What is perimenopause?

 

Perimenopause is the stretch of years leading up to your final period. Your ovaries don't wind down in a neat, steady line. Hormones can at first fluctuate, sometimes month to month, before eventually tapering down. Your body notices these changes and with hormone receptors throughout the body - symptoms can present in a range of ways. For most women it starts in their mid-to-late 40s, although it can begin earlier, and it lasts around four years on average. For some women it's much longer.

 

Menopause itself is one day: the point when you've gone 12 months without a period. In Aotearoa and Australia that's around age 51 on average. Everything after that is postmenopause.

 

The signs and symptoms of perimenopause can vary a lot from woman to woman. Periods change first for many: closer together, further apart, heavier or lighter. Then come the ones people talk about less: hot flushes and night sweats, broken sleep, mood shifts, feeling more anxious or flat than usual, brain fog, achy joints. Most women notice at least some of these. And because hormone levels swing so much, a single blood test often can't confirm perimenopause. That's why NZ and UK guidance says that for women over 45, it's usually recognised from symptoms rather than bloods. So if you've been told “your bloods are normal”, that can be true and you can still be in perimenopause.

 

This is also a time when the foundations for health matter more. Because our bodies are going through so much physiological change, our windows of tolerance to stress can be reduced making us feel more vulnerable to stressors. It is also a time where we need to be more considerate of our bone health, metabolic health, and cardiovascular health.

 

None of this means something is wrong with you. It's a normal life stage we all go through. Having more of an understanding helps us navigate this period with more clarity, confidence, and resilience.