Symptoms of the perimenopause stage

Periods are often the clearest clue: they may become less predictable, with changes in timing, flow or duration. Some people notice hot flushes or night sweats, difficulty sleeping, headaches, breast tenderness, bloating or reduced sexual desire. Vaginal dryness and discomfort with sex may also develop as hormone levels fluctuate.

Emotional symptoms can include irritability, anxiety, low mood or reduced concentration. The pattern is not identical for everyone, and symptoms may come and go. Similar changes can result from pregnancy, thyroid problems, anaemia, stress or medicines, so a new or disruptive symptom deserves a proper review.

Track periods, bleeding intensity, sleep, temperature episodes, mood, pain and treatments in a diary or app. Wear breathable layers, keep the bedroom cool and use a suitable vaginal moisturiser for dryness if advised. Seek support when symptoms affect daily activities; treatment can be tailored to the symptom rather than the label alone.

Contact a clinician about bleeding between periods, bleeding after sex, very heavy bleeding, persistent pelvic pain or symptoms that suddenly change. Urgent care is appropriate for faintness, severe pain, breathlessness, or heavy bleeding with weakness. Low mood with thoughts of self-harm requires immediate support.

Which of my symptoms fit perimenopause? Could another condition explain them? What can help with bleeding, sleep or flushes? How should I manage vaginal discomfort? What warning signs need urgent help?