Understanding Perimenopause and Menopause, and Managing Menopause Symptoms

Menopause is a natural phase in every woman’s life, but everyone’s journey can vary significantly from one individual to another. While most people are familiar with menopause, the transitional stage before it, known as perimenopause, is often less understood. Let’s explore the differences between these two stages, and what symptoms you may experience as you navigate through them.

What is perimenopause?

Perimenopause refers to the period before menopause when your body begins to experience hormonal changes. Perimenopause can start between 45-55 years, however for some women it may start earlier. On average, perimenopause can last for 4-6 years, although for some women it may last for up to 10 years.

During this phase, your body undergoes hormonal fluctuations as the ovaries gradually produce less estrogen. As hormone levels shift, you may experience erratic ovulation and changes in your menstrual cycle, such as longer cycles, heavy bleeding or irregular periods. It is important to note that this journey will look different for every person and some women may experience many symptoms while other women experience little to no symptoms.

What is menopause?

Women officially graduate to menopause when you have not experienced a period for 12 months. This marks the end of your menstrual cycles and fertility. The average age for menopause is 51, but it can occur anytime between your late 40s and early 50s. By the time you reach menopause, most of the hormonal fluctuations experienced during perimenopause will have settled, but you may still experience lingering symptoms for a few years.

Common symptoms of perimenopause

1. Mood Changes
   Hormonal fluctuations can impact your mood, leading to feelings of irritability, anxiety, or sadness. These emotional shifts are common and often vary throughout the perimenopausal years.
2. Night Sweats
   A common symptom during perimenopause, night sweats are episodes of excessive sweating during the night that can disrupt your sleep and leave you feeling overheated.
3. Hot Flashes
   Hot flashes are sudden feelings of intense heat, often accompanied by sweating, which can last from a few seconds to several minutes. These can occur during the day or night and are commonly associated with perimenopause.
4. Difficulty with Concentration and Memory
   You may experience what some women call “brain fog.” This can manifest as forgetfulness, difficulty concentrating, or trouble with multitasking. This is a normal part of perimenopause due to hormonal changes.
5. Trouble Sleeping
   Sleep disturbances, such as insomnia or waking up frequently during the night, are also common during perimenopause. These can be caused by hot flashes, night sweats, or other hormonal changes.
6. Vaginal Dryness
   Decreased estrogen levels can lead to vaginal dryness, which can cause discomfort during sex and increase the risk of urinary tract infections (UTIs).
7. Changes in Sexual Desire
   As estrogen levels decrease, many women experience changes in sexual desire. Some may notice a decrease in libido, while others may feel an increase in sexual interest.
8. Headaches
   Fluctuating hormone levels can lead to an increase in headaches or migraines.

How to Manage Symptoms During Perimenopause and Menopause

Navigating the transition through perimenopause and menopause can be challenging, but there are strategies you can adopt to make this journey more comfortable. While you can’t change the fact that hormonal fluctuations are occurring, there are several things you can do to manage symptoms and feel more at ease during this time.

1. Hormone Therapy

For some women, hormone replacement therapy (HRT) can help balance estrogen levels and relieve symptoms. It’s essential to consult with your GP to discuss your specific symptoms and explore your options when considering HRT. Your healthcare provider can guide you on the best approach tailored to your needs.

2. Vaginal Moisturisers

If you’re experiencing vaginal dryness, using lubricants or vaginal moisturisers can alleviate discomfort, especially during sexual activity. This can enhance your comfort and overall well-being during perimenopause and menopause.

3. Healthy Lifestyle

Adopting a healthy lifestyle is one of the most effective ways to manage symptoms. Focusing on four key pillars—diet, exercise, sleep, and stress management—can have a significant impact on symptom management.

Diet and manging perimenopause and menopause symptoms

A nutrient-rich diet can help you manage symptoms more effectively. Key dietary guidelines include:

• Protein: Aim for 30g of protein with each main meal to support muscle mass and overall muscle function.
• Fiber: Include 30g of fiber daily, which can come from fruits, vegetables, nuts, seeds, beans, and whole grains. Fiber promotes digestive health and keeps you feeling fuller for longer, helping with weight management.
• Hydration: Drink plenty of fluids to support your body’s hydration needs.
• Healthy Carbs: Choose high-quality, less processed carbohydrates and control portion sizes. This helps manage blood sugar and insulin levels, reducing the risk of insulin resistance, weight gain, and low energy.

As estrogen declines, muscle mass and tone can decrease, and you might notice changes in body composition, particularly around your midsection. Eating adequate protein can help build and maintain muscle, while fibre aids digestion and prevents constipation, which can become more common during this phase.

Managing menopause symptoms with Exercise

Exercise is crucial for maintaining overall health and managing perimenopausal and menopausal symptoms. The Heart Foundation recommends:

• 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity per week, or a combination of both.
• Strength training (e.g., resistance or weight training) at least 2 days a week.
• Reduce sedentary time: Even light physical activity can help offset the risks of sitting for long periods.

Regular exercise can improve body composition, reduce hot flashes and night sweats, and support your mental health by boosting mood and energy.

Sleep and menopause

Sleep disruptions are common during menopause, with reports of up to 56% of women experiencing sleep difficulties. Sleep deprivation can lead to chronic fatigue, irritability, and mental health concerns. It can also worsen conditions like digestive issues and increase the risk of chronic diseases.

To improve sleep quality:

• Wind down before bed: Create a calming routine by dimming lights and avoiding screens (TV, phones, etc.) at least an hour before sleep.
• Optimise your sleep environment: Keep the room cool, use breathable cotton sheets, and ensure good airflow.
• Eat sleep-friendly foods: Foods like sour cherries, kiwi fruit, oats, cheese, or chicken are rich in melatonin, which can help regulate your sleep cycle.

Stress Management

Fluctuating hormones can affect your mood, with decreased progesterone contributing to increased stress and irritability. At this time in life, many women are also juggling work, family, and caregiving responsibilities, which can add to the stress.

To manage stress:

• Incorporate mindfulness practices, yoga, or relaxation techniques into your routine. These can help you manage mood swings, reduce anxiety, and improve sleep quality.

Conclusion

Perimenopause and menopause are significant life transitions that every woman experiences, though the timing and severity of symptoms vary from person to person. By understanding what to expect during these phases and adopting a proactive approach to managing symptoms, you can navigate this natural part of aging with confidence and empowerment. To help you understand and improve your lifestyle changes to help manage your symptoms, book a consultation with our dietitian or one of our Physiotherapists or Exercise Physiologists.

Why Choose Hiya Health?

At Hiya Health, we understand that every woman’s experience with perimenopause and menopause is unique—and so is the support you need. Our team of physiotherapists, exercise physiologists, and dietitians are experienced in managing Women’s Health and the symptoms of perimenopause and menopause, helping you feel your best through evidence-based, modern therapy approaches.

✅ Personalised Care – We tailor your treatment plan to your specific needs, whether it’s managing hot flashes, improving bone density, or maintaining a healthy weight.
✅ Holistic Approach – From strength training and mobility exercises to nutritional guidance and lifestyle strategies, we address all aspects of your health.
✅ Experienced Team – Our clinicians are experienced in women’s health, ensuring you receive the latest, research-backed treatments.
✅ Support at Every Stage – Whether you’re just starting perimenopause or navigating post-menopause, we’re here to help you stay strong, active, and confident in this new chapter of life.

If you’re looking for expert guidance to help you feel your best during perimenopause and beyond, we’d love to partner with you.

Author: Hilary Harris, Dietitian

Hilary Harris

Dietitian

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