Menopause never shows up overnight! It is always preceded by a transition phase that is more or less long and more or less turbulent, called perimenopause (or premenopause). During this pivotal period, which affects all women, ovarian function gradually slows down: oestrogen and progesterone production goes up and down, leading to changes in the menstrual cycle as well as a range of physical and emotional symptoms in around 80% of women.
- Understanding the hormonal transition: Looking at hormonal changes helps you better understand this natural stage before periods stop for good.
- Identifying all the signs: Spotting the full range of physical, cognitive and emotional symptoms early helps you choose the right everyday strategy, far beyond hot flushes alone.
- Looking after your pelvic floor health: Toning the pelvic muscles is an essential reflex for preserving urinary comfort through targeted training such as pelvic floor training.
What is perimenopause and at what age does it start?
The definition of perimenopause refers to the phase of hormonal transition that comes before the final stopping of menstruation and lasts until 12 months in a row after the last ovulation.
On average, the age at which it begins to show its first signs is around 47. However, it can start earlier (in your 30s or 40s) because of an early decline in the stock of eggs or a family history.
How long does this period last?
The average duration is 2 to 4 years, but this process can last from 4 to 8 years, or even 10 years depending on how your body responds to hormonal changes
Healthcare professionals distinguish two main stages:
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Early perimenopause: the decrease in progesterone secreted by the ovary creates an imbalance. The menstrual cycle shortens (less than 21 days), menstrual flow changes and premenstrual syndrome (PMS) becomes more intense.
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Late perimenopause: the drop in oestrogen production becomes sharp and unstable. Ovulation becomes rare, the cycle lengthens unpredictably (more than 35 days), alternating between heavy bleeding and temporary amenorrhoea.
What are the symptoms of perimenopause and how does it affect the body?
The presence of hormone receptors throughout the body explains why this climacteric transition affects both physical health and mental wellbeing.
The most common symptoms are:
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Hot flushes and increased sweating: during this period, hormonal changes disrupt the temperature control centre located in the brain. You can ease this hot flush or night sweat by wearing natural-fibre clothing (cotton, linen) and avoiding stimulants such as coffee, alcohol or spicy foods.
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Irregular periods and premenstrual syndrome: these discomforts come from the drop in progesterone that creates an imbalance in your cycle. You can reduce these tensions by moderating your salt intake and speaking to a healthcare professional to assess whether suitable progestogen support would help.
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Disrupted sleep and fatigue: night sweats and sleep disorders (such as insomnia) disturb your rest. To get back to good-quality sleep and avoid chronic fatigue, make sure your bedroom stays cool at 18 °C and switch off screens before bed.
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Mood swings and brain fog: brain fog, loss of concentration, irritability and anxiety are directly linked to neurological fluctuations. You can help ease these feelings by doing gentle exercise (walking, yoga) and relaxation exercises.
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Intimate dryness and lower libido: the decrease in vaginal lubrication causes dryness in the intimate area and lower libido. Regular use of a vulvar moisturiser and a lubricant helps reduce discomfort during sex.
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Urinary incontinence or bladder discomfort: lower oestrogen levels weaken the mucous membranes and pelvic muscles. You can effectively stop each urinary leak by regularly doing pelvic floor strengthening.
Are you dealing with involuntary leaks every day? Read the story of a user who regained her comfort in 2 weeks thanks to Emy Trainer!
Why do urinary leaks happen during perimenopause?
These urinary leaks are mainly linked to hormonal changes during menopause. The production of female hormones (oestrogen and progestogen) decreases, which can affect the bladder and reduce tissue elasticity. With lower oestrogen levels, some women also experience an increased urge to urinate.
The risk of urinary tract infections also increases, because the mucous membranes are less well supplied with blood and therefore more sensitive to bacteria. Repeated infections in turn increase the risk of developing bladder weakness.
Important: urinary incontinence can affect all women - whatever their age - and should not be a taboo subject! Women affected can turn to a ·healthcare professional, who can advise them and, in particular, suggest pelvic floor training to take practical action against these problems.
To better understand how pelvic floor rehabilitation helps prevent the risk of urinary leaks during this transition period, discover Catherine's story.
What contraception should you use and what medical support should you consider?
Although fertility decreases, the stock of eggs can still lead to unpredictable ovulation. The risk of an unwanted pregnancy remains as long as periods have not stopped for a full year. Effective contraception (such as hormonal contraception with a progestogen or an IUD) should therefore be maintained.
If symptoms are troublesome, it is essential to consult a healthcare professional (gynaecologist, GP or midwife) for a full assessment.
Key takeaways on perimenopause:
- Embrace the hormonal transition: Adapting your lifestyle and daily routine helps you move through hormonal changes more smoothly.
- See a healthcare professional: Having regular check-ups with a doctor helps you find the treatment or solutions that best suit you.
- Look after your pelvic floor: Pelvic floor rehabilitation helps reduce urinary discomfort, and there are devices you can use at home independently, such as the Emy Trainer pelvic floor trainer
Perimenopause FAQ: Understanding and Relieving Your Symptoms
At what age does perimenopause start, and how long does it last?
Perimenopause (also called premenopause) usually begins around age 47. This hormonal transition period comes before menopause and lasts on average between 2 and 4 years, until your periods stop completely.
What are the first symptoms of perimenopause?
The most common signs are caused by a drop in progesterone: irregular periods, hot flashes, night sweats and premenstrual syndrome (breast tenderness, irritability). You may also feel tired, have sleep problems or experience "brain fog" (difficulty concentrating).
Does perimenopause cause weight gain?
Weight gain and changes in body shape are common. They are linked to a slower metabolism and lower oestrogen levels. Regular physical activity and healthier eating habits can help you manage your weight.
Is it normal to have urinary leaks during perimenopause?
Yes, it is very common. Hormonal changes often lead to genitourinary symptoms. Lower hormone levels weaken and relax the tissues of the pelvic floor, which can cause vaginal dryness, a frequent need to urinate, or small stress urinary leaks.
How can you reduce leaks linked to perimenopause?
During this period when your pelvic muscles relax, it is essential to tone them.
The connected pelvic floor trainer Emy Trainer helps you train your pelvic floor at home thanks to fun biofeedback exercises. By strengthening this muscular “hammock”, you regain bladder control and reduce urinary leaks.
Can you still get pregnant during perimenopause?
Yes, pregnancy is still entirely possible. Although fertility decreases with age, it is essential to keep using contraception until menopause is medically confirmed (that is, no periods at all for one year). Talk to your doctor so you can adapt your contraceptive method.
How can you better live with perimenopause symptoms day to day?
To reduce discomfort, adopt a healthy lifestyle:
- Do regular physical activity (such as walking) to help limit weight gain.
- Stay well hydrated throughout the day.
- Limit stimulants (coffee, tea, alcohol), which can trigger hot flashes.
- Do not hesitate to have a preventive check-up with a healthcare professional (doctor, midwife) so your care can be adapted.
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