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Perimenopause: Symptoms and Treatments

at Omniya Clinic in London

Perimenopause is a natural phase in a woman’s reproductive life cycle. During this time, ovarian function gradually declines, leading to reduced oestrogen levels. This phase can last for several years until menstruation ceases entirely, marking the onset of menopause.

Perimenopause typically begins in a woman’s 40s but can start earlier. Symptoms often include irregular periods, hot flushes, and mood swings. Factors such as genetics, lifestyle, and environment can influence the timing and severity of symptoms.

Patient during hormone therapy consultation with Dr Annaradnam

What Treatments Are Available For Perimenopause?

Perimenopausal symptoms can vary in intensity and frequency, potentially disrupting sleep and daily activities. If this is the case for you, we recommend the following treatments at Omniya to ease your symptoms.

Symptoms of Perimenopause

Symptoms can vary widely among women and may include:

  • Irregular Periods: Changes in menstrual cycle length, flow, and frequency. Periods may become lighter or heavier, with intervals between periods changing.
  • Hot Flushes: Sudden intense warmth, mainly affecting the face, neck, and chest, often with sweating and redness.
  • Night Sweats: Intense sweating at night that disrupts sleep.
  • Mood Swings: Increased irritability, anxiety, and depression due to hormonal changes.
  • Vaginal Dryness: Reduced oestrogen levels causing thinning and drying of vaginal tissues, leading to discomfort and itching.
  • Sleep Disturbances: Difficulty falling or staying asleep, often due to night sweats or hormonal changes.
  • Fatigue: Persistent tiredness and lack of energy.
  • Cognitive Changes: Memory lapses, difficulty concentrating, and “brain fog.”
  • Joint Pain: Aches and stiffness in joints due to reduced oestrogen.
  • Urinary Tract Infections (UTIs): Increased frequency of UTIs due to changes in the urinary tract.
  • Weight Gain: On average, women gain about 1.5 kg per year during perimenopause, mainly around the abdomen and upper body.

Signs that perimenopause is ending

Perimenopause can last for several years, and knowing the signs that it is ending can help you prepare for menopause. Common signs include:

Irregular Menstrual Cycles
Periods become more irregular and eventually stop. If you haven’t had a period for 12 consecutive months, you have reached menopause.

Overall Symptom Reduction
A decrease in the intensity and frequency of perimenopausal symptoms.

Stabilised Hormone Levels
Hormonal fluctuations become less erratic, though lower oestrogen levels remain.

Each woman’s experience is unique, and the duration and intensity of symptoms can vary widely. For personalised advice, book a consultation with one of our practitioners.

Lifestyle Changes to Manage Perimenopause Symptoms


Regular physical activity improves mood, promotes better sleep, and aids in weight management. Activities like walking, swimming, yoga, and strength training are beneficial.


A balanced diet rich in fruits, vegetables, whole grains, and lean proteins supports overall health and hormone balance. Foods high in calcium and vitamin D help maintain bone health, while omega-3 fatty acids reduce inflammation and improve mood.

Stress Management

Techniques like mindfulness, meditation, and yoga reduce anxiety and improve emotional well-being. Deep breathing exercises and engaging in hobbies can help manage stress effectively.

Sleep Hygiene

Establishing a regular sleep routine and a comfortable sleep environment is crucial. Go to bed and wake up at the same time every day. Create a calming pre-sleep routine, keep the bedroom cool and dark, and avoid screens before bedtime.


Personalised supplements support hormonal balance and alleviate symptoms. Recommended supplements include:

  • Solgar MenoPrime™: Contains botanical extracts like hops and sage to manage hot flushes and night sweats.
  • Nutri Advanced FemForte® Balance: A blend of vitamins, minerals, and herbs to support hormonal health.
  • Designs for Health FemGuard + Balance: Combines herbs like black cohosh and chaste tree with essential nutrients for hormonal balance.
  • Cytoplan Menopause Support: Includes soy isoflavones and sage extract to regulate hormones and alleviate symptoms.
Patient during hormone therapy consultation with Dr Roked

Perimenopause Tests and Consultation at Omniya

We specialise in diagnosing and arranging perimenopause tests, finding the best approach for you to overcome perimenopause symptoms.

  1. Hormonal Testing
    We assess oestrogen, progesterone, FSH, and LH levels through a comprehensive perimenopause blood test to understand your hormonal balance. This helps in identifying any hormonal deficiencies or imbalances that could be contributing to your symptoms.
  2. Advanced Diagnostics
    We offer referrals for ultrasound scans to assess ovarian function and endometrial health. These scans provide a detailed view of your reproductive organs, helping to identify any structural changes or abnormalities.
  3. Health Assessments
    Our thorough health assessments involve reviewing your medical history, lifestyle factors, and symptoms. This holistic review helps us understand the full picture of your health and how perimenopause is affecting you.
  4. Personalised Consultations
    We discuss your test results in detail and offer tailored treatment options. Our consultations also include a holistic approach to lifestyle changes and nutritional supplements. We focus on creating a comprehensive plan that addresses your specific needs and symptoms.
  5. Ongoing Support
    Choosing Omniya Clinic ensures expert care and ongoing support. We provide follow-up consultations to monitor your progress and adjust your treatment plan as needed. Our goal is to support you throughout your perimenopause journey, ensuring you receive the best care and management strategies.


Treatments Available at Omniya Clinic

Based on the test results, we will have a clear picture of your hormonal balance, enabling us to customise treatment plans for you. Our treatments include, but are not limited to:

  • HRT for Perimenopause: HRT involves supplementing your body with oestrogen, progesterone, or a combination of both to balance hormone levels and alleviate symptoms such as hot flushes, night sweats, mood swings, and vaginal dryness.
  • Thyroid Therapy: If your perimenopausal symptoms are exacerbated by thyroid imbalances, we provide thyroid therapy to address these issues. Proper thyroid function is crucial for maintaining overall health and can significantly impact perimenopausal symptoms.
  • Hormones MOT: This comprehensive assessment involves evaluating all relevant hormone levels, including oestrogen, progesterone, testosterone, and thyroid hormones. It helps us create a detailed and tailored treatment plan to manage your symptoms effectively.
  • The Real AGE Test: This test evaluates your overall health and aging markers, providing insights into your biological age versus your chronological age. The results help guide personalised treatment plans that focus on improving your overall health and well-being.


Perimenopause Symptoms FAQs

How long does Perimenopause last?

Perimenopause typically lasts about 4-10 years, with the average duration being around 4 years. The duration can vary significantly among different women.

Can perimenopause affect fertility?

Perimenopause can affect fertility. As women approach menopause, their ovarian function declines, leading to irregular ovulation and decreased fertility. While pregnancy is still possible during perimenopause, the likelihood decreases as fertility declines. It’s important for women who wish to conceive during perimenopause to discuss their options with a healthcare provider and consider fertility treatments if necessary.

Can perimenopause affect my mental health?

Yes, perimenopause can lead to mood swings, anxiety, and depression in some individuals. Hormonal fluctuations during this time can significantly impact mental health.

Are there any lifestyle changes I should consider?

Maintaining a healthy diet, regular exercise, stress management, and avoiding smoking and excessive alcohol can help alleviate symptoms. These lifestyle changes support overall health and well-being during perimenopause.

When should I see a healthcare provider about perimenopause symptoms?

If symptoms interfere with daily life or if there are concerns about reproductive health or overall well-being, consulting a healthcare provider is advisable. Early intervention can help manage symptoms more effectively.

What can I expect during perimenopause in terms of menstrual changes?

Menstrual changes during perimenopause may include irregular periods, heavier or lighter bleeding, or skipped periods. These changes are due to fluctuating hormone levels.

Are there any risks associated with perimenopause?

Risks include osteoporosis, heart disease, and certain cancers. Regular check-ups and screenings are important for monitoring health and managing potential risks.

What types of hormonal tests are available for perimenopause?

Hormonal tests for perimenopause include assessing oestrogen, progesterone, FSH, and LH levels through a perimenopause blood test. These tests help evaluate hormonal balance and guide treatment.

How does perimenopause affect weight gain?

During perimenopause, women may gain approximately 1.5kg per year, primarily around the abdomen and upper body, due to hormonal changes and slowed metabolism. This weight gain can increase the risk of other health issues.

Can perimenopause lead to joint pain?

Yes, reduced oestrogen levels can lead to joint pain and stiffness, as oestrogen has anti-inflammatory properties. Managing oestrogen levels can help alleviate joint discomfort.

How can exercise benefit women during perimenopause?

Regular exercise can improve mood, promote better sleep, aid in weight management, and reduce the risk of osteoporosis and heart disease. It also helps maintain muscle mass and bone density.

What dietary changes can help manage perimenopause symptoms?

A balanced diet rich in fruits, vegetables, whole grains, lean proteins, calcium, and omega-3 fatty acids can support overall health and hormone balance. Avoiding processed foods and sugars is also beneficial.

How can stress management techniques help during perimenopause?

Stress management techniques like mindfulness, meditation, and yoga can reduce anxiety, improve emotional well-being, and help manage perimenopause symptoms. These practices promote relaxation and mental clarity.

Are there specific medical conditions to monitor during perimenopause?

Yes, it’s important to monitor for conditions like osteoporosis, heart disease, and certain cancers through regular check-ups and screenings. Early detection and management can mitigate risks.

What role do supplements play in managing perimenopause symptoms?

Supplements can support hormonal balance and help alleviate symptoms associated with perimenopause. It is important to receive personalised recommendations from a healthcare practitioner to ensure both safety and effectiveness.

Can perimenopause cause cognitive changes?

Yes, women may experience memory lapses, difficulty concentrating, and “brain fog” due to hormonal fluctuations during perimenopause. Cognitive function typically improves post-menopause.

How is a perimenopause blood test conducted?

A perimenopause blood test involves drawing a small sample of blood from a vein, which is then analysed in a laboratory to measure levels of key hormones such as oestrogen, progesterone, FSH, and LH. This helps assess hormonal status.

What are the benefits of advanced diagnostics in perimenopause?

Advanced diagnostics, such as ultrasound scans, provide detailed information about ovarian function and endometrial health. They help identify structural changes or abnormalities and guide appropriate treatment plans.

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