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Advice · Women's health

Perimenopause: what's normal and what's not

Perimenopause is the natural run-up to menopause. Most of its symptoms are common and usually nothing to be alarmed about.

Dr Kerry Whelan, Private GP · GMC 6071610
Reviewed by Dr Kerry WhelanPrivate GP · GMC 6071610
Last updated · June 20264 min read
01

What is normal in perimenopause

Perimenopause is the transition before your periods stop for good, often beginning in your mid-40s as your ovaries make less oestrogen. Because those levels rise and fall unevenly, symptoms come and go, and while they can be a nuisance they are rarely a sign of anything sinister.

Irregular periods, whether shorter, longer, heavier, lighter or more spaced out
Hot flushes and night sweats that come on suddenly
Disturbed sleep, often waking in the early hours
Mood changes and brain fog, such as low mood, anxiety or trouble concentrating
02

What is worth getting checked

A few symptoms are not typical of perimenopause and are worth raising with a GP or specialist so the cause can be confirmed. Please be seen for bleeding after sex, bleeding between periods, very heavy bleeding, or any bleeding after your periods have stopped, and for new severe headaches or overwhelming low mood. If you ever feel unable to keep yourself safe, contact your GP urgently, call 111, or in an emergency call 999.

03

How a consultation can help

You do not usually need a blood test if you are over 45, as your symptoms and cycle history tell the story. Treatments range from lifestyle changes to HRT, which replaces the oestrogen your body makes less of, though HRT is not right for everyone. Your appointment is with Dr Kerry Whelan, our private GP, who offers menopause and HRT consultations and prescribing, and we can usually see you the same or the following week.

04

Common questions

At what age does perimenopause start? +

Most often in the mid-40s, but it can start in your late 30s or early 50s.

Do I need a blood test? +

Usually not if you are over 45, as your symptoms and cycle history are normally enough.

Is HRT right for everyone? +

No, it is not suitable for everyone, so it is discussed individually based on your symptoms and history.

Dr Kerry Whelan, Private GP · GMC 6071610
Reviewed byDr Kerry WhelanPrivate GP · GMC 6071610View profile →
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