Identifying Menopause Symptoms from Perimenopause to Postmenopause

Menopausal symptoms can begin months or even years before menopause and can last for around four years or more following your last period.

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Menopause is a time in a woman’s life that many women approach with trepidation as they come to terms with this natural part of ageing. Although the menopause is when a woman stops having periods and is no longer able to get pregnant naturally, there is also a stage before and after menopause that women have to navigate: perimenopause and post-menopause.

What Is Perimenopause?

In the perimenopause period, it’s likely you will experience a disruption to your menstrual cycle. Periods will usually start to become less frequent over a few months or perhaps for several years before they will stop altogether. Sometimes, women can find that their periods will stop suddenly. Menstrual cycle fluctuation where your periods are longer, shorter or aren’t quite as regular typically start in your 40s, but some women can experience changes to their periods when they are in their 30s too. 

“Perimenopause can feel as though it lasts quite a long time for most women”

“It can continue for 8 to 10 years and lasts up until menopause. Symptoms usually start between the ages of 35 to 45. As well as changes to your period cycle, you may also experience changes to your menstrual flow such as heavier or lighter periods and the duration could become longer or shorter,” explains Omnos hormone expert, Sue Camp. Most women will experience menopausal symptoms. These often start in perimenopause and can continue for a while once your periods have stopped.

Common menopause symptoms:

  • hot flushes
  • night sweats
  • vaginal dryness
  • discomfort during sex
  • heart palpitations
  • breast tenderness
  • increased premenstrual symptoms
  • worsening PMS
  • bloating, joint pain
  • bladder issues
  • skin changes such as the onset of acne
  • skin becoming dry, oily or itchy
  • hair loss
  • weight gain

Menopausal symptoms can also affect your sleep, mood, libido, and impact on your memory and concentration. Any combination of these symptoms can begin months or even years before your periods stop. They can also last for around four years following your last period. Some women could, unfortunately, continue to experience symptoms for much longer.

What Is Menopause?

A woman is at the menopause stage when she has not had a period for 12 consecutive months. Menopause typically occurs between the ages of 45 and 55 as a result of the decline in a woman’s oestrogen levels. In the UK, the average age for a woman to reach the menopause stage is 51.

“What we see as a woman reaches the menopause stage is major changes in their hormone levels,” Sue explains. “Our estrogen levels drop significantly, and this really marks the transition. We experience a 35% reduction in estrogen from the age of 35-50, and this is coupled with a 75% reduction in progesterone over the same period. This results in big changes and what happens as we approach menopause is our levels go up and down all the way through and this goes hand in hand with the wide-ranging symptoms we can experience during this time.” 

“I didn’t recognise I was in perimenopause until I hit menopause”

Susan is now in menopause as it’s been longer than 12 months since her last period. Her symptoms started during perimenopause and lasted for around five years. But she didn’t quite realise that she was experiencing menopause symptoms, and that’s because she didn’t have the classic signs of hot flushes and night sweats. “I experienced period changes and my mood was affected. I also felt a little anxious and my self-confidence was knocked too,” Susan explains. “But it wasn’t until later that I learned this was linked to my hormones fluctuating. I didn’t recognise my symptoms as perimenopause and didn’t really believe it was a thing, to be honest.”

Susan started to learn more about her symptoms and began logging them when she came across menopause specialist, Dr Louise Newson and her free menopause tracking app, Balance. “It really helped me to spot how much of an impact my symptoms were having on me. I was also getting joint pain and numbness in my hands and feet but hadn’t realised they were symptoms of menopause. The app has made such a difference. I’ve been able to print off a symptoms report for my GP and this has helped me to demonstrate the impact they were having.”

Susan had found her GP was unsupportive in the first instance and had offered antidepressants, rather than spotting that her symptoms were also indicative of menopause. Armed with her symptom report from the app, she was able to discuss how they were impacting her and ask for hormone replacement therapy (HRT). “It helps you to become informed and feel empowered when you speak to your GP,” she adds. “I was able to say I wanted to go onto HRT, and it is making a difference.”

What Is Post-menopause?

Post-menopause is that time in a woman's life after they've not had a period for twelve consecutive months. Many women find their symptoms gradually start to reduce when they reach this stage. Joan found the brain fog she experienced in the lead up to menopause has eased now that she is postmenopausal. She was also particularly surprised to find she became intolerant to both dairy and alcohol as part of her symptoms. It’s something that isn’t routinely mentioned as a possible symptom. “I feared that my intolerance to alcohol and dairy could have been a long-term change as it lasted for several years but it is starting to improve,” she explains. Although she no longer has hot flushes, she does still get very warm, especially in the evening. Joan always keeps a fan to hand to manage this. “They don’t feel the same as hot flushes, but I think they are still associated with them,” she adds. 

As both Susan and Joan have demonstrated, being informed about the full spectrum of potential symptoms is important, as the menopause can impact on you in myriad ways.

Joan has noticed her sleep has improved but she has to have a fan by her bedside to prevent her from becoming too warm at night as this can be very disruptive, and also result in night sweats. “It’s almost as though my internal thermostat is still a little faulty,” she says. Her alcohol intolerance started around seven years ago, while her dairy intolerance to creamy lattes or full-fat cheeses began only two or three years ago. “I would have a latte and then feel really sick afterwards. It does seem to be improving gradually but I still have to be careful not to have too much dairy in one go as it can still make me feel nauseous.”

“It’s almost as though my internal thermostat is still a little faulty”

She learned about how developing intolerances can occur during the menopause as part of online research to try and understand what was causing her symptoms. “I couldn’t work out why I was unable to tolerate alcohol or milk all of a sudden and then when I learned it’s something you can experience when you’re going through menopause, it made a lot of sense. It’s just so wide-ranging how the menopause can affect us.”

How At Home Hormones Tests Can Help Menopausal Women

Although there isn't a test for perimenopause or menopause, the Omnos hormone profile from hormone testing can help women understand their hormones and provide them with a hormone roadmap to navigate through these transformational stages with more ease and power.

The Omnos Sex Hormone Female Complete at home blood test gives an extensive analysis of female sex hormones and full thyroid function. It looks at the levels of circulating hormones within the body and key biomarkers for assessing risk of PCOS and menopause. It can also help indicate where a woman is within the stages of menopause and enable her to asses hormone replacement therapy (HRT) dose that may help in relieving her menopausal symptoms.

The Omnos at home Hormones Test, which uses the DUTCH Complete™, analyses 35 different hormones to clearly identify symptoms of hormonal imbalances. For women, the hormones test can highlight possible root causes of symptoms related to menopause, PCOS, fertility, weight gain, fatigue, low libido, premenstrual syndrome, mood disorders, sleep issues. Watch this video for more information on hormone testing for perimenopausal women from our hormones expert, Sue Camp.


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