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Patient Guide

Understanding Perimenopause

It's not all in your head — and it's not just hot flushes

~4 yearstypical duration of perimenopause
40swhen symptoms most often begin
30+recognised symptoms, not just hot flushes

Symptoms you might notice

Hot flushes & night sweats

Often the first thing people link to menopause — sudden heat, flushing or sweating.

Often the first sign people link to menopause.

Changing periods

Cycles becoming shorter, longer, heavier or more irregular.

See your GP if very heavy or unusual.

Mood & anxiety

Hormone shifts genuinely affect mood — it isn't a sign of weakness.

Hormone shifts affect mood — this is real, not weakness.

Sleep & brain fog

Trouble sleeping, waking through the night, or feeling mentally hazy.

Usually eases as things settle.

Aches & joint pains

New or worsening joint and muscle aches.

Very common, often overlooked.

Vaginal & bladder changes

Dryness, discomfort or more frequent urinary symptoms.

Treatable — don't suffer in silence.

Do I need a blood test to diagnose it? Usually no — if you're over 45 with typical symptoms, perimenopause is diagnosed on your history alone. Hormone tests can be misleading at this stage because levels swing day to day. A test is mainly useful if you're under 45, or the picture is unclear.

What Can Help

Everyday things that genuinely help

1

Move regularly

Regular activity supports mood, sleep and bone & heart health

2

Sleep & cool down

A cool bedroom and a wind-down routine ease night sweats and sleep

3

Eat & hydrate well

Regular meals and good hydration help energy and mood

4

Mind your wellbeing

Stress management and support help with mood swings

See your GP sooner if you have...

  • Very heavy, prolonged or frequent bleeding
  • Bleeding after sex or between periods
  • Any bleeding after 12 months with no periods
  • Low mood that won't lift
  • Symptoms before 45, or under 40
  • Symptoms badly affecting work or home life

What your GP can offer

  • A diagnosis based on your symptoms and age
  • MHT/HRT — the most effective treatment for many people
  • Non-hormonal treatments if MHT isn't right for you
  • Vaginal oestrogen for dryness or bladder symptoms
  • Contraception advice — you can still conceive during perimenopause
  • A review of your mood, bone and heart health

Worth noting before your appointment

Symptom diary — Note your main symptoms each day for a week and bring it in — patterns help guide what to focus on first.

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