Perimenopause: symptoms, treatments and advice

The little menopause calendar

Perimenopause, menopause, premenopause… what’s the difference? We’ve delved into scientific studies to draw up a little calendar of the major stages surrounding menopause .

To put it simply, the Perimenopause (or premenopause, it's the same) is the period preceding menopause. It can last 2 years, 4 years or even longer.

The Seattle Midlife Women's Health Journey study , conducted by professors and nurses Nancy Fugate Woods and Ellen Sullivan Mitchell, reveals that perimenopause develops gradually and can be broken down into approximately three-year periods. The onset of perimenopause is marked by a significant delay in menstruation (one week).

Step 1: The first telltale signs

To determine if you are entering perimenopause, pay particular attention to the regularity of your cycles . Initially, they become shorter as your progesterone levels drop . This first stage can last up to 5 years and sometimes begins as early as your late thirties.

Step 2: Perimenopause enters the picture

Next, you enter perimenopause . Your estrogen levels also drop, your cycles become longer, and you have less frequent periods (that's great!) . Perimenopause lasts on average 3 years.

Step 3: The menopausal queen is here

Finally , you enter menopause . You are officially menopausal one year after your last menstrual cycle . For your information, The average age of menopause in France is 51 years (report of the parliamentary mission on menopause, 2025) .

It's worth remembering that there are as many menopause experiences as there are women . Each woman experiences these stages differently.

For some, perimenopause is accompanied by a whole host of unpleasant symptoms. For others, their forties are a long, smooth journey, and the first signs only appear at 50.

Whatever your situation, listen to your body because it has a lot to teach you and it knows exactly what you need.

How can you tell if you are in perimenopause?

Perimenopause doesn't suddenly burst into your life. It progresses tentatively and reveals itself little by little.

It is marked by 2 key events: the fall in progesterone in the early years, then the fall in estrogen before the onset of menopause.

Here are some symptoms that can help you identify the problem:

1. drop in progesterone

• Irregular and shorter cycles (you still ovulate, so you remain fertile);

• A more pronounced premenstrual syndrome with great irritability, uterine pain, headaches;

• Mood disorders with difficulty falling asleep or waking up during the night.

2. drop in estrogen

• Ovulation becomes less frequent, therefore your cycles are longer;

• The first symptoms of menopause appear , such as decreased libido or hot flashes.

If you have the opportunity to have your hormones checked during perimenopause , you will see a high FSH level . Your brain is working hard to produce this hormone in large quantities to compensate for the loss of estrogen. When it stops working and shuts down, you are in menopause.

A quick but important reminder: perimenopausal symptoms are perfectly valid reasons to consult a healthcare professional . They will answer your questions and be able to reassure you .

No, you're not sick, but you're entering a new phase of life. The better informed you are, the smoother the transition will be.

Perimenopause: some special cases

To help you understand perimenopause , we'll talk about averages and explain the general outline. But it's important to keep in mind some specific cases.

The goal? To understand how women's bodies work and to learn to spot the first signs in yourself or your friends.

Here are 3 cases to be aware of:

1.    There Early menopause , or POI (Premature Ovarian Insufficiency), is characterized by the permanent cessation of menstruation before the age of 40. This affects 1 to 2% of women , according to the latest research conducted by INSERM .

2.    Endometriosis This is a gynecological condition that is receiving increasing media attention (and that's a good thing). Specifically, fragments of the uterine lining (endometrium) are located outside the uterus. Menstrual periods are generally more painful , longer, and heavier.

3.    Polycystic ovary syndrome (PCOS) has a significant impact on the hormonal system. Small, immature follicles accumulate around the ovaries and produce an excessive amount of androgens (male hormones). Even before perimenopause, menstrual cycles are already very irregular, or even absent.

In these cases (and many others), the perimenopause process is more complex . Close monitoring is essential to understand the symptoms and benefit from personalized care.

To be an expert on perimenopause

How your body prepares for menopause

Now that you understand what is happening at the hormonal level, let's see what is happening at the level of the body .

Here's a quick recap of the physical changes that generally occur during perimenopause :

• Unexplained weight gain;

• Vaginal dryness during and outside of intercourse;

• A change in the skin (looser and thinner);

• Greater exposure to cardiovascular and osteoarticular diseases (such as osteoporosis).

Because your cycles are irregular , perimenopause also influences your ability to conceive.

A word of caution: even if you are less fertile, you can still get pregnant during perimenopause . If you don't want (or no longer want) children, consider choosing a method of contraception.

During this perimenopausal phase, when your cycles are somewhat irregular, Symptothermal charting is TOP for understanding where your body is at .

This method is based on the daily analysis of three elements: body temperature, position of the cervix, and appearance of cervical mucus. To know exactly where you are in your cycle. It's natural and super reliable!

Is a fulfilling sex life possible during perimenopause?

The answer is YES!

Certainly, hormonal changes impact your body and stimulate your desire, but that doesn't mean that Your libido needs to gather dust. Quite the opposite!

We see perimenopause as a golden opportunity to enter a new era of your sexuality . It's the time to explore new things and learn to make love differently, in a way that is just as sensual but with new rules.

Don't forget that men also have to deal with new hormonal patterns starting in their fifties . If you have a partner, the path to orgasm is therefore a shared one!

Perimenopause: Why are some women depressed?

How can we explain the link between perimenopause and mental health ?

It's always the hormones' fault. Progesterone has calming and relaxing properties. When its level drops, you may feel more easily irritable or anxious .

According to Italian-American neuroscientist Lisa Mosconi, hormones are to the brain what “ fuel is to a car .” Hormonal changes are responsible for both the physical changes and the psychological disturbances that can occur during this period ( Women's Brain Initiative study ).

Beyond this very clinical argument, premenopause is a difficult stage because menopause means the end of fertility .

Since you were a teenager, you've been used to having your period every month , you may have had children and then struggled to find THE right method of contraception… And then gradually, this mental burden is no more.

Of course, we all have different experiences, but some women feel the need to grieve the loss of their ability to give life . Even worse, they are ashamed of no longer being able to conceive.

That's why menopause is still such a taboo subject: 48% of women find it difficult to talk about this subject (2025 report of the parliamentary mission on menopause) .

What if we changed our perspective on menopause ? You're in the prime of life, still active, free from tampons, menstrual cups, and contraceptive implants. It's time to think about yourself, to take care of your body and refocus on your femininity .

Embracing perimenopause: treatments and lifestyle

Small habits that change lives

To stay in shape during perimenopause , here are a few small adjustments to your daily routine:

1. Building muscle reduces the risk of cardiovascular and musculoskeletal diseases during menopause. Weight training, Pilates, swimming, running… The sooner you start, the better!

2. complement each other It helps to alleviate some of the discomfort caused by the drop in hormones. There are, of course, some treatments based on synthetic hormones, but only 6% of women gave in to temptation (INSERM 2023 report).

3. Reviewing your diet is essential to ensure you get all the nutrients you need. Prioritize foods rich in calcium (dairy products, legumes), vitamins (vegetables and fruits), and magnesium (seafood, whole grains, dark chocolate).

For personalized advice , do not hesitate to consult a healthcare professional.

Perimenopause, what if we talked about it?

Our final piece of advice for navigating perimenopause more easily : talk about it with those around you. Openly discuss the topic . Your friends, your mother, your cousin, your sister… they all have questions and probably need reassurance.

Beyond your immediate circle, don't hesitate to seek advice from a healthcare professional :

• The psychologist offers you a safe and supportive space to discuss any issues that concern you. With your therapist, you can talk openly and honestly about your relationship with your body, parenthood, relationships, and your fears.

• THE A sexologist or sex therapist can support you with your sexual needs. Are you experiencing a blockage? Are you worried? Have you lost your libido? This practitioner listens to you, answers your questions, and helps you move forward, alone or with a partner.

What if menopause were a springboard to a new version of yourself? More fulfilled, more confident, sexier, more powerful. Listen to your body and give it what it needs: vitamins, attention, and pleasure. That's the recipe for a successful transition.