Many women come to see us feeling tired, foggy, unsettled, or “not quite themselves,” and often wonder if hormones could be playing a role. If that sounds familiar, you’re not alone. Perimenopause and menopause are common life stages, but they can look very different from person to person, and they’re often misunderstood.

Perimenopause is the transition phase leading up to menopause. It can start in your 40s, and sometimes earlier. During this time, your ovaries begin to produce hormones more irregularly. Because hormone levels can rise and fall unpredictably, symptoms can come and go. Periods may become heavier, lighter, closer together, or further apart. You might notice changes in sleep, mood, energy, memory, or concentration. Hot flushes and night sweats can appear, but they don’t always show up straight away.

Menopause itself is defined as the point when you have not had a period for 12 months in a row. After this, you are considered post-menopausal. Hormone levels are generally lower and more stable than during perimenopause, but symptoms can still continue or even start at this stage. Vaginal dryness, bladder changes, joint aches, sleep problems, and low mood are all common reasons women seek support during and after menopause.