SYMPTOM · PERIMENOPAUSE
Irregular periods
Shorter cycles, longer cycles, or a month skipped altogether: irregular periods are often the first sign of perimenopause.
Why it happens
Ovulation becomes less regular as your egg reserve declines. Cycles can shorten to less than 21 days, stretch beyond 35 days or skip a month or two, until periods gradually become further apart and eventually stop altogether.
What can make irregularity worse
- Stress, which can delay or bring forward ovulation.
- Significant changes in weight.
- Sleep problems, which upset your hormonal balance.
- Very intense physical activity.
In the moment
- Track your cycles to spot your own patterns.
- Keep suitable protection to hand in case your period is early or late.
- Don't worry about a one-off cycle that's out of the ordinary.
Day to day
- Record your cycles over several months so you can see the changes clearly.
- Seek advice if bleeding seems unusually heavy or long.
- Look after your sleep and your stress levels: they have a direct effect on your cycle.
Is your bleeding worrying you?
A healthcare professional can confirm that these changes are down to perimenopause and rule out other causes.
For information only. This does not replace a personalised medical assessment.
If several of these symptoms ring true, it's no coincidence.
Menopause isn't just about hot flushes. Symptoms can begin years before your last period and affect sleep, mood, energy, memory, weight and intimate health.
Click on a symptom to find out more.
Brain fog
You search for words, reread the same sentence twice, lose the thread mid-conversation. Nothing to worry about: your brain is simply running slower, with less glucose to fuel it as oestrogen levels fall.
Sleep problems
Asleep in ten minutes yesterday, wide awake at 3 a.m. today, for no reason. Progesterone, which helped you switch off at night, is in shorter supply, and deep sleep takes the hit straight away.
Anxiety
Stress that spikes over an email, a meeting, running ten minutes late. Oestrogen affects serotonin: when it yo-yos, everything feels heavier to carry than before.
Joint pain
Knees that creak as you stand up, hands that feel stiff in the morning. Cartilage loses its best anti-inflammatory ally as oestrogen falls, and you feel as if you are rusting up all over.
Hot flushes
A wave of heat rising from the chest to the face, lasting one to five minutes. Deprived of oestrogen, the thermoregulatory neurons in the hypothalamus narrow the thermal neutral zone: a few tenths of a degree are enough.
Palpitations
Your heart suddenly races, with no effort and no reason. Oestrogen also influences the nervous system that sets your heart rhythm. Alarming in the moment, rarely serious.
Mood swings
You laugh, and thirty seconds later you could cry or tell everyone where to go. Hormones rise and fall faster than before, and your mood follows, without warning.
Weight gain
Your tummy rounds out even though nothing on your plate has changed. Oestrogen redirects fat storage towards the abdomen, and your metabolism runs a little slower than before.
Low libido
Desire takes longer to arrive, or barely arrives at all. Oestrogen and testosterone fall, and sensitivity with them. The desire is still there; it just takes longer to get going.
Vaginal dryness
A feeling of dryness, sometimes a little discomfort day to day. Tissues lose their natural moisture as oestrogen falls. It is a common symptom, and still too rarely talked about.
Night sweats
Waking up drenched in the middle of the night, sheets to change, sleep cut short. It is the same hot flush as during the day, night-time edition, and it wakes you just as surely.
Pain during sex
Discomfort, sometimes real pain, during or after sex. Tissues thin as oestrogen falls, and what never used to be a problem can become sensitive.
Dry skin
Skin that feels tight, marks more easily and seems to have lost some of its bounce. Collagen declines with oestrogen, by up to 30% in the first few years after menopause.
Chronic fatigue
Tiredness that will not lift, even after a good night. Broken sleep, falling hormones: your body runs less efficiently, and you feel it from morning to night.
Hair loss
More hair in your brush, a parting that seems to be widening. Oestrogen used to extend its growth phase. Without it, the cycle shortens and each strand gets finer.