Am I perimenopausal?

Ovulation becomes more sporadic. Progesterone can begin to drop first, resulting in relatively high oestrogen levels in comparison to progesterone levels.

Typical symptoms include bloating, increased breast tenderness, increased breast size and difficulty losing weight from hips, thighs and bum. Heavier bleeding, increased premenstrual anxiety, physical tension, irritability, anger or tearfulness can also occur.

A time when progesterone remains low and oestrogen levels begin to fluctuate between relatively high and low.

Your cycle can become more irregular and less predictable, weight gain may begin to appear around the waist and can be more difficult to lose – your old techniques no longer work.

Changes in body temperature and feeling hot or some hot flushes may begin which can contribute to sleep problems. Symptoms such as brain fog, difficulty recalling words or names, mood swings, increased anxiety, mental and physical tension, a sense of overwhelm and angry outbursts are common.

By now, both progesterone and oestrogen levels are persistently low and your menstrual cycle will stop.

Irritable bladder (needing to go to the loo often), vaginal dryness or discomfort can occur along with cystitis and/or thrush.

Your skin can become dryer, hair can become thinner and persistent joint pains can become a problem. Hot flushes and night sweats become a more regular feature. You may gain more weight and there can be a loss of confidence, drive and libido.

Oestrogen and progesterone levels have stabilised at a lower level.

Symptoms can still occur especially if stress and poor metabolic health are a significant part of your life. These include hot flushes, genitourinary issues and ageing skin and hair.