Managing Perimenopause: Symptoms and Treatments

Common Symptoms of Perimenopause

Symptoms of perimenopause can vary widely between women, and even from month to month, as hormone levels fluctuate. Some changes are mild; others can feel more disruptive. Recognising the signs early can help you seek support before they impact your quality of life.

Irregular Periods

Cycles may shorten, lengthen, or occasionally skip. Flow can become lighter or heavier as oestrogen and progesterone levels fluctuate.

Hot Flushes & Night Sweats

Sudden waves of heat, often across the face, neck, and chest, sometimes followed by sweating or chills. These can worsen with alcohol, caffeine, spicy foods, or warm rooms.

Mood Changes & Brain Fog

Shifts in hormones can trigger irritability, anxiety, low mood, or emotional sensitivity. Many women also report poor concentration or forgetfulness during this time.

Sleep Disturbance

Falling or staying asleep can become difficult, particularly when night sweats occur. Early waking is also common.

Vaginal Dryness & Discomfort with Sex

Lower oestrogen can cause thinning of vaginal tissues, leading to dryness, itching, or pain during sex. You may also notice urinary frequency or more frequent UTIs.

Fatigue, Headaches & Aches

Many women experience low energy, tension headaches, or joint stiffness linked to changing hormone and inflammatory patterns.

Weight Gain or Body Composition Changes

A tendency to gain weight around the abdomen, hips, or thighs is common, even without major dietary changes, as metabolism naturally slows.

If symptoms are frequent, disruptive, or worrying, or if bleeding is unusually heavy, prolonged, or occurs after sex, please book a medical review.
At Omniya Clinic, our doctors specialise in identifying and treating perimenopausal changes safely and effectively.

Signs Perimenopause Is Ending

Perimenopause can last anywhere from a few months to several years. Knowing when it’s coming to an end can help you prepare for the next stage: menopause, which is confirmed once you’ve had 12 consecutive months without a period.

Common signs that perimenopause is ending include:

Periods becoming increasingly spaced out before stopping completely.
Hormonal fluctuations settling, with fewer hot flushes or night sweats.
Reduced intensity of symptoms such as mood swings and brain fog.
Persistent low-oestrogen symptoms (for example, vaginal dryness or urinary discomfort) that may continue without hormonal support.

Every woman’s transition is unique. For some, symptoms ease naturally; for others, they persist or shift in pattern. If you’re uncertain whether your symptoms indicate the end of perimenopause, our clinicians can assess hormone levels and overall health to guide your next steps.

We offer Hormone Replacement Therapy (HRT) and holistic care to support women through this stage and beyond.

Female Hormone Replacement Therapy, HRT showing the product to client

Lifestyle Support to Manage Perimenopause Symptoms

Lifestyle choices play a powerful role in managing perimenopause symptoms, from hot flushes and mood swings to poor sleep and weight changes. Consistent, realistic habits can make this transition smoother and support long-term health.

Exercise

A mix of aerobic activity (walking, cycling, swimming) and two strength-training sessions per week helps maintain bone density, mood stability, sleep quality, and metabolic health. Even short daily movement breaks can make a difference.

Nutrition

Build meals around lean protein, colourful vegetables, fibre, and healthy fats. Focus on:

Calcium and vitamin D for strong bones
Magnesium for sleep and relaxation
Omega-3 fats for brain and heart health

Stay hydrated, and moderate alcohol and caffeine to reduce flushes and improve sleep.

Stress Care

Brief breathwork, mindfulness, or yoga can lower stress hormones and support emotional balance. Getting morning daylight helps regulate your body clock, while short movement or breathing breaks during the day help you reset and refocus.

Sleep Hygiene

Prioritise a consistent sleep-wake schedule. Keep your bedroom cool, dark, and quiet, reduce late caffeine and screen exposure, and consider a fan or cooling pillow to help with night sweats.

Trigger Management

Identify your personal flush triggers, such as heat, alcohol, caffeine, or spicy foods, and make small adjustments. Even minor changes in routine or environment can reduce symptom frequency and intensity.

Supplements

Certain supplements can be beneficial, particularly if testing shows low levels. These may include:

Vitamin D for bone and immune health
Iron or ferritin if deficient
Vitamin B12 for energy and cognition
Magnesium for sleep and muscle relaxation

Always discuss supplements with your clinician before starting, as needs differ from person to person.

At Omniya Clinic, we combine lifestyle guidance with Hormone Replacement Therapy (HRT), nutrition advice, and medical support to help you navigate perimenopause with confidence and control.

Female Hormone Replacement Therapy, HRT consultation

What Treatments Are Available For Perimenopause?

Female Hormone Replacement Therapy Thyroid Therapy Hormones MOT program The Real Age Test

Perimenopause Tests & Consultation

At Omniya Clinic in Knightsbridge, every consultation begins with a detailed review of your symptoms, health history, and goals. Your clinician will help determine whether perimenopause is contributing to your symptoms and, only where useful, may recommend targeted investigations to guide your treatment plan.

Hormonal Profile

Blood tests may include oestrogen, progesterone (timed to your cycle where appropriate), FSH, LH, and sometimes testosterone or SHBG. These results help identify where your hormones are fluctuating and whether replacement or support may be beneficial.

Health Screen

Broader health markers can influence perimenopausal symptoms. We may check:

Thyroid function
Ferritin and iron levels
Vitamin B12 and vitamin D
HbA1c or glucose for metabolic balance
Lipid profile and blood pressure for cardiovascular health

These insights allow your clinician to tailor both your hormone and overall wellbeing plan.

Pelvic Ultrasound (Referral If Indicated)

Where symptoms suggest, such as heavy or irregular bleeding, we can arrange a pelvic ultrasound to assess the endometrium and ovaries. This ensures your treatment plan is safe, appropriate, and evidence-based.

Safety Review

Your clinician will review your personal and family history to ensure any treatment, including Hormone Replacement Therapy (HRT), is safe and individually tailored.

Personalised Plan & Ongoing Support

You’ll leave your consultation with:

A clear, actionable plan, whether hormonal, nutritional, or lifestyle-based
Follow-up reviews to track your progress and fine-tune results
Guidance on supplements, stress care, and long-term monitoring

At Omniya, we combine medical expertise with holistic support to help you feel your best through every stage of the menopausal transition.

Omniya Clinic Room with with all the equipment

Treatments Available at Omniya Clinic

Every perimenopause journey is unique, which is why your treatment plan at Omniya Clinic in Knightsbridge is fully personalised. We combine medical therapy, hormonal optimisation, and lifestyle support to help you feel balanced, energised, and confident again.

Hormone Replacement Therapy (HRT): HRT is the most effective treatment for vasomotor symptoms such as hot flushes and night sweats, and often improves sleep, mood, energy, and joint comfort. We prescribe body-identical oestrogen (as a patch, gel, or spray) with micronised progesterone if you have a uterus — tailoring dose and route to suit your needs and lifestyle.

Thyroid Therapy: Thyroid function often influences mood, energy, and metabolism. Where hypothyroidism or suboptimal thyroid performance co-exists, targeted thyroid therapy can help improve fatigue, cognition, and weight stability.

Hormones MOT Programme: This advanced hormone assessment provides a comprehensive profile of your oestrogen, progesterone, thyroid, and sometimes testosterone or adrenal markers. It helps our doctors design a precise optimisation plan that supports long-term hormonal balance.

Real Biological Age Test: Your biological age offers insight into inflammation, oxidative stress, and metabolic efficiency. Understanding these internal markers allows your clinician to fine-tune your nutrition, hormone, and lifestyle strategy for better resilience and vitality.

GP Consultation (Wellness Check): A doctor-led review of your medical history, symptoms, and medications, often supported by targeted blood tests. This helps rule in or out contributing factors such as anaemia, thyroid dysfunction, or medication side-effects.

Related Support Where Appropriate

Comprehensive Gut Health Analysis: for bloating or IBS-type symptoms that can overlap with hormonal changes.
Weight Management & Medication: supports metabolism, sleep, and joint health while reducing overall symptom burden.
IV Drips: provide hydration and micronutrient replenishment as part of a broader wellbeing plan.

At Omniya, our goal is to help you navigate perimenopause with clarity, confidence, and control — using evidence-based medicine and ongoing care that evolves with you.

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Hormone And Menopause Clinic man and woman

Perimenopause Symptoms FAQs

How long does Perimenopause last?

It varies, for many, several years. We focus on symptom control and health protection throughout.

Can perimenopause affect fertility?

Perimenopause can affect fertility. As women approach menopause, their ovarian function declines, leading to irregular ovulation and decreased fertility. While pregnancy is still possible during perimenopause, the likelihood decreases as fertility declines. It’s important for women who wish to conceive during perimenopause to discuss their options with a healthcare provider and consider fertility treatments if necessary.

Can perimenopause affect my mental health?

Hormonal fluctuations can influence mood, anxiety and sleep. HRT and lifestyle support often help; we can coordinate with your GP/therapist if needed.

Are there any lifestyle changes I should consider?

Maintaining a healthy diet, regular exercise, stress management, and avoiding smoking and excessive alcohol can help alleviate symptoms. These lifestyle changes support overall health and well-being during perimenopause.

When should I see a healthcare provider about perimenopause symptoms?

If symptoms interfere with daily life or if there are concerns about reproductive health or overall well-being, consulting a healthcare provider is advisable. Early intervention can help manage symptoms more effectively.

What can I expect during perimenopause in terms of menstrual changes?

Menstrual changes during perimenopause may include irregular periods, heavier or lighter bleeding, or skipped periods. These changes are due to fluctuating hormone levels.

Are there any risks associated with perimenopause?

Risks include osteoporosis, heart disease, and certain cancers. Regular check-ups and screenings are important for monitoring health and managing potential risks.

What types of hormonal tests are available for perimenopause?

We use targeted bloods (hormones, thyroid, ferritin/iron, B12, vitamin D, HbA1c/lipids) and, where indicated, ultrasound. Not everyone needs every test.

How does perimenopause affect weight gain?

During perimenopause, women may gain approximately 1.5kg per year, primarily around the abdomen and upper body, due to hormonal changes and slowed metabolism. This weight gain can increase the risk of other health issues.

Can perimenopause lead to joint pain?

Yes, reduced oestrogen levels can lead to joint pain and stiffness, as oestrogen has anti-inflammatory properties. Managing oestrogen levels can help alleviate joint discomfort.

How can exercise benefit women during perimenopause?

Regular exercise can improve mood, promote better sleep, aid in weight management, and reduce the risk of osteoporosis and heart disease. It also helps maintain muscle mass and bone density.

What dietary changes can help manage perimenopause symptoms?

A balanced diet rich in fruits, vegetables, whole grains, lean proteins, calcium, and omega-3 fatty acids can support overall health and hormone balance. Avoiding processed foods and sugars is also beneficial.

How can stress management techniques help during perimenopause?

Stress management techniques like mindfulness, meditation, and yoga can reduce anxiety, improve emotional well-being, and help manage perimenopause symptoms. These practices promote relaxation and mental clarity.

Are there specific medical conditions to monitor during perimenopause?

Yes, it’s important to monitor for conditions like osteoporosis, heart disease, and certain cancers through regular check-ups and screenings. Early detection and management can mitigate risks.

What role do supplements play in managing perimenopause symptoms?

Supplements can support hormonal balance and help alleviate symptoms associated with perimenopause. It is important to receive personalised recommendations from a healthcare practitioner to ensure both safety and effectiveness.

Can perimenopause cause cognitive changes?

Yes, women may experience memory lapses, difficulty concentrating, and “brain fog” due to hormonal fluctuations during perimenopause. Cognitive function typically improves post-menopause.

How is a perimenopause blood test conducted?

A perimenopause blood test involves drawing a small sample of blood from a vein, which is then analysed in a laboratory to measure levels of key hormones such as oestrogen, progesterone, FSH, and LH. This helps assess hormonal status.

What are the benefits of advanced diagnostics in perimenopause?

Advanced diagnostics, such as ultrasound scans, provide detailed information about ovarian function and endometrial health. They help identify structural changes or abnormalities and guide appropriate treatment plans.