The Ultimate Guide to Perimenopause: Symptoms, Treatments and Signs It's Ending

In some cases, perimenopause can start as early as the late 30s, but most of the time it begins between the ages of 40 and 44. The average start date of perimenopause in the UK is 47.5 years, but it heavily depends on race and ethnicity and can also be affected by your lifestyle. Early onset perimenopause can often be due to genetics, and so knowing when your mother started her journey might give you a rough estimate of when you can expect yours to begin.

There are various signs of perimenopause.  These can vary from individual to individual as it isn’t a “one size fits all” scenario. As with the start date of perimenopause, symptoms can differ depending on your lifestyle, ethnicity, race and genetics. 

1.    Irregular menstrual cycles: These are the first signs of perimenopause.  This means that you might experience heavy or light bleeding and sometimes you might skip a cycle altogether. 
2.    Hot flashes and night sweats: These are extremely common. Vasomotor symptoms like hot flashes and night sweats are often influenced by genetic factors too.
3.    Difficulty sleeping:  This might be a consequence of night sweats and other signs.
4.    Vaginal dryness: Oestrogen levels decrease during perimenopause which leads to vaginal dryness. This symptom can also bring about a drop in libido as having sex might cause discomfort. 
5.    Mood changes, depression, anxiety, irritability: Due to the continuous imbalance of your hormones during perimenopause, this can result in frequent mood swings and, in more serious cases, depression. Take a look at our article on mental health and menopause if this is an area you might be struggling with. 
6.    Brain fog and dizziness: Difficulty concentrating and memory lapses, vertigo and loss of balance are some other signs of perimenopause.

There are many more symptoms of perimenopause, but the above are some of the most common. Read on for some information around bladder weakness; another sign that you might have entered perimenopause.

Bladder weakness is a consequence of perimenopause that people mostly keep quiet about as it is believed to be embarrassing and shameful. Of course, not everyone experiences incontinence, however it is more common than you might think, and if you do find yourself experiencing it, you’re definitely not alone.

As with most of the other symptoms of perimenopause, bladder problems happen when oestrogen levels start to decrease. In the years leading up to perimenopause, these hormones play an important role in keeping the pelvic floor and bladder strong. So, when they start decreasing, it’s suddenly harder to control your bladder.

However, managing incontinence before and after menopause is definitely possible. Pelvic floor strengthening exercises are highly recommended, and you can use our Kegel Trainer alongside the Emy app for best results.  

There are also other steps that you can take to prevent bladder leakages like avoiding drinking caffeine and alcohol – check out our exhaustive list of drinks and foods to avoid for more information. Finally, TENA is here to help you with bladder weakness by supplying a wide range of safe, absorbent and discreet incontinence pads and underwear.

The main treatment for perimenopause symptoms is hormone replacement therapy, also known as HRT, which replaces the hormones that are at low levels. We’d recommend consulting your GP for the right types and dosage. 
Perimenopause supplements are also a great natural alternative, and some even lower your chances of developing menopause related symptoms later on. There are different kinds depending on your symptoms, including:

1.    Phytoestrogens 
2.    Calcium
3.    Vitamin D
4.    Bioidentical hormones
5.    Omega 3

In case of loss of libido and if HRT doesn’t seem to work, your doctor might prescribe you testosterone but this can have possible side effects.

These are some of the most common treatments, however we’d recommend always consulting your GP or gynaecologist before starting to take any medication as they will be able to advise on the best option for you.

You will realise that you’re in late perimenopause if there are more than 60 days between your periods. The end of perimenopause coincides with the start of menopause. After 12 months of no periods, you will have officially entered the latter.

The symptoms start to change as well; for example, you might experience fewer headaches but more hot flashes and poorer quality of sleep. However, it’s not all doom and gloom as mood swings might also start to subside, leaving you feeling less emotional. This happens because after entering menopause, your hormones will have stopped fluctuating and now reached a consistent, low level.

The average woman will spend over thirty years in menopause – if you experience bleeding while going through it then this could be a sign of a more serious condition and you should immediately consult your doctor.

Perimenopause is a period in a woman’s life that often gets overlooked, so it is important to communicate with those around you and seek solidarity amongst friends and family. From understanding the signs of perimenopause to learning how to treat it, we hope that you now feel more prepared for your journey.

Take a look at our #LastLonelyMenopause campaign for more guidance, advice and stories from women navigating this life stage.