26/11/2025
It can be quite confusing to know when the first signs of hormonal changes start to occur .
Subtle hormone changes symptoms are noticeable to most women during their monthly cycle .Bloating ,joint and muscle aches ,brain fog ,libido changes ,skin changes are more prominent in the 2 weeks before period starts ,some women get more severe symptoms like mood changes ,irritability,rage ,anxiety as part of premenstrual tension,some can even suffer premenstrual dysphoria disorder which can seriously affect functioning and well being and need a discussion with in professional for advice .
Over the years these hormone changes deepen and often become less regular and more unpredictable .This can happen in late 30s or 40s but sometimes even earlier .This period is called PERIMENOPAUSE and lasts till 1 year after last period when MENOPAUSE is reached .
The hormon level blood tests are not very useful in perimenopause as they change quickly ,even within hours .
It is important however to have general health check including blood tests for diabetes and cholesterol .
If periods stopped without any medication before age of 40 it is called PREMATURE OVARIAN INSUFFICIENCY and the management of this is slightly different
and very important to be done correctly as can have significant future health consequences.
When hormonal preparations are used it can be difficult to know when perimenopause finishes and menopause starts but principles of approach are similar .
Everyone goes through it in a very different way and therefore it needs addressing individually .
Below is a useful summary about this period in life .
This factsheet is written by Dr Lucy Ward, Consultant in Pain Management, at the Royal Free Hospital in London with contributions from Dr Selina Dunn, GP, and Rowanne Eeles pain specialist physiotherapist.