Perimenopause & Menopause
Your guide to perimenopause & menopause
26 / 05 / 2025
What is perimenopause?
Perimenopause is the transitional phase leading up to menopause, where hormone levels start to fluctuate. It can last several years and bring with it physical, emotional, and cognitive changes, even before periods fully stop.
Key takeaways:
- Perimenopause can start in your 40s (or earlier).
- Symptoms include irregular periods, mood swings, brain fog, and hot flushes.
- Lifestyle changes and HRT can help manage symptoms.
- Tracking your cycle and symptoms helps with diagnosis and treatment decisions.
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Common questions about menopause
This article and video series tackle the most frequently asked questions about menopause—from what it actually means to how it affects work, relationships, and mental health.
Key takeaways:
- Menopause is diagnosed after 12 months without a period.
- Symptoms can last for years—support is available.
- Mental health, memory, and mood may be affected.
- There’s no “right way” to do menopause—every journey is personal.
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Symptoms and how to manage them
Hot flushes, night sweats, sleep issues, and vaginal dryness are some of the most common menopause symptoms. However, with the right approach — whether lifestyle, medical, or holistic — they can be effectively managed.
Key takeaways:
- Hot flushes and night sweats are caused by hormonal changes affecting body temperature regulation.
- Sleep disruption is common; sleep hygiene and HRT may help.
- Vaginal dryness can be treated with moisturisers, lubricants, or oestrogen therapy.
- Symptoms are manageable; don’t suffer in silence.
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Physical health and body changes
From bone thinning to joint aches, menopause affects the body in many ways. These changes are real and deserve attention, not just acceptance.
Key takeaways:
- Oestrogen drop affects bone density, increasing osteoporosis risk.
- Aching joints and stiffness may be linked to menopause.
- Staying active, eating calcium-rich foods, and HRT can support long-term bone health.
- Awareness helps you advocate for your own well-being.
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Brain fog and memory
Many people in midlife worry about forgetfulness, lack of focus, or brain fog. These symptoms are very real and often linked to menopause.
Key takeaways:
- Hormonal changes can affect memory, word-finding, and attention.
- Stress, poor sleep, and multitasking can worsen the effects.
- Mental exercises, rest, and in some cases, HRT can help.
- You’re not losing your mind, you’re navigating a transition.
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Hormone replacement therapy (HRT): Supporting menopause wellbeing
Hormone Replacement Therapy (HRT) is a proven and effective treatment for many menopause symptoms, including hot flushes, sleep issues, low mood, joint pain, and vaginal dryness. It works by replacing the hormones—primarily oestrogen and sometimes progesterone and testosterone—that the body stops producing during menopause. While HRT is not for everyone, understanding the benefits, risks, and options can help individuals make informed decisions about their health.
Key takeaways:
- HRT can dramatically improve the quality of life for many people going through menopause.
- There are different types of HRT—tablets, patches, gels, sprays, and vaginal preparations.
- Combined HRT (oestrogen + progesterone) is typically recommended for those with a womb.
- Testosterone can be used in women, too, especially for low libido or energy.
- Unscheduled bleeding is common early on but should always be assessed if persistent.
- Benefits of HRT include reduced risk of osteoporosis and improvement in brain fog, sleep, and mood.
- Discuss risks vs. benefits with your GP based on personal and family health history.
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Early and premature menopause – What you need to know
Menopause typically occurs between the ages of 45 and 55, but for some, it can happen much earlier, sometimes before the age of 40. This is called premature menopause or primary ovarian insufficiency. It may occur naturally or be triggered by medical treatments like chemotherapy or surgery. Early menopause can bring all the usual symptoms—hot flushes, mood swings, fatigue—but it also brings added challenges, particularly around fertility, emotional health, and future planning.
Key takeaways:
- Early menopause is defined as occurring before age 45; premature menopause is defined as occurring before age 40.
- It may be caused by genetics, autoimmune disorders, surgery, or unknown factors.
- Fertility may be significantly affected; options include egg freezing or donor eggs.
- Hormone Replacement Therapy (HRT) is typically recommended until the average age of menopause to protect bone and heart health.
- Emotional impact can be profound; support groups and therapy are helpful.
- Talking early and openly with a healthcare professional is key to managing symptoms and planning ahead.
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Staying healthy during and after menopause
While menopause is a biological transition, lifestyle plays a vital role in how symptoms are experienced and managed. From diet to exercise, small, sustainable changes can make a big difference in easing symptoms, improving mental wellbeing, and preventing long-term health issues like osteoporosis, cardiovascular disease, and weight gain. These Bupa resources offer practical, evidence-based guidance to help women thrive through and beyond menopause.
Key takeaways:
Diet & nutrition
- A Mediterranean-style diet rich in vegetables, oily fish, and whole grains may reduce hot flushes and mood swings.
- Calcium and vitamin D support bone health, essential as oestrogen drops.
- Reducing caffeine, alcohol, and processed sugars can help with sleep and mood.
- Phytoestrogens (found in soy, flaxseeds, chickpeas) may ease hormonal fluctuations.
Movement & exercise
- Regular aerobic activity improves mood, energy, sleep, and heart health.
- Walking, swimming, yoga, and dancing are great low-impact options.
- Strength training helps preserve muscle mass and bone density post-menopause.
- Even 20 minutes a day can have powerful long-term effects.
General wellness
- Manage stress through mindfulness, rest, or creative outlets.
- Prioritise sleep hygiene to tackle night sweats and fatigue.
- Stay connected socially, as mental well-being often declines when women feel isolated during menopause.
- Build routines that support your body’s changing needs rather than resisting them.
Practical strategies for managing menopause through lifestyle
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