Perimenopause symptoms: recognising the signs that speak for themselves.

Perimenopause (also referred to as premenopause) is the hormonal transition period before the menopause, during which the production of oestrogen and progesterone begins to fluctuate and then decline. (1) These variations influence the menstrual cycle, ovulation, sleep, mood, and physical comfort.

These words are often used premenopause, perimenopause and menopause as if they meant the same thing, but they refer to three different stages in a woman's hormonal life.
Premenopause corresponds to the period when a woman still has regular cycles and normal fertility, before any clear changes related to menopause.

Perimenopause is the transition phase: cycles become irregular, hormonal symptoms appear (hot flushes, sleep disturbances, mood changes, etc.), but periods are still present.

The menopause marks the permanent cessation of periods for 12 consecutive months, with low and stable hormonal production (2). 

This phase can begin as early as 35 or 40 years of age in some women, sometimes later. It lasts several years (on average 4 years, often between 2 and 10 years) before the complete cessation of periods and the onset of menopause (defined as 12 consecutive months without periods). During this time, the body does not function in a linear way: cycles become irregular (shorter, longer, sometimes absent for several months), hormonal symptoms appear gradually, and some women notice marked changes in their energy, mood, or sleep (3).

When this transition begins before the age of 40, it is referred to as early premenopause. It remains uncommon but can occur, particularly in cases of family predisposition.

To confirm that this is indeed a hormonal transition, a doctor can measure two hormones: FSH and AMH.

• FSH (Follicle-stimulating hormone): it is a hormone produced by the pituitary gland, located in the brain. Its role is to stimulate the ovaries to mature a follicle in preparation for ovulation. When the ovaries respond less effectively, the brain increases FSH levels to stimulate them. This is why higher FSH levels are observed during perimenopause and menopause.
• AMH (Anti‑Müllerian hormone): it is produced directly by the follicles and therefore reflects the residual follicular reserve. A low AMH indicates a likely end to fertility.
  These tests are not routine, but they help to distinguish between a simple cycle irregularity and the beginning of perimenopause or early menopause, particularly in cases of unintended pregnancy, a desire to conceive, or very pronounced symptoms.

One of the first signs of perimenopause is often an irregular menstrual cycle. The cycle may become shorter, longer, more unpredictable or more variable from one month to the next. Ovulation may occur irregularly, which alters hormone production and makes periods less predictable (4).

The most common changes are:

• more frequent periods, for example every 21 to 24 days.
• or longer cycles, sometimes beyond 35 days.
• heavier or, conversely, lighter menstrual flow.
• months without menstruation, followed by a sudden return of periods.

These variations in the menstrual cycle are often linked to the hormonal fluctuations of perimenopause. They can last several years before the final menopause. In some women, these symptoms are subtle. In others, they are more noticeable and more disruptive in everyday life.

La préménopause ne se manifeste pas seulement par des troubles du cycle. Elle peut aussi provoquer plusieurs symptômes hormonaux qui touchent le sommeil, l’humeur, le corps et la vie intime de la femme.

Les manifestations les plus fréquentes sont (5) :

• des bouffées de chaleur.
• des sueurs nocturnes.
• des troubles du sommeil ou des insomnies.
• une irritabilité, anxiété ou humeur changeante.
• une fatigue persistante.
• une baisse de la libido.
• un brouillard mental ou des difficultés de concentration.
• une légère incontinence ou des fuites urinaires
• une sécheresse vaginale.
• des douleurs articulaires.
• une prise de poids, souvent au niveau abdominal.

Ces symptômes sont liés aux variations hormonales, notamment à la baisse progressive de la progestérone et aux fluctuations des œstrogènes. Cette production irrégulière des hormones peut influencer le cerveau, le métabolisme, la qualité du sommeil, la peau et l’équilibre émotionnel.

Not all irregular menstrual cycles are solely related to perimenopause. Certain signs should prompt a consultation with a healthcare professional, as they may indicate another medical cause.

You should seek medical advice if you experience:

• extremely heavy periods.
• bleeding between periods.
• bleeding after sexual intercourse.
• unusual pelvic pain.
• bleeding after 12 months without a period.

These symptoms may be linked to fibroids, polyps, thyroid disorders or other hormonal imbalances. A medical assessment can help determine whether the changes in your menstrual cycle are related to perimenopause or to another cause.

Une bonne gestion des symptômes au quotidien repose sur quelques habitudes simples. La préménopause n’est pas une maladie, mais une phase de fluctuation des hormones. Elle demande souvent d’adapter son rythme de vie pour limiter les symptômes et mieux accompagner son organisme pendant cette période (6).

Voici quelques habitudes de vie utiles :

• garder un sommeil aussi régulier que possible.
• pratiquer une activité physique douce comme la marche, le yoga ou la natation.
• limiter le café et l’alcool, qui peuvent aggraver les bouffées de chaleur et sueurs nocturnes.
• privilégier une alimentation riche en légumes, protéines, fibres et oméga-3.
• réduire le stress par la respiration, la méditation ou des routines apaisantes.

Chez certaines femmes, la prise de compléments alimentaires autour de la ménopause peut aussi apporter un soutien, notamment lorsqu’ils contiennent du magnésium, des vitamines du groupe B ou certaines plantes. Ils ne remplacent toutefois pas un avis d’un professionnel de santé ni un suivi adapté si les symptômes deviennent importants.

Péri Essentials de Jolly Mama, un multivitamines spécial périménopause qui associe :

• vitamines B6, B9 et B12 qui contribuent au métabolisme énergétique normal et à la réduction de la fatigue
• vitamine D3 + K2 qui participent au maintien d'une ossature normale
• vitamines C et E, zinc et sélénium qui contribuent à protéger les cellules contre le stress oxydatif,
• extrait de Bacopa breveté pour soutenir la concentration, la mémoire et limiter le « brouillard mental ».

Et pour soutenir votre équilibre hormonal, Péri support de Jolly Mama combine des plantes, dont le shatavari, qui aide à soutenir les hormones. 

If hormonal symptoms become bothersome or the menstrual cycle changes significantly, your doctor may suggest a medical assessment. This follow-up may include an evaluation of symptoms, a hormonal assessment or other tests depending on the situation.

A healthcare professional may in particular suggest:

• a hormonal assessment to evaluate the situation.
• a discussion on contraception, as ovulation may continue.
• hormone replacement therapy (HRT) if the situation warrants it.
• additional tests in the event of unusual bleeding.

The aim is not only to confirm perimenopause, but also to rule out other causes and help the woman navigate this period with greater comfort.

Perimenopause often has an impact that goes beyond physical symptoms. This phase of hormonal change can also have a significant emotional effect. Some women experience greater mental fatigue, heightened sensitivity, a loss of confidence, or a sense of no longer recognising their usual rhythm.

It is important to acknowledge that these changes are common and do not reflect any weakness. Hormone production becomes irregular, which can affect mood, concentration and energy levels. Listening to your own needs, slowing down when necessary and adapting your daily routine can make a real difference.

Irregular menstrual cycles can be a sign of perimenopause, but they are not sufficient on their own to make a diagnosis. It is the combination of hormonal symptoms, age, hormone production, cycle regularity, and changes in ovulatory phases that helps to better understand this transition towards menopause.

Understanding these signals better helps every woman navigate this period with greater peace of mind, by identifying what represents a normal change in the cycle and what requires medical attention.