Understanding Perimenopause: Navigating the Transition to Menopause

Perrine Pauwels
Perrine Pauwels
  • Updated

person-massaging-her-feet.jpgEntering perimenopause marks a transformative phase in a woman's life, signalling the gradual transition towards menopause.

Perimenopause is a journey of transformation and self-discovery in the circa 10 years leading up to menopause, your last menstrual bleed. It brings changes, both emotional and physical. Understanding and preparing for this natural phase is key for a smooth transition into menopaused.

Let's explore perimenopause in depth, including its four phases, the changes it can bring, its spiritual dimension, and how to support yourself through this transition.

What is Perimenopause?  

Perimenopause, also called the menopausal transition, typically kicks off in a woman's early 40s or even late 30s, spanning over several years.

Unlike menopause, which is only confirmed after a full year without menstruation, perimenopause unfolds gradually. It's a time of hormonal shifts and changes in menstrual patterns. As oestrogen and progesterone levels dip, women may experience a range of physical and emotional symptoms, each unique in intensity and duration. Typically, oestrogen levels start to decline first, often fluctuating before gradually decreasing. Progesterone levels may also decline, but it tends to occur later in the transition. 

Phases of Perimenopause 

Perimenopause unfolds in four distinct phases, each bringing its own set of changes in menstrual patterns and hormonal ebbs and flows. 

Initially, these changes might be subtle and are easily overlooked by many women. Keeping track of your menstrual cycle in your 20s and 30s helps to understand what's 'normal' for you and spot any shifts.

  1. Shortened Cycles: As oestrogen levels start to fluctuate, menstrual cycles become slightly shorter, perhaps dropping to 26 or 25 days if you're used to a 28-day cycle. 
  2. Anovulatory Cycles: Ovulation becomes irregular or may stop altogether as oestrogen levels gradually decline, leading to further hormonal imbalances and fluctuations in cycle length, some months as short as 14 days and other times as long as 35.
  3. Extended Cycles: Cycles stretch out significantly, with intervals between periods sometimes reaching up to 60 days. Symptoms may intensify as oestrogen levels get really low, and some women experience insulin resistance.
  4. Final Phase: This phase can last for 2 or 3 years, during which bleeding may stop for several months before resuming. Hormonally, oestrogen levels continue to decline, while progesterone levels may fluctuate. Menopause is officially reached when you have gone a full year without menstruating.

Changes during Perimenopause

Perimenopausal symptoms are as diverse as women themselves and many still navigate them unaware that they're linked to hormonal shifts due to the changing menstrual cycle.

A drop in progesterone for example may trigger mood swings, anxiety, depression, breast tenderness and sleep disturbances, while declining oestrogen levels can bring on hot flashes and night sweats.

Additionally, perimenopause may lead to a drop in libido, vaginal dryness, a need to pee often, and trouble concentrating. It may exacerbate existing health issues or introduce new challenges, like heightened risk of osteoporosis and cardiovascular issues.

Some women also experience symptoms that wouldn't typically be linked to perimenopause by doctors, such as joint pain, fibromyalgia and other autoimmune conditions, and elevated histamine levels causing new allergies. Fortunately, these symptoms often fade once menopause is reached.

Supporting Yourself Through Perimenopause

Navigating these changes calls for a holistic approach that embraces both your physical and emotional well-being. It's essential for women to listen to their bodies, advocate for their needs, and seek support from specialised healthcare professionals during this transitional phase.

Nurturing your nervous system is key. Adopting a healthy diet, including supplements like magnesium, adding strength training to your work out routine and reducing your alcohol intake can significantly improve your symptoms.

Exploring alternative therapies such as acupuncture, herbal medicine, and mind-body practices like yoga and meditation can offer additional support. 

If your symptoms still persist, you can explore with your doctor to find the right version of bio-identical hormone replacement therapy (HRT) for you.

For deeper insights into hormonal changes and management during perimenopause, Lara Briden's "Hormone Repair Manual" is an invaluable resource. Offering dietary tips, lifestyle adjustments, and herbal remedies, Briden empowers women to naturally support hormonal balance.

Perimenopause as a Spiritual Transition 

Beyond its physical and emotional manifestations, perimenopause is also a profound spiritual journey. These are the Wild Woman years of your life, preparing the way for the rite of passage of menopause, initiating you into your crone era, or Wisdom Woman phase.

Symbolically and energetically, your perimenopausal Wild Woman years align with autumn, the pre-menstrual phase, and the waning moon, evoking themes of metamorphosis, setting boundaries and releasing what is no longer needed. 

With the Wild Woman archetype guiding you, your priorities may shift, perhaps coinciding with children growing older and possibly leaving home, and a change in your working life. Your energy becomes more precious, leading to a reevaluation of how you spend your time and a call to focus more on yourself. 

Another important theme is to embrace the inherent beauty and resilience of aging instead of resisting this natural change. 


In navigating perimenopause, knowledge is power. 

By embracing perimenopause as a natural, transformative phase in life and adopting a holistic approach to self-care, you can navigate this transition with resilience and self-compassion. 

Progressing towards your crone era is an opportunity for growth and self-discovery, enabling you to emerge as a wiser, more empowered version of yourself, ready to embark on the next chapter of your journey with confidence.

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