Perimenopause and Menopause – Frequently Asked Questions

by | Apr 20, 2023 | Health and Wellbeing, News


Since we launched our Menopause Awareness Training last year, we’ve noticed that the same questions keep popping up around menopause and perimenopause.

Here, we take a look at some of the most frequently asked perimenopause and menopause questions:

1. What’s the difference between menopause and perimenopause?

Perimenopause is the phase that precedes menopause, and it refers to the time during which a woman’s body begins to transition towards menopause. Perimenopause can last for several years and can be characterised by fluctuations in hormone levels, irregular menstrual cycles and numerous debilitating symptoms including hot flushes, brain fog, mood swings and night sweats.

Menopause is the point in time when a woman’s menstrual periods have completely ceased for at least 12 consecutive months. This occurs because the ovaries stop producing as much of the sex hormone oestrogen and no longer release an egg each month. Menopause is a natural biological process that marks the end of a woman’s reproductive years. The average age of menopause is 51, but it can occur a number of years earlier or later.


2. Does my place of work have to know I’m experiencing perimenopause? 

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Perimenopause is a personal health issue and for many women, it does not affect your ability to perform your job. While there is no legal obligation for your place of work to know that you are experiencing perimenopausal symptoms,  it’s important to remember that the menopause transition is normal and that support should be available to help you at work if you need it. The CIPD found that around 60% of women they surveyed reported that their perimenopausal symptoms negatively affected them at work, with BUPA disclosing that almost 900,000 had left their job because of their symptoms.

If you are experiencing symptoms that impact your work performance, you might want to consider discussing your situation with your supervisor or HR department. According to ACAS, employers should make sure they have steps, procedures and support in place to help staff affected by the menopause transition. Having regular conversations at work and asking your employer to listen to your concerns can help resolve issues early and enable you to be provided with the necessary support and adjustments.


3. Do you get menopause symptoms every day?

The NHS reports that ‘most women will experience menopausal symptoms. Some women will experience few, or no, symptoms. But for some, they can be quite severe and have a significant impact on everyday life’.

Menopause symptoms can vary in frequency and intensity from woman to woman, and even from day to day for some women. Many women experience symptoms on a daily basis, while others may have more sporadic symptoms. The duration of menopause symptoms can also vary widely, ranging from a few months to several years and the severity of symptoms can change with time or even on a day to day basis.

Common menopause symptoms include hot flushes, night sweats, mood changes, brain fog, vaginal dryness, sleep disturbances, anxiety and changes in libido. These symptoms are caused by the hormonal fluctuations that occur during perimenopause and menopause. You may experience these symptoms some of the time, all of the time, or not at all.


4. Will menopause make me gain weight?

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Menopause can be a contributing factor to weight gain in some women, although it is important to note that it is not the only factor that can contribute to weight gain during this time.

Changing hormone levels affect the way women store fat. During the menopause, your body will tend to store more calories than it burns which can cause fat to build up.

As women age, the body’s metabolism tends to slow down, which can make it more difficult to maintain a healthy weight. Additionally, changes in lifestyle habits, such as decreased physical activity levels or changes in diet may also contribute to weight gain during menopause.

The menopause can also cause other symptoms that indirectly affect your weight. If you’re experiencing night sweats or struggling to sleep, you could have less energy to exercise and be more prone to eating more sugary or fat-laden foods.

Not all women will experience weight gain during menopause, and those who do may only gain small amounts of weight. Maintaining a healthy diet and regular exercise routine (including strength training) can help manage weight during perimenopause and the menopause transition.

For more information, Newson Health have created a detailed fact sheet looking at changing body shape during the menopause.


5. Can I experience perimenopause in my 20s?

The average age of menopause is 51, while perimenopause typically occurs in women in their 40s or 50s. However, it is possible for some women to experience perimenopausal symptoms in their 20s or 30s, which is known as Premature Ovarian Insufficiency (POI) or premature menopause. This happens when the ovaries stop releasing eggs and stop producing hormones,usually before the age of 40.

The majority of cases of POI have no underlying causes, although links have been found in those women with autoimmune disorders or genetic disorders, as well as those who have undergone surgery to remove the ovaries or cancer treatments such as radiotherapy and chemotherapy.

The symptoms of POI can be similar to those experienced during perimenopause and it can have a significant long term affect on the body due to the early onset of low oestrogen levels. .

If you are experiencing symptoms of perimenopause under the age of 40, it’s important to talk to your GP to determine the underlying cause, and to find out about treatment options. Hormone Replacement Therapy (HRT) may be more likely to be recommended to manage symptoms and prevent long-term health risks.


6. Is using HRT dangerous? 

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A number of years ago, misleading and inaccurate studies were published stating that there were significant risks of breast cancer, heart disease and strokes from taking Hormone Replacement Therapy (HRT). These studies led to a number of women stopping taking HRT and today, many women still fear using HRT to combat their perimenopause and menopause symptoms because of the findings of these studies.

Specialist Menopause Doctors such as Dr Naomi Potter and Dr Louise Newson regularly provide up-to-date medical evidence and information from reports, ongoing studies and published journals to show that the increased risk of breast cancer from using HRT is incredibly minimal, with no proven increased risk of death. In fact, they say that as well as helping with perimenopause/menopause symptoms, HRT can actually be beneficial for your health. HRT can help prevent osteoporosis, and taken early enough, it can decrease long term cardiac risk by helping prevent heart disease and strokes. There are also early studies which are starting to show that HRT can lower the risk of other cancers and dementia, but research is ongoing.

HRT is available as tablets, patches or gel.Taking oestrogen transdermally (through the skin) also creates less risk. If you have a uterus it is important that progesterone is combined with the oestrogen to prevent the lining of the womb building up which can increase your risk of cancer. Taking progesterone removes this risk.

For women with histories of blood clots and other underlying conditions, HRT is still an option but needs to be discussed with your GP.

For additional information about HRT, please take a look at the NHS website or speak to your GP.


7. Does every woman experience menopause?

Menopause means ‘the last menstrual period’ and is a natural event and transition that all women will experience. Additionally, some transgender men, non-binary people and intersex people may also experience menopause.

Women who have had a hysterectomy with the removal of both ovaries will experience surgical menopause which has similar symptoms to perimenopause and menopause. Additionally, women with certain medical conditions or those who undergo certain treatments such as chemotherapy or radiotherapy may also experience early or premature menopause. Their symptoms may be more sudden and/or more severe.

Menopause is not a disease or a medical condition. However, it can have significant effects on a woman’s physical and emotional health, and it is important to seek medical advice and support if you are experiencing symptoms of menopause.


8. How do I know which sources of information are accurate and reliable? 

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When looking for information about menopause and perimenopause, symptoms and treatments, it’s important to receive accurate and up-to-date information. At times this can be challenging, as there is a lot of conflicting information and misinformation available online. Here are some reputable resources to consider:

  1. The NHS website: This is a reliable source of information on menopause in the UK, providing detailed information about the symptoms of menopause, treatments, and lifestyle changes that can help manage menopause symptoms.
  2. Speak to your GP.  If you have questions or concerns about menopause, your GP can provide reliable information and advice that is specific to your individual needs and health history.
  3. Look for information from reputable organisations. The British Menopause Society and Women’s Health Concern are two organisations in the UK that provide reliable information and resources on menopause.
  4. Read books by reputable authors. Look for books on menopause written by reputable authors who are experts in the field, such as Dr Louise Newson.
  5. Be aware of information that is not evidence-based and take note of information that makes claims that are not supported by scientific evidence. Avoid websites or blogs that promote unproven treatments or remedies for menopause symptoms or ask you to part with substantial amounts of money.


9. Why does perimenopause cause so many problems?

Hormones play a crucial role in the health and well-being of women. Hormones are chemical messengers produced by various glands throughout the body and are responsible for regulating many bodily functions, including metabolism, growth and development, and reproductive functions.

In women, the two primary sex hormones are oestrogen and progesterone, which are produced by the ovaries. These hormones play a vital role in the reproductive cycle and also have a significant impact on other bodily systems, such as the cardiovascular and musculoskeletal systems.

Throughout a woman’s life, the levels of these hormones will fluctuate, leading to various physical and emotional changes. During the menstrual cycle, oestrogen and progesterone levels rise and fall, leading to changes in mood, energy levels, and other physical symptoms.

Perimenopause can cause a range of problems because it is a time of significant hormonal fluctuation and transition. During perimenopause, the levels of oestrogen and progesterone in a woman’s body begin to fluctuate more rapidly, leading to many physical and emotional symptoms.

As a woman transitions through perimenopause, the body’s production of oestrogen and progesterone rises and falls. Unfortunately, this doesn’t happen in a steady, measured way and hormone levels can be constantly changing, rising and decreasing continuously, almost like being on a rollercoaster. Many of the changes you experience during perimenopause are a result of decreasing oestrogen. As there are oestrogen receptors all over the body, this explains why every part of the body can be affected in some way.


10. Are there any positive things about the menopause transition? 

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All too often, articles, news reports and research focuses on the symptoms and management of perimenopause and menopause and the challenges and discomforts, whilst overlooking the positive aspects of this time of life. For many women these include (but are not limited to):

1. No more periods – one of the most significant changes during perimenopause is the gradual end to menstrual periods. While this can be a difficult transition for some women, it can also be a relief for those who have experienced heavy or painful periods during their lives.

2. Increased sense of freedom – many women report feeling a sense of freedom during perimenopause, as they no longer have to worry about the possibility of an unplanned pregnancy or managing menstrual periods.

3. Greater sense of self-awareness – perimenopause can be a time of self-reflection and self-awareness, as women navigate the physical and emotional changes associated with this phase of life. Learning how to care for your body, how to support it, and prioritising the different forms of wellbeing can increase self-confidence and self-acceptance

4 Fewer PMT symptoms – as hormone levels begin to fluctuate and eventually become steadier during perimenopause, many women experience a reduction in PMT symptoms. In time, this can include a reduction in mood swings, bloating, and other physical symptoms.

5. Improved relationships – some women report that perimenopause has led to improved relationships with partners, family members, and friends, as they become more attuned to their own needs and communicate more effectively. Female friendships are often strengthened during this time as women experiencing similar symptoms lean on each other for support and advice.

It’s important to note that every woman’s experience with perimenopause and menopause is unique, and not everyone will experience these positive aspects. However, for those who do, perimenopause can be a time of growth and self-discovery.

If you would like more information about menopause or perimenopause or want to provide workplace resources, take a look at our Menopause Awareness Online Training Course.