find out how you can support us