Dealing with pre-menopause

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Many women spend their 40s going through pre-menopause before they reach the full menopause. Here’s how to handle it.

blog imageThe pre-menopause (or perimenopause) begins for most Western women at about the age of 37 or 38 and usually lasts for about ten years, give or take. That means many of us are in pre-menopause throughout our 40s.

What causes pre-menopause is simply that your ovarian hormone production is starting to decline and fluctuate, leading to a range of side effects. Some women get heavier periods, while others might skip periods altogether. For myself, at the age of 44, I recently had the first late period of my life, and very strange it felt too, knocking me quite out of kilter.

Much of the information you can obtain about pre-menopause is depressing and frightening, focusing on the wide range of unpleasant symptoms women experience. Some women get mainly physical symptoms such as night sweats, hot flushes or cold extremities, and many have difficulty sleeping, but for many women the psychological effects are worse than the physical ones, including disorientation, dizziness, and weepiness and over-emotionality.

Because of these changes and how terrible they can make you feel, pre-menopause is traditionally seen as a tough time in a woman’s life. However, there is a strong argument that really we should be grateful for it.

Pre-menopause is your body’s way of slowing down the major changes that will occur once the menopause has hit fully. No-one wants all those changes at once, the way you can get them after hysterectomy or cancer treatment and moving gradually into menopause enables you to adjust to your new self over a period of time.

Your 40s is an opportunity to get ready for menopause and to make this important transition in your life more manageable and tolerable.


Obviously, once you start to get symptoms (see below for a link to a full list), the first thing you should do is consult your doctor. Some symptoms can be relieved with low-dose oral oestrogen, or progesterone cream; herbal remedies that balance the hormones can be very helpful, particularly Agnus Castus; soy supplements contain a phyto-oestrogen and can help relieve many mild symptoms from headaches to vaginal dryness. It is pointless to suffer in silence when there are remedies at hand – we are not our mothers and the medical profession has found great remedies in the past couple of decades.

However, this stage in your life is also a time to take control of some things yourself, which can help you feel more in charge at a time when you may be vulnerable.

Yoga and meditation are tremendously helpful in keeping your body flexible and your mind calm, and yoga also increases progesterone production, which balances your hormone levels. Physical exertion – particularly walking, running and other weight-bearing forms of exercise – will help keep your bones strong and are also mentally calming. You can help to balance your own hormones by switching to a better diet, cutting out refined wheat products and sugars – and stopping smoking if you haven’t done so already.

Lastly, remember that menopause is nature’s gift. It is her way of keeping you alive after your procreative usefulness has ended, and will enable you to pass on your wisdom and experience to a new generation. Like grief, every woman who lives long enough goes through this and you will cope with it, as millions of others have done before you.

* NB: due to physical changes that take place with your ovarian follicles, multiple pregnancies become more likely during pre-menopause. Do not stop using contraception.

* For a technical explanation of how pre-menopause works, click here

* For a chart of symptoms along with ways to deal with them, click here

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