Peri-menopause

The peri-menopause is the transitional phase leading up to the menopause

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The peri-menopause is the preliminary stage of the menopause, the period in time before the final menstrual cycle. In this page, our menopause expert Eileen Durward determines the underlying indicators of the peri-menopause and offers a range of herbal solutions to ease each individual symptom.

An introduction to the peri-menopause

The peri-menopause can be thought of as the first stage of the menopausal phase in a woman’s life and is the time before and around the final menstrual period.

Medically, it starts when the first menopausal symptoms are noticed and ends a year after the last menstrual bleed, or the point in time when menopause has been reached.

The term ‘peri-menopause’ is not often used. Women experiencing symptoms usually refer to being ‘menopausal’ or ‘going through the menopause’.

Why does it occur?

As a woman becomes older, there comes a point when production of the female hormones driving the menstrual cycle starts to decline. This process means that eventually, no more eggs will be released by the ovaries each month - it is Nature’s way of saying that, at this age, the woman is less likely to carry a healthy baby and that her reproductive life should come to an end.

Typically, this process begins in the mid-forties and as hormones fall, an imbalance between oestrogen and progesterone can occur.

Menstrual periods become irregular, heavier or more uncomfortable. Other physical and psychological symptoms may be experienced – some women may describe these as being similar to PMS (pre-menstrual syndrome).

What are the symptoms of peri-menopause?

A wide variety of symptoms can be experienced during the peri-menopause. These are generally the same as the symptoms present during the other stages of the menopause.

However, a few symptoms are more frequently encountered during the peri-menopause. These include:

At the start of peri-menopause, these symptoms may worsen in the week or so before each menstrual period and feel like PMS.

Women in the peri-menopause can also experience hot flushes and night sweats, whether or not they are still having their monthly menstrual bleed.

In addition, the peri-menopause can also give rise to muscle pain and joint pain. These are usually confined to the upper part of the body and described as neck pain or shoulder pain.

How can herbal remedies help?

As the peri-menopause is a normal stage a woman has to go through in life, many prefer to treat symptoms experienced using natural medicines. A number of herbs which can be of help:

Agnus castus. Also known as Chasteberry, this is the herb of choice if symptoms start after ovulation and disappear once menstrual bleeding starts, just as you might expect with PMS (premenstrual syndrome). It can be very useful if you have a number of symptoms and can also help painful periods and breast tenderness
Valerian. The root of the Valerian plant is used medicinally and extracts can help you cope better with stress or anxiety; or help you obtain better sleep
Avena sativa. This is the plant we commonly know as Oats. However, instead of the seed or fruit, it is the leaves and stems of the oat plant which are used medicinally. It helps to relieve mild stress and anxiety
St. John’s wort. This has a long tradition of use to help lift the mood of those who are prone to mood swings or feeling a bit down and sad
Sage. Extracts of sage are now known to have the specific ability to relieve hot flushes and sweats. It can be used at all stages of the menopause
Arnica. This herb is well known for its ability to help with bruising, but also has pain relieving properties. It is useful if you suffer from neck and shoulder pain, muscle aches and joint stiffness
Devil’s Claw. This plant grows only in the Kalahari and has a long tradition of use in treating joint pain and backache.

What about medicines from my doctor?

In general, doctors will be reluctant to use prescription medicines for the peri-menopausal. However, if symptoms are severe and starting to interfere with quality of life, a number of classes of medicine may be suggested.

Hormonal treatments include the low-dose oral contraceptive to treat PMS-like symptoms, or HRT (hormone replacement therapy). In addition, anti-depressants or sedatives may be needed for those suffering depression, anxiety or insomnia.

31 Comments

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Dee — 22.03.2021 06:36
I'm a 49 year old woman and l'm breeding very heavy this month. What remedies would you suggest for peri-menipose. Thank you
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- eileen — 27.03.2021 08:14
  Hi Dee Although this is fairly common as you approach the menopause, it is not good for you and can cause anaemia. If your period doesn't stop or gets worse then it is important to speak to your doctor or pharmacist, they may be able to offer non-hormonal medication to stop or slow down the bleeding. Unfortunately, if the bleeding is very heavy then herbs such as Agnus Castus wouldn't be 'strong' enough to be of benefit, sorry.
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Margaret — 25.11.2019 17:33
Hi Eileen, This is a fantastic site, I’ve recommended it to many friends. I am 51 years old, have the mirena coil for last 2/3 years as periods were so heavy. Blood test for hormones came back normal and yet at different times of month I feel depressed and very tired. I don’t get a monthly show anymore so not even sure if it’s worsening PMT. Could I be experiencing psychological symptoms even though my bloods say otherwise. Thank you in advance of your response
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- eileen — 27.11.2019 12:16
  Thanks for your feedback, Margaret; very pleased you find the site helpful. Do you mean that you don't get your periods anymore? If so then you are probably becoming a little low in oestrogen due to the progesterone from the Mirena coil. The symptoms you mention are associated with low oestrogen, so this is more likely than psychological causes. Blood tests are a 'snap shot' of what's happening at the moment they are taken, so they are not always an accurate measurement.
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jackie — 03.10.2017 11:25
have been diagnosed as peri menopausal, was having really bad mood swings, hot flushes , night sweats, palpitations, anxiety.i wasnt too keen on going on HRT so i am on sertraline, and clonodine , which is keeping me quite stable, im also taking magnesium and the menopause support tablets. my problem is down below, itching ,and i feel like my insides have been scraped with a razor blade. i was given meds for thrush ,and antibiotics as a precaution to a gastric infection...i have a gel that i apply but its still not clearing the itch and soreness.im also using an estrogen and progesterone cream, but nothing is helping .does anyone else get this raw inside feeling and constant itching and soreness??
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- eileen — 04.10.2017 12:25
  Hi Jackie Are you applying the creams to the affected area? If so it is important to check that they are not making symptoms worse as some women are very sensitive in that area to any chemicals. Itching is often caused by falling oestrogen levels drying the vagina walls and also affecting the level of friendly bacteria that help to keep the vagina healthy. Unfortunately, the more times you have antibiotics the more the friendly bacteria are destroyed and this then becomes vicious cycle. I would suggest the Menopause Support which is known to help gently raise and balance oestrogen https://www.avogel.co.uk/herbal-remedies/soy-isoflavones/index.php and also a vaginal probiotic to help restore the vaginal bacteria, for more info see https://www.optibacprobiotics.co.uk/shop/for-women Remember to drink lots of water as dehydration can make this worse and wear only cotton pants to allow good air flow.
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- Libby walsh — 08.07.2021 23:35
  I also have this and have been treating it like thrush God what seems like forever I'm 45
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Corinna singfield — 20.09.2017 16:37
I have been having hot flushes on and off. I don't sleep much at all and when I do I'm having the most vivid dreams. My last period was light considering I've had a copper coil fitted around 4 months ago this period is earlier and the heaveist I've ever had and clotting. My moods are very up and down and my skin on my face is bad and also have had coloured gel like discharge for around 3 months no I no something is not right.
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- eileen — 21.09.2017 13:34
  Hi Corinna Please could you let me know how old you are, thanks.
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Lili — 02.09.2017 21:06
Hi all, iam 41 and have hot flushes about mounth ago , irregular period and this month are missed with no pregnancy . Iam very disappointed and frustrated
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- eileen — 04.09.2017 12:59
  Hi Lili Missing periods, although they can indicate the start of the menopause, can be caused by a number of factors such as stress, fatigue, over work, excessive exercise, change of diet so it is a good idea to get this checked out by your doctor as well.
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Sandra — 01.09.2017 12:50
I am only 39, but am wondering if I am hitting the perimenopause. I have been suffering with significant joint and muscle pains for a year now, had night sweats last year, then significant sleep disruption for months due to the pains, sweats and restless legs. I have been for physio/ osteopath/ acupuncture/ chiropractor treatments, have seen the rheumatologist, had CT scans and just had steroid injections. My mood is accordingly low. I feel like I am dragging myself from pillar to post and not finding any relief. I feel like I have literally 'aged' over night and am struggling. I have always been a fit and healthy, very active person and now I am the exact opposite. I am looking for answers. Am I clutching at straws?
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- eileen — 01.09.2017 14:16
  Hi Sandra Generally, 39 is still a little young to be starting the menopause, although it can happen, especially if other close female relatives started around the same time. Smoking, obesity, ethnic origin and some chronic health issues can cause an early menopause too. However, your symptoms could be due to other factors such as stress, low iron levels or low thyroid function or low vitamin D, have all these been tested by your doctor? If not it is a good idea to ask just to rule them out. They may also be able to test your sex hormone levels and that can indicate what is happening. Has anyone mentioned seeing an Endocrinologist? They specialise in the whole hormone system (not just the sex ones) and issues with the Endocrine System can sometimes mimic menopause ones.
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