Perimenopause describes the time period leading up to menopause as a female's ovaries start to slow down.

Menopause is defined as the point in time when a female has ceased regular menstrual periods (recognised to have occurred after 12 consecutive months without a menstrual cycle).  


Perimenopause can begin 8-10 years before menopause when a female's ovaries gradually produce less oestrogen. It usually starts during the 40's and lasts up until the point when the ovaries stop releasing eggs. In the last 1-2 years of perimenopause, the drop in oestrogen accelerates and many people may experience increasing menopause symptoms.

Natural menopause normally occurs between 46 and 52 years and some of the common symptoms include irregular periods, hot flushes/flashes, brain fog and memory issues, mood swings, sleeplessness and fatigue.  Perimenopause and menopause is a natural life-stage where proactive self-care and symptom management can improve overall quality of life during the transition.

Perimenopause can also be characterised by an increase in menstrual cycle length. If the menstrual cycle length has persistent 7 days or longer differences from month to month it is indicative of early-stage perimenopause.  Alternatively, if 60 days (2 months) passes without a period this can indicate being in a later stage of perimenopause.  The later perimenopause stage may last 1-3 years and ends after 12 consecutive months since the last menstrual period.  Symptoms such as hot flushes / hot flashes and sleeplessness can become more evident in this phase.

Important to note is that symptoms during perimenopause and menopause may vary from woman to woman.

Hot Flushes / Hot Flashes:

Approximately 80% of women will experience these vasomotor symptoms ranging from mild to moderate during perimenopause and moderate to severe during menopause itself.  Hot flushes / flashes can last up to 10 years and mild hot flushes may continue into post menopause years.  Hot flushes in the evening or whilst sleeping are also known as night sweats and can contribute to sleep difficulties.

Mood Swings – Mild Anxiety and Mood Balance

Mild anxiety and flat moods can be experienced during perimenopause.  For some these episodes are fleeting and for others they can be a daily occurrence. Often accompanied with irritability, nervousness, mood swings, tension and palpitations, these symptoms can really take their toll on mental and emotional wellbeing both for the individual experiencing the symptoms, and those close such as partner, family and friends. Feelings of loneliness, sadness, crying, restless sleep are also experience by many women.

Sleeplessness & Sleep Disturbances

Trouble getting to sleep and staying asleep or waking earlier than normal may be experienced whether or not night sweets or hot flushes are experienced in the evenings. Sleep difficulties can persist throughout perimenopause and even after the transition into post-menopausal years.  Sleep is sometimes referenced as being ‘the best clinic in the world’, and it is vitally important to get the circadian system and sleep/wake cycles back on track.

Brain Fog & Cognitive Function

Brain fog and forgetfulness are common hallmarks of perimenopause and may extend right through the complete transition to post-menopausal years.  Not only are differences in short-term memory and concentration exacerbated but the brain cells and nervous system structure, known as brain plasticity, can also be impacted.

Symptoms of mental fatigue can also be more acute for people suffering disturbed sleep due to night sweats and hot flushes.

The terms 'female' and 'woman' refer to people assigned female at birth (AFAB).