Perimenopause, menopause ?  What’s are the options? 

You’ve heard about menopause, hot flushes, irritability and night sweats and have decided it’s not for you.  I know the feeling. Women in their 40s, think it’s a long way off, but most gradually slide into it. 

Whilst this time in a woman’s life has many positives such as more freedom, clarity and wisdom, it can also present us with some challenging and unexpected symptoms.   

Symptoms may creep up on us, especially when we don’t understand the impact menopause can have on our well-being.   

Until recently, women didn’t share their experience of the menopause, even the word had negative connotations for most of us, in fact it still does. 

Fortunately, there has been some really strong voices in this field that are changing the narrative around menopause, giving women the opportunity to open up and seek the advice they need to get them through this tricky stage in their lives. 

Most women start to notice changes in their 40s, however, the average age of menopause is 51, but it varies from woman to woman.   

1 in 100 women will experience premature menopause before the age of 40 – at the other end of the spectrum, some continue to have regular cycles well into their 50s.  Unfortunately, these changes can be haphazard for many of us, with symptoms coming and going – it can be quite disruptive to our lives. 

You’ve probably heard the term  

Peri menopause  

This just means the time leading up to the moment when your periods stop altogether – for some, this topsy turvy time can last up to 10 years before you stop having periods altogether. 

Women may experience symptoms even though they are still having a regular monthly cycle. During the perimenopause your hormones can fluctuate erratically; think of it like puberty in reverse, with the difference being that the general trend is that your hormones are declining. 

Common symptoms you may experience 

  • Less regular periods / heavier bleeding  
  • Sleep issues 
  • Anxiety  
  • Mood swings 
  • Irritability  
  • Weight gain
  • Palpitations 
  • Depression / low mood / brain fog
  • Skin issues (dry, itchy, spots, irritation) 
  • Low libido 
  • Vaginal dryness / painful intercourse  
  • Hot flushes / Night sweats 
  • Urinary tract infections 
  • Dry eyes / mouth 
  • Joint aches 
  • Less or no motivation 
  • Headaches / migraines  
  • Fatigue 

80% of women experience menopausal symptoms.  

The lack of oestrogen seems to make the biggest impact as it declines, but lower levels of progesterone and testosterone can also be felt.   

We have oestrogen receptors all over the body, everywhere from our reproductive organs, brains, cardiovascular system, skin, bladder, vagina and bones. 

It’s no wonder we feel their absence so acutely.  


Is defined by the absence of a period for 12 months.   

Some of the symptoms that women experience may settle down, like hot flushes and insomnia, however, for many women, these symptoms and many others may continue.  That’s because they are living with much lower levels of hormones.  

Dr Louise Newson, The Menopause doctor is an advocate for hormone replacement therapy (HRT), and states that menopausal women are hormone deficient, therefore she believes that most women benefit from taking HRT, if it is safe and appropriate for them to do so. 

Should I take Hormone Replacement Therapy – HRT ?

Replacing oestrogen and progesterone can prevent bone loss, reduce the risk of dying from heart disease, alleviate anxiety and in some cases depression, improve our cardiovascular health, reduce  the risk of Type 2 diabetes, dementia and colon cancer, as well as, help alleviate the many other symptoms associated with menopause.  

Many women report that they have a better quality of life whilst taking HRT.

Historically HRT has had a bad press, however, the risks of HRT and breast cancer have been misreported and much exaggerated.  The tide has begun to turn and studies like the Women’s Health Initiative, 2002 – the original study that alarmed women and medics alike, has been re-evaluated.  Now, it is widely understood that there is a lower risk of contracting breast cancer whilst taking HRT, than originally reported.   In fact you have more risk of getting breast cancer if you’re overweight. Breast cancer is complex!

Unfortunately, that study has had quite a legacy and many women are still afraid of HRT and the prospect of getting breast cancer, understandably.   

It’s a personal choice and even when we’re armed with the correct information, we may of course prefer to take a more natural approach – and of course HRT isn’t for everyone.    

I would suggest that if you’re experiencing symptoms, the first thing to do is to discuss these with a healthcare professional and weigh up your options so that you can make a more informed decision that’s personalised to you. 

No woman needs to suffer in silence these days, we have options. And for many women, once they have their symptoms sorted, they find they feel stronger, happier, more determined and ready for new challenges.  We all deserve that. 

Can diet and lifestyle help ….. ? 


Diet and lifestyle play a huge role, and it’s very important that we consider our stress levels, alcohol intake and ensure our diet is replete to include plenty of plant based foods, essential fats and good quality protein.   

Plant oestrogens known as phytoestrogens may also be helpful, found in foods like soya and flaxseed, and are cited as one of the reasons that Japanese women suffer less with the menopause than we typically do in the west. 

Want to know more, discuss your options, just email book a free 15 minute chat to discuss how I can help you.