Perimenopause and 8 useful steps to take

Perimenopause takes place over several years in advance of the menopause. It is frequently the time when we experience the most common symptoms of menopause. Because perimenopause often takes place while we still have periods it can lead to confusion. Before I hit 47 I'd never heard of perimenopause now I think it's the key to understanding the menopause. For many of us it's all about Peri. Consider the eight helpful steps outlined below. Menopause is one of the few certainties in life for women so, if you have the chance, get ready for it - mentally and physically.

Aisling Grimley, My Second Spring - supporting you at perimenopause.

Aisling Grimley, My Second Spring - supporting you at perimenopause.

What is Perimenopause? Welcome to My Second Spring!

Perimenopause, also known as menopause transition or climacteric (critical period), takes place over several years in advance of the menopause. According to the North American Menopause Society, perimenopause can last for 4 to 8 years. 

During perimenopause the ovaries gradually rebalance their oestrogen and progesterone production in preparation for the menopause and the final cessation of periods. With the average age for menopause being 50 in Ireland, perimenopause generally starts for women in their mid-40s. However, it is possible for perimenopause to start in the late 30s (early or premature menopause) and early 40s.

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Perimenopause – a gradual process of change

For most women, perimenopause is a completely normal, gradual process, and not a disease to be treated. Perimenopause lasts until full menopause, i.e. the time when the ovaries stop releasing eggs. In the last one to two years of perimenopause our bodies create significantly less oestrogen and it is at this point that many of us experience the symptoms of menopause - typically when we are around 48 to 50 years of age.

Hormone production and rebalancing

As hormone production in our ovaries slows down, our bodies are designed to produce oestrogen, progesterone and testosterone, at other sites in the body. For instance, oestrogen, progesterone, and androgens are produced in the adrenal glands, body fat, the skin and the brain.

According to medical sources around 10% of women in Ireland experiencing difficult symptoms will require medical treatment such as HRT. The majority, however, will not require this treatment. If symptoms such as hot flushes and night sweats become unbearable, HRT may provide relief for some women. For most of us, symptoms can be managed through lifestyle changes such as adapting our diet and nutrition, taking exercise and learning to relax. Difficult symptoms may be alleviated by using alternative or complementary treatments and therapies such as acupuncture, homoeopathy, reflexology and naturopathy.

An opportunity to take stock

It is important that, mentally and physically, we are as healthy as possible as we enter this new phase of life. Perimenopause need not be a negative phase of our lives - we can use it as a time to consider what changes we would like to make as we look at ourselves and at our circumstances. We may choose to put ourselves first and consider ways to improve and support our natural health.

Are you looking after yourself? Is perimenopause the prompt you need to put yourself first?

Our endocrine system is responsible for hormone production and it works to rebalance hormones and manage the changes brought on by perimenopause.  The endocrine system may be under pressure coping with the changes in our bodies during this phase of our lives and it may produce uncomfortable symptoms as a clear signal that changes need to take place. This is often the case if we have not been able to look after ourselves properly. For example, many of us are living under significant stress at home or at work. Often our diet fails to meet the body’s increased demands. Some of us may be chronically ill, we may smoke or drink to excess. Many of our relationships can be draining and we may sleep badly. Overall, our energy reserves can be drained. During perimenopause the body may start to ring alarm bells by producing symptoms that make us stop, think and make necessary lifestyle changes – for ourselves. We must listen to our symptoms - they act as alarm bells, indicators that something is not right.

The sooner we accept that we are perimenopausal the better. By addressing the symptoms and spending some time and energy looking after our health we will be able to keep them at bay.

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Symptoms of perimenopause

Women may experience some of the following symptoms during perimenopause. Don't panic you may experience very few of these symptoms or none at all!

How is perimenopause diagnosed?

Very often the diagnosis of perimenopause is based simply on our age and symptoms. Our doctor can take blood tests to check hormone levels as other diseases can sometimes convincingly mimic perimenopause. The doctor may advise us to take several tests because of fluctuations in hormone levels at this time. However, tests are often not conclusive as hormone balance is so individual and can vary from one day to the next and even varies greatly during the day.

Ultimately - the most important indicators come from within – i.e. how we are feeling and the symptoms we are experiencing. It is likely that these symptoms are the manifestation of some underlying imbalance in our lives – physical or psychological.  For many of us perimenopause is like a car that needs an MOT – an opportunity to take stock and make lifestyle changes that will improve our well-being in preparation for the next phase of life.

Solutions: Look at these 8 ways to help manage your perimenopause: 

1. Manage your Weight

Find out what your appropriate weight is and try to attain and maintain it.

2. Take Regular Exercise: 

Take exercise at least 5 times a week to stay healthy mentally as well as physically. If you haven't been exercising regularly start gently and build your stamina gradually. Ensure that you include regular weight bearing exercise in your routine. Brisk walking is great. Cycling and swimming are great for cardiovascular health but not as good for weight bearing.

3. Diet and Nutrtition

Lots of us are nutritionally depleted at midlife - consult a nutritionist or your GP and see if you are in balance. For example, a blood test showed that I was deficient in B12 which accounted for my lack of energy. B Vitamins are essential to the smooth workings of many of our bodily functins. Make sure your diet is balanced with tons of vegetables, protein at every meal and lots of wholegrains to keep blood sugars and hormones in balance 

4. If you smoke, now's the time to stop!

5.  Develop good sleep habits

Get more sleep and try to develop regular sleeping habits - keep mobile phones and TVs out of the bedroom and try to make your bedroom a sanctuary of calm with full blackout of light at night. If you have problems sleeping avoid caffeine after 12 noon substitute with chamomile tea, adopt a regular bedtime routine and gradual unwinding and relaxation. Choose something you like - a lavender bath, a romantic novel, listening to a guided meditation....

6 .Decrease the amount of alcohol and caffeine in your diet

This will help sleep to better and manage weight more easily. Read Vogue Editor Christa D'Souza on the subject of giving up alcohol if you'd like some inspiration.

7. Take Charge!

Find some natural therapies and treatments that you find useful and stress releasing. Or discover a new therapy e.g. yoga, mindfulness, Feldenkrais or acupuncture.

8. Get Support!

Join our mailing list and maybe come along to some inspirational events with relevant experts.

My Second Spring E-book


The Best Friend’s Guide: Anxiety - A Practical Toolkit For Moving Beyond Anxiety at Menopause - €12

Thanks Girls another great book ! Well done My Second Spring, the advice is practical, down to earth and I’m already working on my toolkit. Thank you so much

Order Now

Can I become pregnant during perimenopause?

As the ovaries are still producing eggs, albeit erratically, it is still possible to become pregnant during perimenopause. It is therefore advisable to use birth control until two years after your last period.

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Lately on the Blog - Fennel helps with menopause symptoms, painful sex and BBC research.

New to the blog this week - Painful sex at menopause, fennel for hot flushes and BBC research about menopause in the workplace. Have a look at our blog for inspiration on a very wide range of topics. If you'd like to share some thoughts feel free to comment or even write us a blog - why not?

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My Second Spring runs events on topics of special interest to women over 40. The idea is to learn from Experts and of course from eachother. Find out more here. The Events are a lot of fun as well as being inspirational. It's great to meet so many women in person rather than just communicating in cyberspace.


Some women have generously shared their personal stories, hearing someone else's take and insights can give a lot of clarity to our own situation. I'm sure you'll hear some stuff that resonates with you and some stories that will make you laugh out loud like Catherine's story. Visit our stories section and have a read. I've shared My Aisling's Menopause In 10 have a read and please drop me a line if you'd like to share your story to Thanks for reading. xx Aisling

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