Guide

Perimenopause and menopause

Perimenopause is the time before your last period, when your hormones start to change. It usually starts in your mid forties and lasts four to eight years on average. Menopause is the moment you have gone twelve months without a period, on average around 51. Typical signs are changing periods, hot flushes, night sweats, poor sleep and mood changes.

Perimenopause, menopause, postmenopause

Perimenopause is the transition: your ovaries make less oestrogen and progesterone, and your cycle becomes less regular. Menopause is one day in hindsight, twelve months after your last period. Everything after that is postmenopause. Some symptoms, like vaginal dryness, can start or continue after menopause.

The most common signs

Periods that come closer together, further apart, heavier or lighter. Hot flushes and night sweats. Sleeping badly, waking at 4 am. Mood changes, anxiety, irritability and brain fog. Joint aches, dry skin, a lower sex drive and needing to wee more often. Not everyone gets all of them, and they can come and go.

When does it start?

Most women notice the first changes between 40 and 47. Menopause before 45 is called early menopause, before 40 premature ovarian insufficiency. If your periods stop or change a lot before 45, see your GP: there are good reasons to check it.

What helps

Hormone replacement therapy (HRT) is the most effective treatment for hot flushes and night sweats for most women, and your GP can tell you whether it suits you. Cognitive behavioural therapy helps with hot flushes, sleep and low mood. Regular movement, less alcohol and caffeine, a cool bedroom and layers help many women too.

Why tracking helps

Doctors in the UK usually recognise perimenopause from your symptoms and age, not from one blood test. A record of your cycles, hot flushes, nights and mood over a few weeks makes that conversation much easier. You walk in with facts instead of trying to remember how the last months felt.

Track it in one calm place

PERIOD. meno logs hot flushes, nights, mood, bleeding and your HRT, and turns it into a clear report for your GP. The #1 period tracker that doesn't sell your data, rated 4.8 by 100,000+ women.

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Calculators that help

Period calculator

Questions

How do I know if I am in perimenopause?

If you are over 40 and your periods are changing, and you have symptoms like hot flushes, night sweats or poor sleep, it is likely. Only a doctor can say for sure. In women over 45 with typical symptoms, NICE guidance says a blood test is usually not needed.

How long does perimenopause last?

On average four to eight years, but it can be shorter or longer. Hot flushes last on average about seven years, and for some women longer.

Can I still get pregnant in perimenopause?

Yes. You can still ovulate, even when your periods are irregular. Guidance says to keep using contraception until two years after your last period if you are under 50, and one year if you are over 50.

Is bleeding after menopause normal?

No. Bleeding twelve months or more after your last period should always be checked by your GP, even if it is just a little spotting.

Does HRT cause weight gain?

Research does not show that HRT itself causes weight gain. Many women gain weight around menopause because of age, hormones and changes in muscle and sleep.

Which app helps with perimenopause?

PERIOD. meno lets you log hot flushes in one tap, track sleep, mood, bleeding and HRT, and make a clear report for your GP. Your data is stored in the EU and never sold.

Also on PERIOD.

Trying to conceive

Sources: NICE guideline NG23 Menopause: identification and management (2024); NHS: Menopause and Perimenopause; The Menopause Society position statements.

This page is general information, not medical advice. Questions about your own body go to your GP, midwife or gynaecologist.